What's Critical to Rural, Regional and Urban Opioid Interventions?
An ICMA 2018 session on opioid interventions shared rural, urban and regional diversion program information and offered key takeaways about the role of data.
BALTIMORE – A summary of a session on opioid interventions at the 2018 International City/County Management Association (ICMA) conference featured Kimberly Nelson from the University of North Carolina School of Government, Tom Carr, executive director management coordination of the Washington/Baltimore High Intensity Drug Trafficking Area (HIDTA) and Marie Peoples, director of the public health services office in Coconino County, Arizona.
The speakers presented rural, urban and regional approaches to addressing the crisis, discussed diversion programs and shared critical data takeaways.
Rural Data Challenges
Peoples’ agency is overseeing the second largest county in the contiguous United States serving more than 138,000 people – with 50 percent living in Flagstaff, Arizona. Opioid deaths in this widespread, rural county were too few to compete for funding.
Her team reviewed hospital discharge data and found a 305 percent increase in unique drug-related hospitalizations. With the data, Cococino County was awarded state funding to launch a five-prong opioid interventions strategy:
- Reduce illicit drug acquisition
- Implement prescription drug tracking
- Enhance first responder policies to address the crisis
- Create public awareness messaging
- Strategize substance abuse treatment – the rural region’s greatest challenge
“We use the data to inform where we are at” and drive strategies, she said.
Effective Data Platform Enhances Response
Carr has been leading Washington/Baltimore HIDTA heroin response strategy, which funds various treatment and prevention programs throughout the country through Office of National Drug Control Policy and U.S. Centers for Disease Control grants. Organizing data has been critical to developing an ability to forecast overdose spikes and share information among urban agencies.
"We don’t lack information, we lack good information,” he said.
Carr worked to develop the Overdose Detection Mapping Application Program (ODMAP) – a mobile application that has 60,000 overdose deaths registered by first responders in 44 states since 2017. Any data device connected to an agency’s computer-aided dispatch (CAD) terminal can enter on scene reports of real time overdoses to ODMAP. The tool was developed in 30 days using existing data platforms.
Once first responders enter “fatal or nonfatal,” the data is sent to a map that all agencies see. The challenge is shifting the impact of the opioid epidemic from the criminal justice system to a public health system that Carr said he often hears is not ready.
We have to change the way they are doing business,” he said.
A HIDTA-funded diversion program in Martinsburg, West Virginia, increases recognition of adverse childhood experiences (ACEs) in schools and then provides services to both affected children and their parents. The Martinsburg Initiative program enables public safety to actively make referrals to public health.
Regions Working Toward Shared Measures
Nelson said the Blue Cross Blue Shield-funded collective impact engagement involving 10 county-based North Carolina teams is working towards shared measures for opioid interventions.
Though the program is relatively new and has just completed a stakeholder research phase, she is hoping that in the two years the university will launch and support the regional collective that they will be able to find more detailed data to address interventions and improve support programs and other public services. Some of the statewide challenges that could be addressed with the support of better data might be coroner backlogs and foster care services that are shorter time frames than many treatment programs affected parents need.
3 Key Data Takeaways
- Rural areas can look at data in a different way to compete and acquire funding to implement opioid interventions
- Harnessing data with strong analytical support can tighten community and regional responses
- Public safety-public health partnerships are critical to community-level interventions