The Office of the District Attorney in Alabama’s 22nd Judicial Circuit will concentrate on response and prevention. Response will include the formation of the opiate abuse prevention task force, which will be responsible for providing expedited responses for all opiate overdoses as well as for violent crimes involving opiates. The office will provide training for all local first responders on proper crime scene management and preservation as well as treating overdose victims and witnesses. Overdose response kits will be distributed to all police and fire departments in the county. Advertising campaigns will encourage those present during an overdose to call 9-1-1 without fear of arrest, provided they are not directly responsible for the overdose. The task force will host meetings with local doctors and pharmacists to develop and promote safe prescribing protocols. In the event that patients are found to be abusing prescriptions, the office will take the proper procedures to hold them accountable and to promote treatment through rehabilitation. The office will take all available steps to prosecute any doctors found to be illegally or unnecessarily prescribing opiates. Prevention efforts will be directed at high school students through part-time work-study peer helpers, who will be hired to maintain communication with students to warn them about the dangers of opioid use. The office will also partner with Operation Save Teens, a program that shows area teenagers the dangers of opiate abuse.
The Alabama Department of Public Health will develop updated training for prescription drug monitoring program (PDMP) users, produce public service announcements to educate the public, integrate the PDMP into electronic health records and pharmacy dispensing software, and analyze the PDMP data.
The Jefferson County Board of Health will create the Recovery Resource Center Peer Navigation Initiative (RPC-PNI). The project's overarching goal is a 30 percent reduction in opioid overdose deaths in Jefferson County. In 2014, Jefferson County reported a 140 percent spike in heroin deaths, and from 2013 to 2016, it underwent a 340 percent increase in fentanyl deaths. The program will provide a peer navigator to connect 600 individuals to treatment services immediately after a nonfatal overdose or to identify a need for treatment services absent an overdose. RPC-PNI will also convene a multidisciplinary oversight team to develop effective strategies and provide overdose prevention education to 750 individuals in the community. The University of Alabama at Birmingham (UAB) Department of Emergency Medicine will serve as the project’s research partner.
The Arkansas Department of Health will create a data repository that links prescription drug monitoring program (PDMP) data, emergency department/hospitalization data, and death certificates using semantic integration; develop a risk prediction tool for identifying individuals at risk for opioid overdose using the linked data sets, creating a graphical user interface for the linked databases and a risk-prediction tool; and implement a statewide campaign using the new tools created by this application to increase awareness of opioid overdose risk in Arkansas.
The Arkansas Department of Health seeks to convene an action group, the Prescription Drug Overdose (PDO) Advisory Council, to encourage and support cross-system planning and collaboration to reduce the incidence of morbidity and mortality related to opioid overdose. The approach will include integrating prescription drug monitoring program (PDMP) data with all identified data sets, developing composite tables that combine indicators across data sources, providing training and education to opioid prescribers, assessing the impact of specific policy changes to the PDMP, and creating the Opioid Misuse Action Group to provide feedback on the data sets. The Arkansas Department of Health will also implement the Dose of Reality educational campaign to combat opioid abuse.
The Ventura County Health Care Agency–Ventura County Behavioral Health Department, the Ventura County Sheriff’s Office, the Ventura County Public Health Department, the Ventura County Emergency Medical Services Agency, and the Ventura County Ambulatory Care Department will convene the County Opioid Abuse Suppression Taskforce (COAST) to improve the quality, consistency, sharing, and integration of local and state prescription drug monitoring program (PDMP) data to monitor community-level conditions/outcomes and target/coordinate resources to increase impact in response to the opioid abuse epidemic. Funds will also be used to complete, document, and disseminate an evaluation of state and local prescriber trends by scope of practice and to deploy the ESRI ArcGIS Opioid Epidemic Solution. EVALCORP Research and Consulting will serve as the research partner for the proposed project.
The Longmont Department of Public Safety, located in Boulder County, Colorado, will expand its Crisis Outreach Response and Engagement (CORE) program. Grant funds will be used to support a paramedic, two peer case managers, a project coordinator, and treatment for individuals who are struggling with substance use or co-occurring disorders. The University of Colorado, Boulder, will serve as the research partner on the proposed project.
The Connecticut Prescription Monitoring Program (PMP), in partnership with other state agencies, will merge the Office of the Chief Medical Examiner (OCME) and the state forensic laboratory system with the Connecticut Prescription Monitoring and Reporting System (CPMRS) to allow prescribers and pharmacists to identify patients who have died and reduce inappropriate dispensing; create a new module to allow law enforcement users access to both death data and toxicology information within the CPMRS to assist in their investigations; and conduct educational campaigns to introduce these new features and the benefits that would expand the ability of prescribers, pharmacists, and law enforcement to avoid and deter controlled substance misuse or diversion.
Pinellas County is developing a Strategic Information Partnership (SIP) to (1) support real-time/timely data collection from key stakeholders to better articulate the current state of the problem; (2) improve communication for targeted outreach, enforcement, and education; (3) support cross-system planning and data evaluation to better inform policymakers on targeted interventions; and (4) leverage scarce resources and avoid duplication of efforts.
The Savannah Police Department proposes to establish a pre-arrest diversion and behavioral response initiative by providing enhanced crisis intervention team training and offering substance abuse recovery treatment and behavioral health treatment. The applicant will provide data through Overdose Detection Mapping Application Program (ODMAP). David A. Bell, PhD, LLC, an independent evaluator, will serve as the evaluator for the proposed project.
Clinton, Iowa, will increase community collaboration with a multidisciplinary team to address high-frequency utilizers of multiple systems. To tackle this community epidemic, the multidisciplinary team engaged in this project has determined to formulate and implement a Drug Abuse Response Team (DART) composed of Clinton police officers and Clinton Fire Department EMS, as well as specially trained Area Substance Abuse Council members, who will work in partnership with other community agencies such as Mercy and Bridgeview to identify, educate, assist, and provide resources to at-risk individuals. In addition, a medication-assisted treatment (MAT) program will be implemented that will partner to provide peer recovery support services, cognitive behavioral therapy, and case management. Dr. Barbara St. Marie of the University of Iowa College of Nursing will serve as the research partner for the proposed project. The applicant agreed to provide data through the Overdose Detection Mapping Application Program (ODMAP).
The Hamilton County, Indiana, Council on Alcohol and Other Drugs will implement an initiative known as the Community Opioid Prevention Effort (COPE). COPE will follow the Quick Response Team (QRT) diversion model, which will provide immediate intervention at on-scene overdoses, conduct visits to survivors of nonfatal overdoses, and provide recovery support and other community resources to individuals and their families. Treatment providers and recovery coaches will develop and implement strategies to identify and provide treatment and recovery support services. COPE will also encourage cross-system planning and collaboration among community officials, law enforcement, pre-trial services, the courts, probation, health-care providers, public health providers, emergency medical services, and substance abuse treatment providers.
The City of Brockton will use award funds to support its Project Link Up, primarily through salaries for police officers and crime analysts, as well as city surveillance cameras and enhanced street lighting in targeted areas. The Brockton Police Department Project Link Up will focus on substance use disorders and firearms violence-reduction efforts.
Plymouth County Outreach (PCO), a police and treatment outreach approach to high-risk individuals, will continue to develop its countywide, multifaceted approach involving law enforcement, hospital, recovery, and local treatment partnerships that conduct post-overdose home follow-up visits to overdose survivors who are not initially admitted to a hospital or treatment services. The local research partner, Kelley Research Associates, created a unique, real-time overdose tracking system that supports the daily overdose response program. The East Bridgewater Police Department will make data available through the Overdose Detection Mapping Application Program (ODMAP).
St. Mary’s County Health Department in Maryland will work with other community agencies to expand the data that are used to support the Opioid Intervention Team. The utilization of Overdose Detection Mapping Application Program (ODMAP), Prescription Drug Monitoring Program (PDMP), and first responder data will be increased. In addition, the agency will increase the multidisciplinary engagements with community organizations and neighboring jurisdictions and increase recovery support services and educational opportunities for prescribers and patients.
The Detroit Police Department’s Opioid Abuse Diversion Program will create and implement a law enforcement-led pre- and post-arrest diversion in Detroit using the Law Enforcement Assisted Diversion (LEAD) model. The School of Criminal Justice at Michigan State University will serve as the research partner for the proposed project. The applicant agreed to provide data through the Overdose Detection Mapping Application Program (ODMAP).
The Clare County, Michigan, Prosecuting Attorney’s Office will establish a task force to focus on drug-related problems, to include the opioid epidemic. Representatives from all five of the law enforcement agencies that service Clare County, medical personnel, substance abuse counselors, pharmacists, a representative from probation and parole, and any other professionals who are identified during the implementation will comprise the task force. Federal agencies will also be invited to participate in the task force to participate in investigations that might be more effectively prosecuted at the federal level. The assistant prosecutor in charge of the program will coordinate with the U.S. Attorney’s Office for the Eastern District.
The Opioid Community of Practice (OCP) began in October 2017 and is coordinated by St. Louis County Department of Public Health. The OCP is a multijurisdictional learning collaborative composed of public health entities and action researchers that provides a designated space for strategic planning, knowledge sharing, protocol evaluation, peer review, and innovation. OCP members are engaged in a continuous process of learning to identify barriers, highlight successful interventions, and identify new opportunities for potential collaboration. Participation of local public health agencies ripples from anchoring jurisdictions from St. Louis County, St. Louis City, St. Charles County, Kansas City, Jackson County, Clay County, Columbia–Boone County, and Springfield–Greene County. The group aims to improve outreach on OCP initiatives to the growing number of jurisdictions (currently 72) participating in the St. Louis County Prescription Drug Monitoring Program (PDMP) and beyond. The group also includes researchers from the Missouri Institute of Mental Health at the University of Missouri–St. Louis and leaders from local law enforcement, the Missouri Hospital Association, United Way of Greater St. Louis, the Behavioral Health Network of Greater St. Louis, and the Missouri Department of Health and Senior Services. The goals and objectives for this project are: (1) collaborate to improve data identification, collection, and utilization of opioid data; (2) prioritize and enhance community-based interventions and system-level strategies using improved opioid data and collective action that address social determinants of health; and (3) leverage action researchers, local public health entities, and regional data collaborative groups to evaluate the collective impact of the learning community and the impact of resulting interventions on reducing opioid misuse. St. Charles County, Kansas City, Jackson County, Clay County, Columbia–Boone County, and Springfield–Greene County. The group aims to improve outreach on OCP initiatives to the growing number of jurisdictions (currently 72) participating in the St. Louis County Prescription Drug Monitoring Program (PDMP) and beyond. The group also includes researchers from the Missouri Institute of Mental Health at the University of Missouri–St. Louis and leaders from local law enforcement, the Missouri Hospital Association, United Way of Greater St. Louis, the Behavioral Health Network of Greater St. Louis, and the Missouri Department of Health and Senior Services. The goals and objectives for this project are: (1) collaborate to improve data identification, collection, and utilization of opioid data; (2) prioritize and enhance community-based interventions and system-level strategies using improved opioid data and collective action that address social determinants of health; and (3) leverage action researchers, local public health entities, and regional data collaborative groups to evaluate the collective impact of the learning community and the impact of resulting interventions on reducing opioid misuse.
The Morris County Sheriff’s Office will use funds to maintain and expand its Hope One Mobile Outreach vehicle program, which is deployed twice a week to areas experiencing a high volume of opiate overdoses. This expansion will include the launch of a Police Assisted Addiction and Recovery Initiative (PAARI), utlizing municipal and county law enforcement with the assistance of community partners. The research partner, Epiphany Community Services, will be provided with the data to track client progress and report progress so that any necessary program adjustments can be made.
The Pueblo of Pojoaque will create the Pueblo of Pojoaque Opioid Prevention and Intervention Project, a court-based, pre-prosecution diversion program. A project coordinator and an outreach worker/case manager will be hired. The State of New Mexico Sentencing Commission will serve as the evaluation partner for the proposed project.
The Reno Police Department, in partnership with the Washoe County Health Department and other community partners, will implement evidence-based practices in the field of tobacco prevention by launching a mass-reach health communication campaign with the goal of changing the social norms surrounding prescribed opioids. This program will also follow up with individuals/families who have experienced a suspected overdose and provide information regarding resources such as how to seek a substance abuse evaluation and/or counseling, medication-assisted treatment (MAT) and other treatment, and where to obtain naloxone. Finally, the program will launch a prescriber education campaign.
The Dutchess County Department of Behavioral and Community Health will lead an effort to prevent overdose fatalities through timely, comprehensive information sharing within a communitywide collaborative that includes public safety, public and behavioral health, and other vested partners. This will strengthen community capacity to respond to acute overdose-related risks and build a sense of shared efficacy and resiliency in the face of an ongoing, ever-evolving epidemic. These goals will be achieved by applying objective methodology in three areas: (1) transformation of an existing underdeveloped task force into a streamlined, well-equipped, data-driven, opioid response collaborative, (2) enhanced overdose surveillance relating to populations at risk as well as emergent, high-risk substances, and (3) comprehensive capacity building initiatives aimed at integrating harm-reduction principles into existing service delivery models and identifying and addressing disparities in access to behavioral health services.
Erie County, New York, will establish an opioid mortality review board to inform future public health practice and policy related to primary and secondary prevention of opioid addiction and mortality through action research that operationalizes insight gained from mortality reviews.
Dayton, Ohio, will enhance the Get Recovery Options Working (GROW) program. GROW is a coordinated multidisciplinary response team that includes the Dayton Police Department, Dayton Fire Department, and peer recovery specialists. Dr. Mary Huber from Wright State University will serve as the research partner for the proposed project. The applicant agreed to provide data through the Overdose Detection Mapping Application Program (ODMAP).
The objective of the initiative is to enhance public safety, behavioral health, and public health by leveraging existing data sets to inform implementation of highly focused opioid interventions. Columbus Public Health will hire a HIDTA/ODMAP data integration project manager and contract with an IT vendor to develop and implement application program interfaces to export real-time, first responder overdose data from the local records management system to ODMAP. The project team will then train local police and fire departments on how to access and analyze countywide HIDTA data. Columbus Public Health will also hire a substance use disorder epidemiologist to combine local public health and social determinant data with HIDTA public safety data. This data set will serve as the foundation for a countywide interactive overdose data tool. Mighty Crow, Inc. will serve as the evaluator for the data integration project.
Fairfield County, Ohio, will implement the Fairfield County Overdose Response Team (FORT). Strategies include deploying an Overdose Response Team to perform follow-up visits with persons who have had a nonfatal overdose; providing expedited access to treatment, including medication-assisted treatment (MAT), to persons who have had a nonfatal overdose; performing overdose fatality case reviews; connecting people who identify as having a substance use disorder with available treatment and recovery options outside of the criminal justice system; and tracking every overdose in real-time using the Overdose Detection Mapping Application Program (ODMAP). Miami University in Oxford, Ohio, will serve as the research partner for the proposed project.
Between 2003 and 2015, Franklin County experienced a 343 percent increase in residents dying from drug-related overdoses. To combat what the DEA has referred to as “Ground Zero” of the opiate and carfentanil crisis, the government of Franklin County, Ohio, will implement the Diversion Alternative–Project Opioid (DA–PO) program, a comprehensive and multifaceted approach to reducing the impact of the opioid crisis. Expanding treatment and support services and reducing the number of overdoses and fatalities are the project’s main goals. In addition, the DA–PO program calls for planning and implementation of a Community Mayor's Drug Court, the launch of a robust harm-reduction campaign that will include hosting town hall meetings, distributing naloxone kits to families of overdose survivors, and distributing fentanyl test strips to those in active addiction. Mighty Crow Media will partner with Franklin County as the project’s researcher.
In Beaver County, Pennsylvania, accidental overdose deaths increased by 240 percent from 2014 to 2016, and more than 600 naloxone reversals were reported in 2016. Beaver County is also the first county in the region to report an overdose death from carfentanil, an analog of the synthetic opioid analgesic fentanyl, 10,000 times more potent than morphine. In response, Beaver County will implement a program to analyze the underlying causes of opioid misuse and to create a data exchange system for use by the Criminal Justice Advisory Board, the Sequential Intercept Model Committee, and the Drug Coalition to influence policy. Additional goals include evaluating outreach, prevention, and treatment efforts and to work to expand prescription drug monitoring. Townsend Associates LLC will serve as the project’s research partner.
The Pennsylvania Commission on Crime and Delinquency (PCCD) will fund projects for counties that work with the Technical Assistance Center at the University of Pittsburgh School of Pharmacy’s Program Evaluation and Research Unit to implement evidence-based programs to reduce overdose deaths.
The Pennsylvania Department of Health will develop a robust prescriber and dispenser-controlled substance report, strengthen the prescription drug monitoring program (PDMP) system by improving data quality and compliance, produce and disseminate Rx Awareness educational material, and connect to the RxCheck hub to support interstate data sharing.
The Southeastern Pennsylvania Transportation Authority (SEPTA) will implement a Police Rapid Response Pilot Program. The Rapid Response Team will be the lead responding unit to overdose calls in the Kensington Transit Corridor. SEPTA officers will provide naloxone to overdose patients, social services information, and transportation to a treatment facility for individuals who wish to be seen by medical professionals. Dr. Jerry Ratcliffe from Temple University will serve as the research partner for the proposed project, and Philadelphia-based nonprofit Angels in Motion will provide linkages to social support services.
The Rhode Island State Police will implement the Heroin-Opioid Prevention Effort (HOPE) Initiative, the nation’s first statewide law enforcement-led opioid overdose outreach program, modeled after the Police Assisted Addiction and Recovery Initiative (PAARI). The HOPE Initiative engages law enforcement personnel in a proactive outreach strategy to combat the opioid overdose epidemic by bringing together substance-use professionals and members of law enforcement with the mission of reaching out to individuals at risk of overdosing and encouraging them to be assessed and treated. The project will support the technology, professional expertise, and partnerships needed to gather comprehensive data, perform outreach visits, execute research, and contribute to the administration of the HOPE Initiative. Data gathered through the HOPE Initiative will be shared with the Overdose Detection Mapping Application Program (ODMAP). Kelley Research Associates will serve as the project evaluator.
The Rhode Island State Police will implement the Heroin-Opioid Prevention Effort (HOPE) Initiative, the nation’s first statewide law enforcement-led opioid overdose outreach program, modeled after the Police Assisted Addiction and Recovery Initiative (PAARI). The HOPE Initiative engages law enforcement personnel in a proactive outreach strategy to combat the opioid overdose epidemic by bringing together substance-use professionals and members of law enforcement with the mission of reaching out to those who are at risk of overdosing and encouraging them to be assessed and treated. The project will support the HOPE Initiative by enhancing the ongoing efforts of state and local government to address the opioid overdose epidemic, including gathering real-time law enforcement data on opioid overdoses to identify individuals with opioid use disorder. In addition, the project will support a program involving law enforcement and case management to provide outreach to individuals with opioid use disorder. Outreach efforts will include victims and child welfare services. Data gathered through the HOPE Initiative will be shared with the Overdose Detection Mapping Application Program (ODMAP). Kelley Research Associates will serve as the project evaluator.
The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) will establish the Tennessee Comprehensive Opioid Response Strategies program, in collaboration with the Tennessee Department of Finance of Administration, Office of Criminal Justice Programs (OCJP). Funding will be used for the update of a statewide plan, the Prescription for Success Plan. A new statewide opioid response plan has been implemented during 2018 and is now the guideline for implementation strategies under the project. Local communities are being selected to participate in Sequential Intercept Mapping planning workshops. The action plans developed in these workshops will be supported by implementation funding through the grant. State planning resources will be integrated into local planning workshops.
The Tennessee Department of Mental Health and Substance Abuse Services will develop the Sullivan County Overdose Response Team (SCORT) in Sullivan County. Grant funds will be used to support a coordinator and peer navigator(s), and a case manager will provide support services to both individuals who have overdosed and victims as well as administrative grant support. The case manager will also coordinate with the Tennessee Alliance for Drug Endangered Children (TADEC) and the Sullivan County District Attorney’s Office through the Sullivan County Family Justice Center. The SCORT coordinator will be responsible for exporting and uploading all relevant data into the Overdose Detection Mapping Application Program (ODMAP) data collection tool. An independent evaluator will serve as the project evaluator.
The Tennessee Department of Mental Health and Substance Abuse Services will develop the Hamilton County Police and Community Overdose Response Team (PCORT) in Hamilton County. Grant funds will be used to support a coordinator and peer navigator(s), and a case manager will provide support services to both individuals who have overdosed and victims, as well as providing administrative grant support. The case manager will also coordinate with the Tennessee Alliance for Drug Endangered Children (TADEC) and the Hamilton County District Attorney’s Office through the Hamilton County Family Justice Center. The PCORT coordinator will be responsible for exporting and uploading all relevant data into the Overdose Detection Mapping Application Program (ODMAP) data collection tool. An independent evaluator will serve as the project evaluator.
Multiple departments within the Makah Tribal Organization have developed the concept of a “Healing Together House” (HTH). The HTH project will support a Law Enforcement-Assisted Diversion (LEAD) program as an alternative to the judicial system, addressing those who cycle in and out of the system with no resolution to their underlying needs. The project will develop a drop-in house to provide services such as a 24-hour safe place, recovery coaching, and a space to share meals with and provide education to a community.
From 2009 to 2014, deaths related to heroin have doubled in Mason County, Washington; the county had the fourth-highest rate of death (2011–2013) attributed to opiates, with a rate of more than 14.1 per 100,000 compared with the state rate of 8.6 per 100,000. This project includes a public education campaign, a prescription drug take-back component, and naloxone distribution as well as a comprehensive look at Mason County’s treatment and recovery system. Project goals include reducing the number of opioid-related deaths, increasing the number of opioid users who own naloxone take-home kits, developing a local recovery and treatment services network. and improving public awareness about the dangers of opioids and about local treatment and recovery support services.
The Seattle Police Department, in partnership with the Washington State Department of Corrections, King County Prosecuting Attorney’s Office, and the Public Defenders Association, will enhance in-custody access to services, mentoring, and peer support; expand reentry access to services (including stable housing and opioid abuse-related treatment), mentoring, and peer support; and provide options for diversion to treatment for persons on community supervision instead of return to custody. BetaGov/Litmus at New York University (NYU) will serve as the research partner for the proposed project.
Kenosha County, Wisconsin, has the fourth-highest rate of opiate-related overdose deaths and the highest rate of heroin-related overdose deaths in the state. To stem increasing rates of opioid overdose, the Kenosha County Department of Human Services will implement the Kenosha County Opioid Overdose Reduction Project, which builds on the community's naloxone distribution-enabling Wisconsin Prescription Drug/Opioid Overdose-Related Deaths Prevention Project (WI-PDO). The project utilizes certified peer specialists to link overdose survivors with treatment. In addition, the project stipulates the creation of a community education campaign about opioid abuse, harm reduction, and abuse treatment alternatives. To ensure long-lasting success, the project will leverage key data sets to provide an extensive analysis of the opioid crisis to guide policymaking. NJM Management Services, Inc. will serve as the action research partner.
The Menominee Indian Tribe of Wisconsin will develop a Police Assisted Addiction and Recovery Initiative (PAARI) model of law enforcement diversion to reduce opioid abuse and the number of overdose fatalities. Grant funds will be used to support a program coordinator, who will assist in implementing the program; a clinical therapist; and three peer support specialists. The applicant agreed to make data available through the Overdose Detection Mapping Application Program (ODMAP).
The City of Huntington, West Virginia, will implement a community Quick Response Team (QRT) that will include medical care providers, law enforcement, and recovery and treatment providers, along with research partners. This multidisciplinary team will strive toward a significant reduction in the number of overdoses, with an emphasis on the recurrent cases. Federal funds will be used to assess project participants’ needs and assess their capabilities and preferences to determine appropriate plans for intervention, which includes, but is not limited to, provision of access to recovery and treatment services. Community capacity and cohesion will be fostered by engaging and educating those communities that have been disproportionately affected by the crisis in substance abuse, mental health, treatment, and recovery service awareness. The overall target through the collaborative efforts of the QRT is to decrease the number of overdoses by at least 20 percent annually and the number of recurrent overdoses by 40 percent annually. The Marshall University Department of Public Health will serve as an action research partner.