A Community-Based, Data-Driven Approach to Decreasing Overdose Deaths

February 24 @ 6:19 pm

A Community-Based, Data-Driven Approach to Decreasing Overdose Deaths

Following a rapid increase in the rate of overdose deaths in New York State between 2010 and 2017, both state officials and researchers at the Columbia School of Social Work began to consider what innovative interventions would effectively address the opioid crisis and save lives. In April 2019, CSSW received an $86 million grant from the National Institute on Drug Abuse (NIDA) to address this epidemic using community-based, data-driven approaches, and the HEALing Communities Study (HCS) was implemented the same year.

HCS Principal Investigator Nabila El-Bassel, PhD is also the Director of the Social Intervention Group at Columbia School of Social Work, and a University Professor at Columbia University. Dr. El-Bassel leads a team made up of many multidisciplinary scientists, and has shown a commitment to implementing community-based approaches, both throughout her thirty years as a research scientist and with HCS.

“I am convinced that our community engagement model, which was designed by the HCS study team and implemented with engagement of the counties’ community coalitions, including drug treatment and harm reduction programs, can be applied to addressing other health and social issues impacting our communities. Without true community engagement including people with lived experience and their families, the design and implementation of interventions to address the overdose crisis will not lead to lasting outcomes and good science,” said Dr. El-Bassel.

Sixteen total NY State counties are participating in HCS, with the first eight counties having completed Wave I on June 30, 2022. The impact of HCS across these sites – Cayuga, Columbia, Erie, Greene, Lewis, Putnam, Suffolk, and Ulster Counties – was measurably significant, thanks to partnerships with New York State Department of Health, and more than 100 agencies and community partners.

“HCS could not be successful without the true collaboration of the New York State Department of Health, county health and mental health commissioners, and a firm local commitment from each county coalition. HCS also benefits from a multidisciplinary team of investigators from Columbia and other schools dedicated to making this type of intervention succeed and be sustained by the communities involved,” Dr. El-Bassel said.

HCS applies harm reduction principles anchored in human rights and focuses primarily on quality of life for affected individuals and communities rather than total drug use cessation, in order to create a safer environment for individuals with substance use disorders and prevent overdose. Harm reduction also affords people who use drugs the respect and voice necessary to help create effective policies that will better reflect their needs.The HCS coalitions implemented more than 177 evidence-based practices with partnering agencies, and made a particular effort to reach out to diverse communities to ensure these practices reached communities of color and other marginalized groups.

Each participating county has a coalition including collaborations with County Health and Mental Health commissioners, local law enforcement, healthcare providers, emergency departments, homeless assistance agencies, youth-serving organizations, and elected officials and policy makers. And as HCS begins to implement Wave II, eight more highly-affected counties in NY State will benefit from the Study’s harm reduction-based campaigns, which will build upon the innovative strategies of Wave I and emphasize the importance of real-time data collection to rapidly respond to highly-impacted communities.

“Our data dashboards with interactive visualizations provide easily understood visuals to support the coalitions to quickly and accurately draw conclusions, make decisions, and take action to deploy evidence-based practices. The dashboard also includes visualizations on simulation and prediction of the level of interventions needed by the coalitions, such as opioid use disorder treatment, naloxone, or linkage to care,” said Dr. El-Bassel. Real time data helps the research team to understand who is at risk for drug overdose, what types of services are available, who has access, and how to provide broader availability of evidence-based prevention and treatment to all in need.

As the overdose epidemic continues to evolve, particularly with overdoses involving fentanyl, which is 50 times more potent than heroin, the CDC reports that the majority of the 104,034 drug fatalities that occurred between February 2021-2022 involved illicitly manufactured fentanyl. Increasingly, communities of color are experiencing a dramatic rise in overdoses. As governments continue to tackle the crisis, they must address the lack or delay of data by race and ethnicity, which is needed to develop culturally-congruent solutions that will  address specific community needs.