Kentucky Overdose Data to Action: Morbidity Surveillance

In 2017, Kentucky had a drug overdose (DO) age-adjusted mortality rate of 37.2 deaths per 100,000 residents, 5th highest in the U.S. (CDC/NCHS, 2018). Encouraging statistics on Kentucky substance use indicate that the percentage of individuals aged 12 and older who engaged in illicit substance use in the past month in Kentucky was 9.02% compared to 10.90% in the U.S. for 2016-2017 (SAMHSA, 2019). The multifaceted aspect of the substance use disorder and epidemic require a multipronged approach: 1) tracking and identification of substance use disorders and drug overdoses through comprehensive surveillance strategies; and 2) development, implementation, and evaluation of evidence-informed, evidence-based, and promising prevention program and policy strategies to reduce the burden of substance use disorders and drug overdoses in the Commonwealth of Kentucky. The Kentucky Injury Prevention and Research Center (KIPRC), as a bona fide agent for the Kentucky Department of Public Health, will collaborate with state, university, and community partners to implement CDC’s Overdose to Action (OD2A) surveillance strategies including timely analysis of drug overdose emergency department encounters, fatal drug overdoses using multiple data sources, and an innovative strategy to implement public health surveillance using remnant serum and urine samples from patients treated at the University of Kentucky Emergency Department for suspected drug overdose. Kentucky OD2A prevention strategies include the integration of Kentucky All Schedule Prescription Electronic Reporting (KASPER) data into electronic health records to inform clinical opioid prescribing decision making, integration of state and local prevention response efforts including support for local health department interventions and providing community technical assistance, timely linkage to SUD treatment facilities through FindHelpNowKY.org, establishment of a perinatal quality collaborative to enhance substance use disorder (SUD) prenatal and perinatal care for better maternal and infant outcomes, partnership with public safety on joint public health and safety data sharing and analysis to inform public health interventions and law enforcement interdiction, development and evaluation of a bystander intervention training targeting young adults, and establishment of a peer-to-peer learning network for other states to strengthen their efforts to rapidly link individuals to SUD treatment facilities. Through improved surveillance and targeted evidenced-based interventions, Kentucky OD2A hopes to impact inappropriate opioid prescribing, opioid misuse and opioid use disorder, patient standard of care, referrals to SUD treatment and sustained recovery, and fatal and non-fatal overdoses, to improve Kentuckian health outcomes.