HIGHLIGHTS
- Massachusetts sought to curb high rates of fatal and nonfatal overdoses.
- Abt extracted and analyzed emergency department, medical examiner, and EMS records of overdoses.
- Better surveillance helped target efforts to respond to overdoses.
The Challenge
Identifying opioid overdose events in administrative records is not always straightforward. Not all people who overdose are taken to hospitals, and some overdoses are reversed by administering naloxone (Narcan), which can be done by first responders, family members and friends. Developing counts of these nonfatal overdoses is especially difficult. The challenge is to develop decision rules for capturing information about opioid overdoses—both fatal and nonfatal—in various electronic and paper records kept by different statewide organizations and agencies.
The Approach
Abt and its team extracted and analyzed information about deaths from the state’s medical examiner’s office, drug-related visits to hospital emergency departments, and drug-related use of emergency medical services statewide. With the state’s Department of Public Health, we refined rules for identifying opioid overdoses and collected other information to describe the contexts in which overdoses occur. We surveyed stakeholders to learn what information they want or need and developed reports to be disseminated.
The Results
Information about opioid overdoses was provided to the Centers for Disease Control and Prevention’s Enhanced State Opioid Overdose program, a multistate surveillance system. The Commonwealth monitored accurate data on fatal and nonfatal opioid overdoses and observed overdose trends across time and place. This provided an evidence base for the state to develop and monitor interventions aimed at reducing opioid overdoses. Project results were shared in 2019.