Enhanced State Opioid Overdose Surveillance (ESOOS) Program Overview

These slides were presented at the Enhanced State Opioid Overdose Surveillance (ESOOS) Program Overview Partner meeting, led by CDC and organized by ASTHO in March of 2019. 

Presenters

Puja Seth, PhD – Lead, Epidemiology and Surveillance

Alana Vivolo-Kantor, PhD – Morbidity Lead

Christine L. Mattson, PhD – Mortality Lead

Objectives

March 27, 2019

Exploring Drug Overdose Mortality Data in Harris County, Texas

Drug overdose mortality is a growing problem in the United States. In 2017 alone over 72,000 deaths were attributed to drug overdose, most of which were caused by fentanyl and fentanyl analogs (synthetic opioids). While nearly every community has seen an increase in drug overdose, there is considerable variation in the degree of increase in specific communities. The Harris County community, which includes the City of Houston, has not seen the massive spikes observed in some communities, such as West Virginia, Kentucky, and Ohio.

June 18, 2019

Finding Chances to Intervene Before the Fatal Overdose: Linking ED and Mortality Data

In 2017, 951 Missouri residents died from an opioid overdose, a record number for the state.1 This continues the trend from 2016, which saw an increase of over 30% in opioid overdose deaths compared to 2015. The Missouri Department of Health and Senior Services (MDHSS) manages several public health surveillance data sources that can be used to inform about the opioid epidemic. Opioid overdose deaths are identified through death certificates which are collected through the vital records system.

June 18, 2019

EMS Heroin Overdoses with Refusal to Transport & Impacts on ED Overdose Surveillance

As a Centers for Disease Control and Prevention Enhanced State Opioid Overdose Surveillance (ESOOS) funded state, Kentucky started utilizing Emergency Medical Services (EMS) data to increase timeliness of state data on drug overdose events in late 2016. Using developed definitions of heroin overdose for EMS emergency runs, Kentucky analyzed the patterns of refused/transported EMS runs for both statewide and local jurisdictions.

June 18, 2019

Drug Overdose Trends among Black Indiana Residents: 2013-2017

Black Hoosiers, the largest minority population in Indiana, make up almost 10% of the state's population, and accounted for 8% of the total resident drug overdose deaths from 2013-2017 compared to whites at 91%. However, a closer look at race-specific mortality rates might reveal racial inequalities. Therefore, the purpose of this project was to analyze drug overdose morality rates among white and black Hoosiers to discover possible racial inequalities and to discover trends in drug involvement in overdose deaths among blacks.

June 18, 2019

Improving risk factor identification for opioid overdose deaths in Tennessee

Using death certificates alone to identify contributing substances in drug overdose deaths may result in misclassification and underestimation of the burden of illicit and prescription opioids and other drugs in drug-related deaths. To enable timely and targeted prevention in Tennessee (TN), the identification and monitoring of new drugs and trends in use should utilize toxicology and medicolegal death investigation data directly, as recommended by others 1-3. These data can inform mortality outcome definitions for improved surveillance and risk factor identification 4-7.

June 18, 2019

Enhancing Drug Overdose Alerts with Spatial Visualization

Since 2008, drug overdose deaths exceeded the number of motor vehicle traffic-related deaths in Indiana, and the gap continues to widen1. While federal funding opportunities are available for states, it often takes years for best practices to be developed, shared, and published. Similarly, local health departments (LHDs) may experience lengthy delays to receive finalized county health statistics.

June 18, 2019

Comparing Syndromic Data to Discharge Data to Measure Opioid Overdose Emergency Department Visits

Timely and accurate measurement of overdose morbidity using emergency department (ED) data is necessary to inform an effective public health response given the dynamic nature of opioid overdose epidemic in the United States. However, from jurisdiction to jurisdiction, differing sources and types of ED data vary in their quality and comprehensiveness. Many jurisdictions collect timely emergency department data through syndromic surveillance (SyS) systems, while others may have access to more complete, but slower emergency department discharge datasets.

June 18, 2019

Evaluation of Syndromic Surveillance for Opioid Overdose Reporting in Illinois

Accuracy in identifying drug-related emergency department admissions is critical to understanding local burden of disease and assessing effectiveness of drug abuse prevention and overdose-reduction initiatives. In 2018 the Illinois Department of Public Health (IDPH) began implementation of a mandatory opioid overdose reporting law, applicable to all hospital emergency departments (ED). The mandate requires reporting of patient demographics, causal substance and antagonist ED administration within 48 hours of presentation. This reporting is not name-based.

June 18, 2019

Beyond Overdose: Surveillance of Recreational Drug Use and Corresponding Toxicology Testing

Drug overdose deaths are increasing nationally and in Minnesota (MN). This is only a fraction of the overall burden that recreational drug use exacts on emergency departments (ED) and hospitals. In addition to opioids and other drugs, three outbreaks of synthetic cannabinoids and cathinones have occurred in MN recently. ICD codes do not adequately identify patients treated for drug use. Also, toxicology data for these patients are limited: routine toxicology testing is not performed at hospitals as results are not timely enough to be useful for clinical care.

June 18, 2019

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