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CBHJ

Michigan Overdose Data to Action (MODA)

September 2021

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The overdose crisis is a complex social problem that is often intertwined with criminal/legal systems. Therefore, research and support staff from several of the CBHJ initiatives worked collaboratively to generate, collect, translate, link, and analyze data regarding overdose prevention and response in Michigan. The policy briefs below reflect the objectives and activities completed by the CBHJ as part of the Michigan Overdose Data to Action (MODA) team, which is funded by the Michigan Department of Health and Human Services (MDHHS) via the Centers for Disease Control and Prevention (CDC). They are divided into two broad areas  Harm reduction and overdose prevention and Overdose data to action  with three briefs in each of these areas.  

Harm reduction and overdose prevention

Harm reduction is a philosophy that guides strategies towards individuals or groups that aim to reduce the harms associated with certain behaviors. As a public health strategy, harm reduction was initially developed for persons who use drugs to help each other survive when abstinence was not feasible. Programs using a harm reduction philosophy have been successful in reducing morbidity and mortality among drug users and have also shown benefits for HIV, teen pregnancy, alcohol use, among other social problems. When applied to substance use disorders, harm reduction accepts that a continuing level of drug use (both licit and illicit) in society is inevitable and defines objectives as reducing adverse consequences related to these activities, including overdose. Strategies focus on keeping people safe and alive by avoiding judgments and fighting the stigma and prejudice that can prevent people from seeking the services they need. There is a commitment to the rights and autonomy of people who use drugs, and supporting any positive change in behavior, as defined by the individual.  As part of the MODA funding from MDHHS the CBHJ completed three major activities:

Harm reduction and overdose prevention

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Harm reduction training for peer recovery coaches

Harm reduction training for peer recovery coaches describes efforts to build capacity for harm reduction training and shared strategies for use among peer recovery coaches.

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Harm reduction based naloxone distribution

Harm reduction-based naloxone distribution provides a feasibility study on a truly innovative idea: the distribution of naloxone through vending machines. This brief describes local efforts to implement these machines in county jails and harm reduction settings in Michigan.

image of fentanyl chemical structure

Fentanyl in rural Michigan

Fentanyl in rural Michigan reviews a polydrug analysis on accidental overdose deaths that occurred in nearly a dozen rural counties to reveal that, while methamphetamine deaths are increasing, they are almost exclusively tied to fentanyl. We provide information and resources on fentanyl testing strips. 

 

Overdose data to action

Bringing data to action is part of the CBHJ's mission. We help partners from a variety of disciplines make sense of complex, often disconnected data so that they can access programs, evaluate outcomes, and make real-time data driven decisions. Data Director, Dr. Erin Comartin, is an expert in local jail data systems and leads the CBHJ Data Team in navigating the complexities of more than two dozen unique data management systems in Michigan. This team has extensive experience integrating data across desperate systems to inform behavioral health services for those in criminal-legal settings. To inform policy in action we build on existing partnerships and expertise to integrate overdose and related-date elements both at the county and individual level.  

Overdose data to action

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Opioid Treatment Ecosystem in county jails

Opioid Treatment Ecosystem in county jails describes survey results from local jails and illustrates the near total lack of treatment or best practices for OUD in these settings along with recent research on the risks that this presents for fatal overdose. It highlights the best practices that are integrated in the CBHJ Medications for Opioid Use Disorder In-Jail Model and provides partners with the tool to assess these practices.

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Quantifying prevention touchpoints in Michigan

Quantifying prevention touchpoints in Michigan builds on existing data integration efforts at the CBHJ to determine the prevalence of two key overdose touchpoints: incarceration and non-fatal overdose. Much of the effort here has focused on facilitating and organizing the data integration, with preliminary findings reported while analysis of these integrated data is ongoing.

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Michigan Overdose Data to Action county scorecard

The Michigan Overdose Data to Action county scorecard aims to extend current CBHJ efforts at assessing county-level factors that are associated with the incarceration of persons with behavioral health disorders to those factors associated with overdose. The scorecard uses CDC best practices on overdose prevention as a framework to operationalize and identify data points across Michigan counties.  

 

  • References
    1. Boisvert RA, Martin LM, Grosek M, Clarie AJ. Effectiveness of a peer-support community in addiction recovery: participation as intervention. Occupational Therapy International. 2008;15(4):20520.
    2. Cos TA, LaPollo AB, Aussendorf M, Williams JM, Malayter K, Festinger DS. Do Peer Recovery Specialists Improve Outcomes for Individuals with Substance Use Disorder in an Integrative Primary Care Setting? A Program Evaluation. J Clin Psychol Med Settings. 2019 Sep 13;
    3. Min S-Y, Whitecraft J, Rothbard AB, Salzer MS. Peer Support for Persons with Co-Occurring Disorders and Community Tenure: A Survival Analysis. Psychiatric Rehabilitation Journal. 2007 Win;30(3):20713.
    4. O'Connell MJ, Flanagan EH, Delphin-Rittmon ME, Davidson L. Enhancing outcomes for persons with co-occurring disorders through skills training and peer recovery support. Journal of Mental Health. 2017 Mar 10;0(0):16.
    5. Reingle Gonzalez J. Hogg Foundation for Mental Health Grant Program: Project CRE-001 Evaluation of DSHS Re-entry Project. [Internet]. University of Texas School of Public Health; 2019. Available from: https://hogg.utexas.edu/wp-content/uploads/2019/02/Re-Entry-Peer-Support-Final-Report-Jan-10-2019.pdf
    6. Rowe M, Bellamy C, Baranoski M, Wieland M, O'Connell MJ, Benedict P, et al. A Peer-Support, Group Intervention to Reduce Substance Use and Criminality Among Persons With Severe Mental Illness. PS. 2007 Jul 1;58(7):95561.
    7. Tracy K, Burton M, Nich C, Rounsaville B. Utilizing peer mentorship to engage high recidivism substance-abusing patients in treatment. Am J Drug Alcohol Abuse. 2011 Nov;37(6):52531.
    8. Ray B, Watson DP, Xu H, Salyers MP, Victor G, Sightes E, et al. Peer recovery services for persons returning from prison: Pilot randomized clinical trial investigation of SUPPORT. Journal of Substance Abuse Treatment. 2021 Jul;126:108339.
    9. Victor G, Sightes E, Watson DP, Ray B, Bailey K, Robision L, et al. Designing and implementing an intervention for returning citizens living with substance use disorder: discovering the benefits of peer recovery coach involvement in pilot clinical trial decision-making. Journal of Offender Rehabilitation. 2021 Feb 17;60(2):13858.
    10. Goddard P. Changing attitudes towards harm reduction among treatment professionals: a report from the American Midwest. International Journal of Drug Policy. 2003 Jun 1;14(3):25760.
    11. Goddard P, Mallott MA, Grindle ME. Reliability and Validity of the Harm Reduction Acceptability Scale. PsycEXTRA Dataset [Internet]. [cited 2021 Jun 28]; Available from: https://www.academia.edu/17630094/ Reliability_and_Validity_of_the_Harm_Reduction_Acceptabiity_Scale
    12. Chou R, Korthuis PT, McCarty D, Coffin PO, Griffin JC, Davis-O'Reilly C, et al. Management of Suspected Opioid Overdose With Naloxone in Out-of-Hospital Settings: A Systematic Review. Annals of Internal Medicine. 2017 Dec 19;167(12):867.
    13. Chamberlain JM, Klein BL. A comprehensive review of naloxone for the emergency physician. The American Journal of Emergency Medicine. 1994 Nov 1;12(6):65060.
    14. Wermeling DP. Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access. Ther Adv Drug Saf. 2015 Feb;6(1):2031.
    15. Clark AK, Wilder CM, Winstanley EL. A Systematic Review of Community Opioid Overdose Prevention and Naloxone Distribution Programs. Journal of Addiction Medicine. 2014 Jun;8(3):15363.
    16. Naumann RB, Durrance CP, Ranapurwala SI, Austin AE, Proescholdbell S, Childs R, et al. Impact of a community-based naloxone distribution program on opioid overdose death rates. Drug and Alcohol Dependence. 2019 Nov 1;204:107536.
    17. Alex B, Weiss DB, Kaba F, Rosner Z, Lee D, Lim S, et al. Death After Jail Release: Matching to Improve Care Delivery. J Correct Health Care. 2017 Jan 1;23(1):837.
    18. Binswanger IA. Mortality After Prison Release: Opioid Overdose and Other Causes of Death, Risk Factors, and Time Trends From 1999 to 2009. Ann Intern Med. 2013 Nov 5;159(9):592.
    19. Binswanger IA, Stern MF, Deyo RA, Heagerty PJ, Cheadle A, Elmore JG, et al. Release from Prison A High Risk of Death for Former Inmates. New England Journal of Medicine. 2007 Jan 11;356(2):15765.
    20. Lim S, Seligson AL, Parvez FM, Luther CW, Mavinkurve MP, Binswanger IA, et al. Risks of Drug-Related Death, Suicide, and Homicide During the Immediate Post-Release Period Among People Released From New York City Jails, 20012005. American Journal of Epidemiology. 2012 Mar 15;175(6):51926.
    21. Victor G, Zettner C, Huynh P, Ray B, Sightes E. Jail and Overdose: Assessing the Community Impact of Incarceration on Overdose. Addiction. 2021;
    22. Darke S, Larney S, Farrell M. Yes, people can die from opiate withdrawal. Addiction. 2017;112(2):199200.
    23. Potter RH, Lin H, Maze A, Bjoring D. Jails and Public Health Service Delivery and Empirical Knowledge: The Impact of Jail Population "Flow." Am J Crim Just. 2012 Jun 1;37(2):2008.
    24. Doe-Simkins M, Quinn E, Xuan Z, Sorensen-Alawad A, Hackman H, Ozonoff A, et al. Overdose rescues by trained and untrained participants and change in opioid use among substance-using participants in overdose education and naloxone distribution programs: a retrospective cohort study. BMC Public Health. 2014 Apr 1;14(1):297.
    25. OpiRescue [Internet]. OpiSafe. [cited 2021 Jun 29]. Available from:https://opisafe.com/products/opirescue
    26. National Institute on Drug Abuse. Overdose Death Rates [Internet]. National Institute on Drug Abuse. 2021 [cited 2021 Jun 29]. Available from: https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates
    27. Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA psychiatry. 2014;71(7):8216.
    28. Grau LE, Dasgupta N, Harvey AP, Irwin K, Givens A, Kinzly ML, et al. Illicit use of opioids: Is OxyContin® a "gateway drug"? The American Journal on Addictions. 2007;16(3):16673.
    29. Rudd RA, Paulozzi LJ, Bauer MJ, Burleson RW, Carlson RE, Dao D, et al. Increases in heroin overdose deaths28 states, 2010 to 2012. MMWR Morbidity and mortality weekly report. 2014;63(39):849.
    30. Strickler GK, Zhang K, Halpin JM, Bohnert AS, Baldwin G, Kreiner PW. Effects of mandatory prescription drug monitoring program (PDMP) use laws on prescriber registration and use and on risky prescribing. Drug and Alcohol Dependence. 2019;
    31. Gladden RM. Fentanyl law enforcement submissions and increases in synthetic opioidinvolved overdose deaths27 states, 20132014. MMWR Morbidity and mortality weekly report. 2016;65.
    32. O'Donnell JK, Halpin J, Mattson CL, Goldberger BA, Gladden RM. Deaths involving fentanyl, fentanyl analogs, and U-4770010 states, JulyDecember 2016. MMWR Morbidity and mortality weekly report. 2017;66(43):1197.
    33. Hedegaard H. Drug Overdose Deaths in the United States, 19992018 [Internet]. 2020 [cited 2020 Mar 25]. Available from: https://www.cdc.gov/nchs/products/databriefs/db356.htm
    34. Volkow ND, Blanco C. The changing opioid crisis: development, challenges and opportunities. Molecular Psychiatry. 2020 Feb 4;116.
    35. Magura S, Weller BE, Smith DR, Saxton MM, Amaratunga P. Surveillance by oral fluid of drugs subject to misuse among individuals under arrest. The American Journal of Drug and Alcohol Abuse. 2021 Mar 4;47(2):24754.
    36. Park JN, Rashidi E, Foti K, Zoorob M, Sherman S, Alexander GC. Fentanyl and fentanyl analogs in the illicit stimulant supply: Results from U.S. drug seizure data, 20112016. Drug and Alcohol Dependence. 2021 Jan 1;218:108416.
    37. Jacka BP, Goldman JE, Yedinak JL, Bernstein E, Hadland SE, Buxton JA, et al. A randomized clinical trial of a theory-based fentanyl overdose education and fentanyl test strip distribution intervention to reduce rates of opioid overdose: study protocol for a randomized controlled trial. Trials. 2020 Nov 26;21(1):976.
    38. 38. Zibbell JE, Peiper NC, Duhart Clarke SE, Salazar ZR, Vincent LB, Kral AH, et al. Consumer discernment of fentanyl in illicit opioids confirmed by fentanyl test strips: Lessons from a syringe services program in North Carolina. International Journal of Drug Policy. 2021 Jul 1;93:103128.
    39. Peiper NC, Clarke SD, Vincent LB, Ciccarone D, Kral AH, Zibbell JE. Fentanyl test strips as an opioid overdose prevention strategy: Findings from a syringe services program in the Southeastern United States. Int J Drug Policy. 2018 Oct 3;
    40. Ma J, Bao Y-P, Wang R-J, Su M-F, Liu M-X, Li J-Q, et al. Effects of medication-assisted treatment on mortality among opioids users: a systematic review and meta-analysis. Mol Psychiatry. 2019 Dec;24(12):186883.
    41. Fullerton CA, Kim M, Thomas CP, Lyman DR, Montejano LB, Dougherty RH, et al. Medication-Assisted Treatment With Methadone: Assessing the Evidence. PS. 2014 Feb;65(2):14657.
    42. Mattick R, Kimber J, Breen C, Davoli M. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. In: The Cochrane Collaboration, editor. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2003 [cited 2019 Apr 17]. Available from: http://doi.wiley.com/10.1002/14651858.CD002207.pub2
    43. Mattick RP, Breen C, Kimber J, Davoli M. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Drugs and Alcohol Group, editor. Cochrane Database of Systematic Reviews [Internet]. 2009 Jul 8 [cited 2019 Apr 17]; Available from: http://doi.wiley.com/10.1002/14651858.CD002209.pub2
    44. Connery HS. Medication-Assisted Treatment of Opioid Use Disorder: Review of the Evidence and Future Directions. Harvard Review of Psychiatry. 2015 Apr;23(2):63.
    45. Connock M, Juarez-Garcia A, Jowett S, Frew E, Liu Z, Taylor R, et al. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess. 2007;11(9):1171.
    46. Macmadu A, Adams JW, Bessey SE, Brinkley-Rubinstein L, Martin RA, Clarke JG, et al. Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study. International Journal of Drug Policy. 2021 May 1;91:102841.
    47. Vestal C. New Momentum for Addiction Treatment Behind Bars [Internet]. 2018 [cited 2020 May 15]. Available from: https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2018/04/04/new-momentum-for-addiction-treatment-behind-bars
    48. Welch-Marahar M, Pinals D. Jail MAT Survey. Michigan Department of Health and Human Services.; 2021.
    49. McCarty D, Gustafson DH, Wisdom JP, Ford J, Choi D, Molfenter T, et al. The Network for the Improvement of Addiction Treatment (NIATx): Enhancing Access and Retention. Drug Alcohol Depend. 2007 May 11;88(23):13845.
    50. Fields D, Knudsen HK, Roman PM. Implementation of Network for the Improvement of Addiction Treatment (NIATx) Processes in Substance Use Disorder Treatment Centers. J Behav Health Serv Res. 2016 Jul 1;43(3):35465.
    51. MS ACE, PhD TR, Fitzgerald MM, PhD DHG. Teaching the NIATx Model of Process Improvement as an Evidence-Based Process. Journal of Teaching in the Addictions. 2008 Sep 17;6(2):2137.
    52. Ray BR, Lowder EM, Kivisto AJ, Phalen P, Gil H. EMS naloxone administration as non-fatal opioid overdose surveillance: 6-year outcomes in Marion County, Indiana. Addiction. 2018 Dec;113(12):22719.
    53. Formica SW, Apsler R, Wilkins L, Ruiz S, Reilly B, Walley AY. Post opioid overdose outreach by public health and public safety agencies: Exploration of emerging programs in Massachusetts. International Journal of Drug Policy. 2018 Apr 1;54:4350.
    54. Ray B, Lowder EM, Kivisto AJ, Phalen P, Gil H. EMS naloxone administration as non‐fatal opioid overdose surveillance: 6‐year outcomes in Marion County, Indiana. Addiction. 2018;113(12):22719.
    55. Lowder EM, Amlung J, Ray BR. Individual and county-level variation in outcomes following non-fatal opioid-involved overdose. J Epidemiol Community Health. 2020 Jan 9;jech-2019-212915.

 

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