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3-2018
Using Data to Guide and Evaluate Responses to the Opioid Crisis: Rhode Island's Drug Overdose Dashboard Brandon Marshall Brown University
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Welcome to the Webinar
Using Data to Guide and Evaluate Responses to the Opioid Crisis: Rhode Island’s Drug Overdose Dashboard To Connect to Webinar Audio 1. To receive a call back, provide your phone number when you join the event, or call the number below and enter the access code 624 494 571 2.
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Substance Use Disorder Resources from the National Library of Medicine (NLM) • Opiate Addiction and Treatment Information Guide https://sis.nlm.nih.gov/enviro/addiction.html • Disaster Lit® search of opioid guidelines, reports, factsheets, etc., including: Fentanyl Safety Recommendations for First Responders https://disasterlit.nlm.nih.gov/record/16121 How HIPAA Allows Doctors to Respond to the Opioid Crisis https://disasterlit.nlm.nih.gov/record/16093 Preventing Opioid Misuse in the States and Territories: A Public Health Framework for CrossSector Leadership https://disasterlit.nlm.nih.gov/record/15995 • MedlinePlus Opioid Abuse and Addiction https://medlineplus.gov/opioidabuseandaddiction.html Abuso y adicción de opioids https://medlineplus.gov/spanish/opioidabuseandaddiction.html • HealthReach low-literacy patient materials about opioids, opioid addiction, and opioid treatment (includes documents, videos, and audio) PHPartners Information Access for the Public Health Workforce https://phpartners.org/ PHP Partners aggregates public health news, some of it involving substance misuse from a public health point of view, http://www.pewtrusts.org/en/multimedia/audio/2017/treating-the-opioid-epidemic.
Substance Use Disorder Resources from the National Library of Medicine (NLM) Opiate Addiction and Treatment Information Guide https://sis.nlm.nih.gov/enviro/addiction.html
Your Webinar Presenter
Brandon DL Marshall, PhD
Associate Professor, Department of Epidemiology, Brown University School of Public Health
[email protected]
Using Data to Guide & Evaluate
Responses to the Opioid Crisis: Rhode Island’s Drug Overdose Dashboard
Brandon DL Marshall, PhD Associate Professor of Epidemiology Brown University School of Public Health
Today’s Objectives Learn about national and state surveillance systems to track the overdose epidemic
Learn about strategies to improve the collection, analysis, and dissemination of overdose surveillance data Discuss best practices for the communication of overdose-related public health information
Drug Overdose Deaths, United States, 1980-2016
50,000 Peak HIV/AIDS deaths (1995) 40,000
Peak gun deaths (1993)
30,000
20,000
1980
‘85
‘90
‘95
’00
‘05
‘10
‘15
Source: https://www.cdc.gov/nchs/data/databriefs/db294.pdf
Source: https://www.cdc.gov/nchs/data/databriefs/db294.pdf (December 2017)
Developing our state’s strategic plan • Authored by an academic research team • Approved and endorsed by the Governor’s Overdose Prevention and Intervention Task Force
• Spent dedicated time to develop data sharing policies, data quality, and data management systems • Political and Governmental support increased our ability to collect timely data and develop clear measures to track progress
Developing our state’s strategic plan • Authored by an academic research team • Approved and endorsed by the Governor’s Overdose Prevention and Intervention Task Force
• A public “dashboard” would be created to track the state’s overdose epidemic and our progress • Spent dedicated time to develop data sharing policies, data quality, and data management systems
Goals of the Dashboard • Comprehensive data resource • Increased surveillance data usage & data visualization • Naloxone and treatment locator maps • Facilitate data sharing to promote timely public health action • Communicate emerging issues (e.g., fentanyl) • Track the Governor’s Overdose Action Plan — Accountability
What resources did it take? • Content Expertise • Stakeholders, Community Partnerships, Data Work Group
• Analysis & Data Visualization • RI DOH, BHDDH, and Brown
• Data Management & Software • Tableau, ArcGIS, Google Maps, Wordpress, MySQL, Bluehost, Stronghold
• Funding: CDC grant (RFA-CE15-1501)
Stronghold • A secure computing and storage environment enabling Brown researchers to analyze sensitive data • Meets the security requirements an controls for HIPAA
• All data is stored and analyzed in a highly secure, dedicated computing environment • Eliminates “data silos” • Deterministic record linkages using identifiers
Source: Green et al. JAMA Psychiatry, 2018
Managing Dashboard Quality • Ongoing dashboard feedback from the public, monitoring • Standing data sharing agreements support frequent data refreshes and website updates • Emphasis on clear visuals, plain language and accessibility, data focused messaging
Summary of data sources used to populate overdose surveillance on www.PreventOverdoseRI.org
https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
National overdose death surveillance • State vital registration offices sends death records to NCHS • Deaths reported by the jurisdiction in which the death occurred • Causes of death are coded according to ICD guidelines • There is a significant lag time between when the death occurred and when the data are available for analysis
• Provisional estimates now reported 6 months after date of death
Are drug overdoses underreported? • Not all jurisdictions record specific drug(s) or drug classes that caused the overdose death • Varies by jurisdiction (Ruhm, 2017) • >99% deaths have specific drugs recorded in Rhode Island • Only around half the time in Pennsylvania, Indiana, and Louisiana
• Results in an underestimate of drug-specific fatal overdoses
RI Overdose Death Reporting Investigates all unnatural deaths
OSME
RIDOH Office of Vital Records
RIDOH
Sends final ICD-coded records to Office of Vital Statistics
Send cause, manner, and circumstances of each OSMEconfirmed overdose death
Updates death certificate
Sends death certificate to CDC
CDC Codes deaths according to ICD-10
RIDOH
Brown University
Number of Accidental Drug Overdose Deaths
Drug Overdose Mortality in Rhode Island 336
350 290
300 232
250 200 150
138
151
173
287*
240
182
100
50 0 2009 2010 2011 2012 2013 2014 2015 2016 2017
* 2017 data is preliminary and includes deaths from January - November Source: Rhode Island Office of the State Medical Examiners & www.PreventOverdoseRI.org
Source: www.PreventOverdoseRI.org
Goals of the Dashboard • Comprehensive Data Resource • Increased surveillance data usage & data visualization • Naloxone and treatment locator maps • Communicate emerging issues (e.g., fentanyl) • Track the Governor’s Overdose Action Plan — Accountability
Goals of the Dashboard • Comprehensive Data Resource • Increased surveillance data sharing & data visualization • Naloxone and treatment locator maps • Communicate emerging issues (e.g., fentanyl) • Track the Governor’s Overdose Action Plan — Accountability
• Powerful synthetic opioid analgesic, 50 to 100 times more potent than morphine • Non-pharmaceutical fentanyl is synthesized in labs and mixed in an increasing array of illegal drugs • The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl
Goals of the Dashboard • Comprehensive Data Resource • Increased surveillance data sharing & data visualization • Naloxone and treatment locator maps • Communicate emerging issues (e.g., fentanyl) • Track the Governor’s Overdose Action Plan — Accountability
Rhode Island’s overdose crisis has t ouched communit y in t he st at e. Publiclyevery Tracking the Action Plan Ent er t he Governor’s Overdose Prevent ion Act ion Plan With this plan, Rhode Island will reduce overdose deaths by 1/ 3 in 3 years — that means saving hundreds of lives.
We have one goal:
to save lives.
Hospital-based naloxone distribution, 2016-2017
Direct monthly reporting to Governor and agency directors
Expanded Stakeholder Analyses
Our Dashboard is being viewed across the US
Dashboard interactions are increasing
“See The Data” is our most popular page
Acknowledgements
Todd Hampson, BA, Maxwell Krieger, BS, Jesse Yedinak, MPA, and our dedicated team of Brown University students
Overdose Data Working Group Members
Jennifer Koziol, MPH & Meghan McCormick, MPH
Nicole Alexander-Scott, MD, MPH, Director, Rhode Island Department of Public Health
Drs. Priya Banerjee, MD, Patricia Ogera MD, and the staff at the Rhode Island Office of the State Medical Examiners
Traci Green, PhD & Josiah Rich, MD
Funding from the Centers for Disease Control & Prevention (CDC RFA-CE15-1501)
Questions???? Please type your questions in the chat box.
Thank you Brandon for sharing your expertise! Thank you all for Attending this Webinar!
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