System for Opioid Overdose Surveillance (S.O.S.)


In 2016, a record number of Americans died of an opioid-involved overdose, bringing devastation to families and communities in urban and rural communities alike. Now more people in America die from drug overdoses than car accidents. In response to this alarming public health crisis, the Office of National Drug Control Policy (ONDCP) is supporting the development of opioid overdose monitoring systems in High Intensity Drug Trafficking Areas (HIDTA). The University of Michigan Injury Prevention Center has partnered with the Michigan HIDTA to develop a real-time System for Opioid Overdose Surveillance (S.O.S.).

The S.O.S. was piloted in Washtenaw County, a Michigan HIDTA county. The state of Michigan has great need to increase the timeliness of fatal and non-fatal opioid overdose reporting through rapid surveillance of opioid overdose for public health and law enforcement response. Currently overdose death reporting lags 18 months and there is no system for non-fatal overdose surveillance statewide. Improvements on opioid overdose surveillance in Michigan can have broad implications for both public health and public safety, allowing for implementing interventions aimed at preventing fatal and non-fatal overdoses. Timely surveillance is critical for evaluating and implementing public health interventions and law enforcement efforts, as well as to see where and when more resources are needed.

The major goal of the project is to expand the System for Opioid Overdose Surveillance (S.O.S.) to the additional Michigan High Intensity Drug Trafficking Areas (HIDTA) counties. This includes:

  • Obtaining non-fatal and fatal opioid overdose data from emergency medical services (EMS), emergency departments (ED), and medical examiners (ME) in real-time. Specifically, data for the System for Opioid Overdose Surveillance (S.O.S.) will be pulled from the centralized EMS database Michigan EMS Information System (MI-EMSIS), the Health Information Exchange (HIE) company Great Lakes Health Connect (GLHC), and the electronic death database Medicolegal Death Investigation (MDILog).
  • Linking EMS, ED, and ME datasets through probabilistic matching which allows for real-time assessment of the number of fatal and non-fatal overdoses without over or under counting cases.
  • Developing an online interface of hotspot mapping and aggregate data briefs.

S.O.S’ multi-disciplinary model to access data from EMS, hospital EDs, and ME provides an unprecedented partnership and opportunity to collect and analyze data on a real-time basis, allowing law enforcement and public health officials to utilize limited resources in a focused, more efficient response in localities where they are most needed. In the subsequent 3 years, S.O.S. will be expanded statewide. Furthermore, the S.O.S. model of linking non-fatal HIE and fatal MDILog overdose data can be further expanded to additional states that do not have state-wide databases, as 22 states utilize MDILog to varying degrees. This project will create a functional model system that can be replicated across the nation.