As COVID-19 quickly materialized from a mysterious pneumonia to a global pandemic, federal, state, local, and tribal governments and communities were faced with the challenge of balancing two national public health emergencies: opioids and COVID-19. As restrictions progressed from social distancing to stay-at-home orders, those on the front lines of the opioid epidemic began to deliberate the possible implications of COVID-19 on substance use disorder (SUD) populations. Concurrently, the Overdose Detection Mapping Application Program (ODMAP) Program Office received multiple requests from media, communities, ODMAP users, and quick response teams, inquiring about the data and impact on this population. As a result, beginning on March 23, 2020, we have analyzed the data weekly. Preliminary analysis presented a potential decline, however, as the pandemic has progressed, no statistically significant change has been observed. Here are a few reminders regarding ODMAP data:
Many state and local governments have never captured non-fatal suspected overdose data, so a control does not exist;
Drug trends are continually evolving due to the rapid introduction of synthetic analogs, which makes it difficult to use historical data as a predictor of future data;
ODMAP defers to state and local agencies to define "suspected overdose," so there are concerns with data quality and consistency across jurisdictional boundaries;
There are areas that are not reporting suspected overdoses into ODMAP and/or not doing so consistently; and
Analysis to date has been conducted on a small sample size of the highest level of data integrity.
The Cheektowaga Police Department (CPD) and the Erie County Department of Public Health have been utilizing ODMAP since August 2017. The integrative public health and public safety model has been led by Assistant Chief Brian Gould, (CPD) and Cheryll Moore, Medical Care Administrator. The partnership we have established with Brian and Cheryll has been incredibly productive, giving us an opportunity to co-present on this issue at numerous national meetings. Given the data integrity, consistency, and historical nature of their data, it was a natural starting point to evaluate trends/patterns. As the pandemic progressed, Chris Yeager, ODMAP Analyst, found that suspected overdoses reported in ODMAP for Erie were increasing. Prior to this observation, suspected overdoses within Erie County had been on a significant decline for nearly two years. We reached out to Brian and Cheryll to review and validate the data and trends and were informed, regrettably that the data was accurate. Cheryll and Brian reported the pandemic appears to be affecting a population, which they have not engaged with previously. Overdose victims are being found in their residences or motels, no longer in public places as they had previously witnessed. There does not appear to be a dominant drug as they are ranging from cocaine, prescription pills, heroin, and more. Arguably, the most detrimental component of the epidemic are the stay-at-home orders, which are not only producing a change in overdose locations, but also the method in which harm reduction services occur. Cheryll and Brian report community-level outreach has been reduced, peer recovery coaches are conducting virtual outreach, and community Naloxone training has been halted.
Brian and Cheryll have always been progressive and determined, and as a result, are continuing to respond with innovative methods to keep people alive. They are now working with partners such as food pantries, soup kitchens, and first responders to distribute Naloxone to residents during their daily routines. They are also targeting messaging and access to hotels, homeless shelters, and gas stations. Did I mention that Brian and Cheryll are so committed that Cheryll’s personal number is utilized for people to contact about access to Naloxone? Of course, this is all anecdotal, but we can’t wait for the data to be perfect to develop strategies. We have to act now, so our communities will be around to thank us later.
Senior Program Manager