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. 2023 Apr 1:245:109804.
doi: 10.1016/j.drugalcdep.2023.109804. Epub 2023 Feb 10.

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

Redonna Chandler  1 , Edward V Nunes  2 , Sylvia Tan  3 , Patricia R Freeman  4 , Alexander Y Walley  5 , Michelle Lofwall  6 , Emmanuel Oga  3 , LaShawn Glasgow  3 , Jennifer L Brown  7 , Laura Fanucchi  6 , Donna Beers  5 , Timothy Hunt  8 , Rachel Bowers-Sword  5 , Carter Roeber  9 , Trevor Baker  5 , T John Winhusen  10
Affiliations

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

Redonna Chandler et al. Drug Alcohol Depend. .

Abstract

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 Education 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 accounting 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.

Trial registration: ClinicalTrials.gov NCT04111939.

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

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Conflict of interest statement

Conflict of interest statement No conflicts to declare.

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