Project Summary:
The role of illicit fentanyl in the unprecedented increase in overdose mortality in the U.S. is a major public health crisis. Almost half (47%) of people who inject drugs are estimated to have one or more nonfatal lifetime overdoses, and 50-58% of people who inject drugs report witnessing a prior-year fatal or nonfatal overdose of a peer.
Recognizing the many opportunities community service organizations have to intercept overdose, the U.S. Centers for Disease Control and Prevention promoted a nationwide Overdose Data to Action (OD2A) program, emphasizing community responses through multisector opioid rapid response teams (ORRT). Since the OD2A framework is broadly defined, communities with different resources, service history, and infrastructure have incorporated various types and combinations of evidence-based interventions and/or home-grown programs into OD2A-type efforts. ORRT composition and structure and the form and level of coordination among ORRT organizations also vary.
Little research has examined these responses to determine the key components of OD2A implementation efforts needed to achieve effective collective responses to overdose incidence and related mortality, or to identify factors affecting the implementation and coordination of the responses among multiple agencies.
The researchers in this study propose an innovative person-centered framework of multi-agency overdose intercept services that includes the full spectrum of service incept points. This study will specify a multilevel systems critique using a systems-thinking process to produce a conceptual and analytical causal loop diagram of the overdose response system using qualitative data and stakeholder group modeling.
This approach is demonstrated to be effective in empowering stakeholders to examine complex systems, and to share and integrate divergent perspectives in formulating problems and proposing solutions. The process can also promote trust and buy-in from participants engaged in systems critique of complex problems, leading to increased commitment to implementing strategies for improvements they develop together guided by the model.