Preventing opioid overdoses in Massachusetts communities

Fatal and non-fatal opioid overdoses have been on the rise in Massachusetts since the 1990's. Influenced by a combination of increased accessibility to low cost heroin and increased opioid prescription medication misuse, community and political will met to try to address this issue. In 2008, 15 communities received funding from the MA Department of Public Health as part of SAMHSA's Strategic Prevention Framework State Incentive Grant (SPF-SIG) to reduce unintentional fatal and non-fatal opioid overdoses in the Commonwealth. A comprehensive audit of research literature and the collection of local indicator data identified a core set of intervening variables and risk factors related to opioid overdose. These include: Barriers (failures or delay) to contacting emergency medical services out of fear for police involvement; Loss of tolerance (due to abstinence, incarceration emergency services in prison or jail, detoxification, treatment and other periods of non-use of opioids); and Lack of post-overdose medical intervention/linkages to treatment. This presentation will examine the intervening variables and risk factors that were most common among funded MA communities; how communities are addressing these factors through a combination of programs, policies, and practices; how communities chose to evaluate their work; and preliminary data on effectiveness. Case studies will also be presented.