This section of the toolkit was developed using information gathered through interviews and focus groups with public health stakeholders, who represent those working to impact health at the community level and work at the local health department.
Below you will find promising overdose response strategies identified by public health stakeholders in Washtenaw County. Each promising strategy is detailed below, along with stakeholder identified barriers to accomplishing the proposed strategies, and how the System for Opioid Overdose Surveillance (SOS) may assist stakeholders’ ability to accomplish each promising strategy.
Promising Strategies
Targeted Public Health Messaging
Near real-time geographic and demographic data for fatal and non-fatal suspected overdoses is helpful in creating and disseminating targeted public health messaging and campaigns to the community. These messages can be tailored to the demographics found in areas with high concentration of suspected overdoses to best connect with those impacted and provide information most relevant to them. In particular, each demographic group has different needs and are impacted by unique factors and exposures that can increase or decrease their risk for overdose.
One stakeholder elaborates further, with “Look at the campaign based on the data you give us you know, either for race or for gender or age, how that information will become valued because it can’t be one size fits all.” Keeping this in mind, we can begin to better understand how differences in location, race, gender, and age should be accounted for in planning effective response strategies.
Local public health workers also note the importance of coordinating with other public health and safety organizations to gather additional contextual overdose information to inform targeted health messages and campaigns.
“Talk to our sheriffs…and…hospitals to see, … are you seeing a certain type of drug; … was it a bunch of kids that came in from some kinda party that happened; are you seeing it from seniors; … what’s going on and how can we…do a better campaign or information sharing with the public.”
Public Health Stakeholder
Public Health Education and Training
Public health stakeholders report being able to use the data and trends shown through the overdose reports to create training materials for public health staff, such as how to administer naloxone. Emphasis is placed on enhancing staff’s awareness of the geographic-specific impact of the opioid epidemic in local communities. This will aid in providing services to impacted families by knowing where to concentrate efforts.
“We’re looking at a training plan for staff because they’ve always been interested and so far, they’ve been on the outside maybe seeing some clients who may or may not have said you know… there are drugs in the home or we have a family member who’s affected by this. So we’re looking at how we can get them up to speed based on the fact that… we have real data in front of us saying… this is a problem, maybe this area might be a little bit more affected than others.”
Public Health Stakeholder
Coordinated Community Naloxone Training
Public health providers emphasize the importance of community naloxone administration and training to reduce future opioid overdose deaths. Coordination with stakeholders to strategically plan and implement naloxone training for a wide variety of organizations and community members can help prevent fatal overdoses. This includes trainings in community-based areas not traditionally included in overdose response and prevention efforts. One public health worker notes that it’s important to “Work with other agencies who may be a little scared about [naloxone] and train them for the use of that.” She explains that overdoses are likely to occur in community-based areas, such as schools or libraries, and that community members and organizational staff members should be prepared. In order to reach and engage community organizations and families, it is imperative that public health and other organizations doing work related to the opioid epidemic coordinate efforts to provide and disseminate these trainings in a variety of settings. The question of where to concentrate these efforts requires a data-driven answer that can be provided through access to the near real-time opioid overdose reports.
Barriers
Like other organizations, public health agencies struggle with limited resources when creating and implementing new overdose response strategies. Resource limitations include limited funding and human capacity. Public health stakeholders noted the potential to use the near real-time suspected overdose data to justify the need for additional funding to increase resources available to fight the opioid epidemic. Given the paucity of resources, data-driven answers on how, and where, to allocate those scarce resources reserved for rapid response is critical. Public health pays close attention to the impact that stigma and denial have on planning and implementing opioid overdose response strategies.
One stakeholder states, “I think a lot of people still have their head in the sand as to what’s going on in the community. I think they still think it’s a certain demographic or age group that is having this issue when it actually is happening across all races, across all age groups, and across you know, the gender spectrum.” Having access to near real-time fatal and nonfatal opioid overdose demographic data highlights changing demographics of the epidemic and which groups are most heavily impacted by the epidemic within specific communities. This data also shows how wide the opioid epidemic’s impact has been across many different demographics and can be used to influence increased action from legislators and funders.
“I think just internal resources. Like a lot of agencies, we don’t have either human resources or financial resources really to gauge a response right now.”
Public Health Stakeholder
Near Real-Time Data Impact
Near real-time demographic data provided by the overdose reports allows local public health departments to address the many facets of the opioid epidemic. For example, demographic information provided to local health departments informs the need for age-specific, and culturally relevant, response strategies. The near real-time aspect of the reports allows these messages to be delivered in a timely manner within the geographic areas where the message will be meaningful.