4.4 Article

Community selected strategies to reduce opioid-related overdose deaths in the HEALing (Helping to End Addiction Long-term SM) communities study

Journal

DRUG AND ALCOHOL DEPENDENCE
Volume 245, Issue -, Pages -

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2023.109804

Keywords

HEALing Communities Study; Naloxone; Medication for opioid use disorder (MOUD); Opioid prescribing; Opioid-overdose Reduction Continuum of Care Approach (ORCCA)

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The HEALing Communities Study aims to reduce overdose deaths in highly impacted communities by implementing evidence-based practices. The ORCCA organizes strategies under three menus: OEND, MOUD, and SPDP. This paper examines strategy selection and tests two hypotheses related to OEND and MOUD strategies.
The Helping End Addictions Long Term (HEALing) Communities Study (HCS) seeks to significantly reduce overdose deaths in 67 highly impacted communities in Kentucky (KY), Massachusetts (MA), New York (NY), and Ohio (OH) by implementing evidence-based practices (EBPs) to reduce overdose deaths. The Opioid-overdose Reduction Continuum of Care Approach (ORCCA) organizes EBP strategies under three menus: Overdose Edu-cation and Naloxone Distribution (OEND), Medication Treatment for Opioid Use Disorder (MOUD), and Safer Prescribing and Dispensing Practices (SPDP). The ORCCA sets requirements for strategy selection but allows flexibility to address community needs. This paper describes and compiles strategy selection and examines two hypotheses: 1) OEND selections will differ significantly between communities with higher versus lower opioid-involved overdose deaths; 2) MOUD selections will differ significantly between urban versus rural settings.Methods: Wave 1 communities (n = 33) provided data on EBP strategy selections. Selections were recorded as a combination of EBP menu, sector (behavioral health, criminal justice, and healthcare), and venue (e.g., jail, drug court, etc.); target medication(s) were recorded for MOUD strategies. Strategy counts and proportions were calculated overall and by site (KY, MA, NY, OH), setting (rural/urban), and opioid-involved overdose deaths (high/low).Results: Strategy selection exceeded ORCCA requirements across all 33 communities, with OEND strategies ac-counting for more (40.8%) than MOUD (35.1%), or SPDP (24.1%) strategies. Site-adjusted differences were not significant for either hypothesis related to OEND or MOUD strategy selection.Conclusions: HCS communities selected strategies from the ORCCA menu well beyond minimum requirements using a flexible approach to address unique needs.

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