The Iowa Department of Health and Human Services (Iowa HHS), Bureau of Substance Use
Prevention, Treatment and Recovery in the Division of Behavioral Health proposes to implement
Iowa - Overdose Data to Action in States (Iowa-OD2A-S) to decrease drug morbidity and
mortality by strengthening relationships between critical surveillance and prevention partners
and increasing the use of data to inform and evaluate prevention initiatives. Iowa HHS is
applying for funding for competitive optional Strategy 4 Biosurveillance.
Background: Thought to be an issue only in major U.S. cities or more populated states, use of
various licit and illicit substances (e.g., opioids, methamphetamines) is becoming a problem of
epidemic proportions in more rural areas of the country, including Iowa. In 2021, The Iowa HHS
Bureau of Health Statistics reported 471 deaths statewide with overdose as the underlying cause
of death (All Drug definition) and Iowa SUDORS data indicated 400 overdose deaths of
unintentional and undetermined intent. During that same year, 5,935 of all Iowa Emergency
Department (ED) visits were drug-related; 13% of drug overdose admissions were
opioid-related; the ED drug overdose admission rate was 185.9 per 100,000 Iowans. Processes to
ensure data accuracy and quality often present a barrier of timely reporting of unusual drug
overdose frequencies. Such delays lead to missed opportunities for preventing additional
overdoses through real-time targeted interventions and trend analyses.
Purpose: High quality, comprehensive, and timely data on overdose morbidity and mortality will
lead to a better understanding of the drug overdose crisis in Iowa and inform more effective
prevention efforts. Improved data collection and analysis as a result of the Iowa-OD2A-S project
will assist with: (1) Tracking the spread and severity of Iowa’s overdose crisis; (2) Gaining
insight into populations most at risk in order to prioritize resources; and (3) Evaluating the best
way to allocate resources and to help identify emerging trends. CDC funding will allow Iowa to
address the overdose crisis by: (1) Harnessing existing data collection systems (e.g., ED); (2)
Improving data collection mechanisms (e.g., abstraction of data related to UUDO deaths); and
(3) Using data to prioritize and enhance prevention activities.
Outcomes: By the end of the project period Iowa HHS will: (1) Increase use of findings from
data sources (e.g., Prescription Monitoring Program, ED, mortality) to inform and focus
prevention efforts; (2) Increase real-time response to overdose “outbreaks” by offering
prevention and treatment services; (3) Increase prevention intervention and peer navigator
connections with local public health; and (4) Increase partner collaboration.
Focus Populations: Data indicate that Iowans 25 to 34 years old are the primary focus
population for Iowa-OD2A-S. By overlaying additional health indicators, Black, non-Hispanic
and individuals diagnosed with HCV are identified as important priority subpopulations at risk
for health disparities.
Strategies and Activities:Surveillance Strategies: (1) Enhance Iowa’s surveillance data
infrastructure to inform prevention efforts; (2) Collect and disseminate timely ED data on all
suspected opioid and stimulant overdoses; (3) Collect and disseminate descriptions of drug
overdose death circumstances using death certificates and SOME data; and (4) Gather
laboratory data from from specimens in EDs to better inform drug overdose trends.
Prevention Strategies: (6) Support clinical education and training as well as Iowa’s PMP
program; (7) Engage public safety through collaborations; (8) Collaborate with and promote
harm reduction efforts; and (9) Support community-based linkage to care services.