Public Safety, Behavioral Health, and Public Health Information-sharing Partnerships

The Comprehensive Addiction and Recovery Act (CARA) Program is the first major federal substance use disorder treatment and recovery legislation in 40 years and the most comprehensive effort to address the opioid epidemic. CARA establishes a comprehensive, coordinated, and balanced strategy through enhanced grant programs that expand prevention and education efforts while also promoting treatment and recovery. The Comprehensive Opioid Abuse Site-based program was developed as part of the CARA legislation signed into law on July 22, 2016.

The Comprehensive Opioid Abuse Site-based Program aims to reduce opioid abuse and the number of overdose fatalities, as well as to mitigate the impacts on crime victims. The program also supports the implementation, enhancement, and proactive use of prescription drug monitoring programs to support clinical decision making and prevent the abuse and diversion of controlled substances.

To respond effectively to the opioid epidemic, stakeholders need access to timely and accurate data that provide a comprehensive view of the drug abuse environment. Unfortunately, data on drug abuse, treatment, and public safety outcomes are often maintained in different agencies and are not integrated in a way that supports the policy and practice needs of public safety, public health, or behavioral health partners. However, there are a growing number of models at the local and state levels that leverage information from a variety of public health and public safety data sources to analyze substance abuse issues and identify potential solutions from public health, treatment, and public safety perspectives. Specifically, models such as drug monitoring initiatives, overdose fatality review teams, and New York City’s RxStat Program create an opportunity to bring together stakeholders with different perspectives and different data sets. This information can be used to drive changes in policy or practice, monitor community-level outcomes, and implement proven practices on a larger scale.

The Indiana State Department of Health (ISDH) will increase the timeliness and robustness of fatal drug overdose reporting. This will be accomplished by funding comprehensive toxicology testing for suspected cases of drug overdose deaths across Indiana. ISDH will also obtain more comprehensive demographic data of persons who suffered from a fatal drug overdose. By providing mini grants to overcome barriers associated with using ISDH’s coroner case management system, coroners will be encouraged to utilize this system and thus provide more comprehensive demographic data on fatal overdoses. ISDH will link toxicology results with existing demographic information regarding the deceased persons and disperse aggregated data to the opioid data working group. ISDH will also develop an innovative pilot project that will involve the enhanced toxicology testing of leftover clinical samples (blood and/or urine) from patients who are treated in a hospital following a suspected drug overdose event. Such testing would provide more robust public health information that will provide situational awareness of illicit and licit drug use that result in drug overdose events. It will also allow local and state officials to track drugs circulating in Indiana and would allow the identification of novel substances in its communities. Finally, ISDH will utilize the data collected by the toxicology testing from both fatal and nonfatal drug overdoses to inform targeted interventions. Indiana University-Purdue University will serve as the researcher for the proposed project.

CA/NCF