A recent collaboration enabled key information sharing about Tennessee residents arrested in South Carolina on methamphetamine distribution charges to further an existing investigation. The SC DIO passed the felony arrest information to the TN DIO who then shared the arrest information with local agency contacts in TN. One of the subjects arrested in SC was the subject of an ongoing investigation in TN.  The DIOs in SC and TN were able to provide information to support the local investigation with valuable information about the out-of-state felony arrest that was previously unknown to the investigating authorities in TN. The DIO network enabled the exchange of valuable information for the ongoing investigation.

A post-overdose response team (PORT) pilot in Hawaii, an extension of an existing social work team and patient navigators, engages unintentional overdose survivors at the Queen’s Medical Center emergency department. One of the PORT team’s major challenges was reaching patients who might leave before a patient navigator contacts them, particularly those without contact information or addresses. The HI PHA identified Coordinated Overdose Response and Engagement (CORE) Program care pouches, a strategy tested in a previous ORS pilot project in South Carolina, as a possible solution and also advocated for funding of prepaid cell phones. The PHA contacted the hospital team and connected them with local HI providers, The Courage Center management team and the former South Carolina PHA, for insights on implementation. The PHA also assisted in creating a brochure for cellphone distribution at the hospital emergency department. To ensure that the document would be well received by people who use drugs, the PHA submitted the draft brochure to the Lived Experience Subject Matter Workgroup of the National Council for Mental Wellbeing. The PORT team obtained funding for phones and continued the pilot to identify those at the highest risk for overdose. Interest in PORT interventions continues to grow; following this pattern, the Hawaii HIDTA Director connected EMS leadership and overdose prevention providers to collaborate on expanding linkages to care for patients at risk of overdose.

Sharing timely overdose data and information is crucial to understand and develop strategies to reduce overdoses nationwide. In the following stories, the Louisiana ORS team and the Idaho ORS team proactively initiated collaborations with key public health and public safety partners to share overdose knowledge and establish response strategies.

In Louisiana prior to 2023, there was no data sharing between the ORS and coroners outside of Orleans Parish. The limited data sharing and lack of updated vital record data prohibited real-time overdose surveillance in Louisiana. Additionally, LA has a decentralized coroner system, where each parish elects its own coroner. To achieve data sharing, each individual coroner’s office must be contacted. In September 2023, the LA PHA arranged meetings with the DIO and contacts in the Calcasieu Parish to discuss coroner death data, overdose trends and related projects within the parish. The PHA also emailed contacts in other parishes to request an introduction to their respective coroner’s offices. Following outreach, the LA ORS team received updated coroner death data, covering 2022 through August 2023, from Calcasieu Parish, Jefferson Parish and East Baton Rouge Parish. Analyzing this data, the team created informative bulletins for law enforcement and public health agencies. Following the success of the coroner outreach project, the LA DIO has been asked to provide training to other DIOs within the Gulf Coast High Intensity Drug Trafficking Area in 2024. The training will be a way for the LA ORS team to discuss the future direction of their bulletins, as well as provide tips for successful outreach and enhanced data analysis and visualization.

In Idaho, a decentralized county coroner system and challenges with timely toxicology testing has contributed to historically underreported fatal drug overdoses. Since mid-2022, the ID ORS team has worked with Idaho State Police Forensics Services (ISPFS), Idaho Department of Health and Welfare Drug Overdose Prevention Program (DOPP) and a former coroner to improve the quality and timeliness of postmortem toxicology testing and data collection for fatal overdoses in the state. The team pursued two main objectives: first, providing funding to ISPFS to acquire a rapid toxicology instrument that rapidly screens blood and urine samples for prescription and synthetic drugs, and second, conducting in-person trainings with each of Idaho’s 44 county coroners. In these trainings led by a long-serving former Idaho coroner, coroners learn how to perform overdose death investigations, submit samples to the ISPFS lab and input testing results to ODMAP. The new instrument was delivered to the ISPFS state lab in June 2023. The ID ORS team continues to support this project by attending monthly meetings with the project partners and assisting coroner’s offices with ODMAP.

In 2020, Minnesotans ages 15-24 experienced a 26 percent increase in drug overdose deaths and those ages 25-34 experienced a 57 percent increase. Consequently, the Minnesota Department of Health identified a need to reach youth and young adults, warning them of the dangers of counterfeit pills and connecting them to overdose prevention and treatment resources. The North Central HIDTA partnered with the Minnesota Department of Health to fund a youth prevention campaign. The campaign works in collaboration with an existing adult prevention campaign funded by the Minnesota Department of Human Services, called “Know the Dangers”. The youth campaign was co-created with local youth from two schools in the Twin Cities. The youth came up with ideas for content and were involved with casting videos and providing feedback on materials. The digital media campaign aimed to reach youth via Tik Tok, Snapchat, Google ads and Facebook/Instagram platforms. Ads directed the audience to the “Fentanyl Facts” website within the larger “Know the Dangers” website, which has an extensive set of resources including a naloxone finder map, treatment locator, overdose data and stories of hope from people who are in recovery.

The Delaware Division of Public Health recognized the need for police participation in naloxone leave-behind programs and engaged the DE ORS team to encourage law enforcement involvement in the program. Since 2021, the DE DIO and PHA have been soliciting participation from the state’s 48 police departments. In early 2022, a total of 18 police departments, representing just over one-third of Delaware law enforcement agencies, completed the necessary requirements to participate in the program. In 2023, the DE ORS team reached out to the leadership of departments that were not yet participating in the program and, as a result, secured the participation of six more agencies. This effort increased the participation level to 24 out of 48 police departments (or 50 percent). Moving forward, the ORS team will continue to follow up to increase participation from the remaining departments.