Overdose Data to Action: Surveillance Strategy 4

Kentucky continues to be plagued by the drug overdose epidemic. In 2021, Kentucky had age-adjusted drug overdose mortality rate of 53.6 deaths per 100,000 residents, 3rd highest state in the United States. (CDC NCHS, 2023). Since 2018, Kentucky the age-adjusted drug overdose mortality rate has increased 81%. (Steel & Mirzaian, 2022). The drug overdose mortality burden is high in Kentucky as is drug overdose morbidity. In 2021, the age-adjusted rate of drug overdoses treated in Kentucky emergency department (ED) was 308.2/100,000 residents – 8 percent increase since 2018. Rates of ED visits for any reason with a co-occurring substance use disorder diagnosis has increased nearly 5% from 1002.1 in 2018 to 1049.1/100,000 in 2019. (KIPRC, 2022). The burden of overdose is felt disproportionately. Black Kentuckians have higher age-adjusted mortality (58.5/100,000) and morbidity (359.2/100,000) than white Kentuckians (mortality (53.5/100,000) and morbidity (324/100,000)). Nine of the 10 counties with the highest age-adjusted mortality rates are rural counties, and 9 of 10 counties with the highest age-adjusted morbidity rates are also rural. To reduce these rates, there must be multipronged approaches implemented: 1) identification and monitoring of substance use disorders (SUD) and drug overdoses through comprehensive surveillance; and 2) enhancing development, implementation, and evaluation of evidence-informed, evidence-based, and promising prevention program and policy strategies. 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 surveillance and prevention strategies. Surveillance strategies include enhancing the surveillance infrastructure; the timely analysis of drug overdose ED encounters and fatal drug overdoses using multiple data sources; bio surveillance of drug involvement in non-fatal overdoses; and data linkages to criminal justice data at the individual level; harm reduction data temporally to overdose data, and optional strategies of biosurveillance and data linkage. KIPRC’s prevention strategies include educating clinicians on best pain management practices using CDC prescribing guidelines; training clinicians on OUD (Opioid Use Disorder) and Stimulant Use Disorder (StUD) patient standards of care; supporting ED linkage to care with navigators; expanding Prescription Drug Monitoring Program data sharing; developing public health (PH)/public safety (PS) partnerships; improving PH/PS data sharing; developing PH/PS OUD and StUD trainings; using harm reduction (HR) navigators to connect people to services; developing a statewide harm reduction services resource list; hosting annual in-person HR services training; using recovery navigators to link vulnerable individuals to available SUD treatment with FindHelpNowKentuckY (FHNKY) and recovery housing with FindRecoveryhousingNowKentukckY(FRHNKY); developing a recovery monitoring system; developing a recovery resident management system; and developing a comprehensive resources section within FRHNKY. KIPRC hopes to reduce overdose mortality and morbidity, improve the standard of care and linkage to care for individuals with SUD, and increase access to recovery support through prevention efforts guided by enhanced surveillance.