The California Department of Public Health Substance and Addiction Prevention Branch (CDPH-SAPB) intends to use the Centers for Disease Control and Prevention’s Overdose Data to Action in States funds to continue its data-informed, comprehensive, and multi-sector strategic collaboration to address the dynamic drug overdose epidemic in California. The purpose of this project is the following: 1) We seek to improve the quality, completeness, and timeliness of opioid, stimulant, and other drug data, including information on risk and protective factors, treatment, and health consequences; and 2) We intend to use these data to inform overdose prevention interventions in California while focusing on closing gaps related to access to care and services to reduce health inequities for populations at the greatest risk for overdose.
CDPH-SAPB has planned four surveillance activities. For Strategy 1: Surveillance Infrastructure, CDPH-SAPB will build and sustain capacity for mortality surveillance. For Strategy 2: Morbidity Surveillance, CDPH-SAPB will collect, analyze, and report annual billing/discharge data for Emergency Department (ED) visits and hospitalizations related to drug poisoning to CDC. We will also disseminate CA ED visit and hospitalization data on nonfatal drug overdoses. For Strategy 3: Mortality Surveillance, CDPH-SAPB will report de-identified data on undetermined and unintentional drug overdose (UUDO) deaths from death certificates and medical examiner and coroner (ME/C) reports to CDC. We will also disseminate mortality data products. Additionally, CDPH-SAPB is applying for the optional and competitive surveillance Strategy 5: Data Linkage, where we propose linking fatal opioid overdose data to nonfatal opioid overdose-related ED visits and linking opioid overdose-related death and ED visits to individual-level criminal justice and social determinants of health (SDOH) data.
CDPH-SAPB will use the data collected in the surveillance strategies above and collaborate with multiple partners to implement our four planned prevention strategies. Strategy 6: Clinician/Health System Engagement and Health IT/PDMP Enhancement, Strategy 7: Public Safety Partnerships/Interventions, Strategy 8: Harm Reduction, and Strategy 9: Community-Based Linkages to Care. Our prevention activities include a focus on reaching groups disproportionately affected by the overdose epidemic, ensuring culturally relevant interventions, and providing equitable delivery of prevention services.
Through the proposed surveillance and prevention activities, we have identified short-term, intermediate, and long-term outcomes we expect to achieve throughout the cooperative agreement period of performance, which align with the Overdose Data to Action in States logic model. Ultimately, our surveillance and prevention activities will contribute to us achieving our long term outcomes, which include the following: 1) decrease overall fatal and nonfatal drug overdoses, particularly overdoses involving either opioids or stimulants or both, among those disproportionately affected by the drug overdose epidemic; 2) decrease illicit opioid and stimulant use, opioid use disorder, and stimulant use disorder; 3) increase uptake of evidence-based treatment and retention with long-term recovery supports; 4) improve health equity among groups disproportionately affected by the drug overdose epidemic and those previously underserved by overdose prevention programs and the healthcare system; and 5) decrease stigma related to substance use and overdose.