Characteristics of post-overdose public health-public safety outreach in Massachusetts

Scott W Formica; Katherine M Waye; Allyn O Benintendi; Shapei Yan; Sarah M Bagley; Leo Beletsky; Jennifer J Carroll; Ziming Xuan; David Rosenbloom; Robert Apsler; Traci C Green; Allie Hunter; Alexander Y Walley

doi:10.1016/j.drugalcdep.2020.108499

Characteristics of post-overdose public health-public safety outreach in Massachusetts

Drug Alcohol Depend. 2021 Feb 1:219:108499. doi: 10.1016/j.drugalcdep.2020.108499. Epub 2020 Dec 31.

Authors

Affiliations

¹ Social Science Research and Evaluation, Inc., 21-C Cambridge Street, Burlington, MA 01803, USA. Electronic address: sformica@ssre.org.
² Grayken Center for Addiction and Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston Medical Center/Boston University School of Medicine, 801 Massachusetts Avenue, Boston, MA 02118, USA.
³ Grayken Center for Addiction and Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston Medical Center/Boston University School of Medicine, 801 Massachusetts Avenue, Boston, MA 02118, USA; Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine/Boston Medical Center, Boston, MA 02118, USA.
⁴ Northeastern University School of Law and Bouve College of Health Sciences, 350 Huntington Avenue, Boston, MA 02115, USA; Division of Infectious Diseases and Global Public Health, University of California at San Diego School of Medicine, La Jolla, CA, USA.
⁵ Elon University, Department of Sociology and Anthropology, 2035 Campus Box, Elon, NC 27244, USA; Warren Alpert School of Medicine of Brown University, 222 Richmond Street, Providence, RI 02903, USA.
⁶ Boston University School of Public Health, Department of Community Health Sciences, 801 Massachusetts Avenue, Boston, MA 02118, USA.
⁷ Boston University School of Public Health, Department of Health Law, Policy and Management, Talbot Building, 715 Albany Street, Boston, MA 02118, USA.
⁸ Social Science Research and Evaluation, Inc., 21-C Cambridge Street, Burlington, MA 01803, USA.
⁹ Warren Alpert School of Medicine of Brown University, 222 Richmond Street, Providence, RI 02903, USA; Brandeis University, The Heller School for Social Policy and Management, 415 South Street Waltham, MA 02453, USA; Center of Biomedical Research Excellence on Opioids and Overdose, Rhode Island Hospital, 8 Third Street, Second Floor, Providence, RI 02906, USA.
¹⁰ Police Assisted Addiction and Recovery Initiative (PAARI), 253 Amory Street, Boston, MA 02130, USA.

PMID: 33421800
DOI: 10.1016/j.drugalcdep.2020.108499

Abstract

Background: As a response to mounting overdose fatalities, cross-agency outreach efforts have emerged to reduce future risk among overdose survivors. We aimed to characterize such programs in Massachusetts, with focus on team composition, approach, services provided, and funding.

Methods: We conducted a two-phase cross-sectional survey of public health and safety providers in Massachusetts. Providers in all 351 municipalities received a screening survey. Those with programs received a second, detailed survey. We analyzed responses using descriptive statistics.

Results: As of July 2019, 44 % (156/351) of Massachusetts municipalities reported post-overdose outreach programs, with 75 % (104/138) formed between 2016-2019. Teams conducted home-based outreach 1-3 days following overdose events. Police departments typically supplied location information on overdose events (99 %, 136/138) and commonly participated in outreach visits (86 %, 118/138) alongside public health personnel, usually from community-based organizations. Teams provided or made referrals to services including inpatient addiction treatment, recovery support, outpatient medication, overdose prevention education, and naloxone. Some programs deployed law enforcement tools, including pre-visit warrant queries (57 %, 79/138), which occasionally led to arrest (11 %, 9/79). Many programs (81 %, 112/138) assisted families with involuntary commitment to treatment - although this was usually considered an option of last resort. Most programs were grant-funded (76 %, 104/136) and engaged in cross-municipal collaboration (94 %, 130/138).

Conclusions: Post-overdose outreach programs have expanded, typically as collaborations between police and public health. Further research is needed to better understand the implications of involving police and to determine best practices for increasing engagement in treatment and harm reduction services and reduce subsequent overdose.

Keywords: Drug overdose; First responder; Interagency collaboration; Opioids; Outreach; Post-overdose intervention.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Community-Institutional Relations*
Cross-Sectional Studies
Drug Overdose / prevention & control
Harm Reduction
Humans
Law Enforcement
Male
Massachusetts / epidemiology
Naloxone / therapeutic use
Narcotic Antagonists / therapeutic use
Opiate Overdose / therapy*
Organizations
Police / education
Public Health*
Surveys and Questionnaires

Substances

Narcotic Antagonists
Naloxone

Grants and funding

R01 CE003052/CE/NCIPC CDC HHS/United States