Massachusetts Responds to Increasing Opioid Overdoses

In response to a six-fold increase in annual opioid-related fatal overdoses between 1990 and 2006, the Massachusetts Department of Public Health implemented several initiatives to reduce the number of overdoses, improve the management of overdose when they occur, and diminish the diversion and misuse of prescription opioids. These efforts include an overdose education and naloxone distribution program directed at potential bystanders and first responders, supporting medication-assisted treatment in community health centers, expansion of screening, brief intervention and referral to treatment services, and funding of 15 municipalities to develop and implement community-level overdose prevention strategies. These efforts were organized and supported by the state health department, yet they were implemented through community –based institutions with established access to and relationships with high risk populations. The implementation of these policies was focused on a common goal of decreasing opioid overdose and used a set of tools that are evidence-based. It was adapted in each case to be feasible and meet the needs of the local communities. Lessons learned in implementing each of these programs will be described, along with the policy and dissemination lessons learned.