Due a current crisis and epidemic of overdose and misuse of opioids, it is important to develop initiatives for mechanisms of action to address this public health problem. We have developed a proposal that includes innovative initiatives or strategies in Puerto Rico for the benefit of the population. In PR there are many people who have chronic conditions and use pain medications to treat diseases outcomes, a risk for misused, addiction and overdose. In addition, PR experienced a non-typical situation, due to an atmospheric event in 2017 that triggered a series of adverse effects on health status and hindered recovery plan and imposing additional limitations or barriers to manage the opioid crisis and address the epidemic. In this proposal are developed various strategies with activities and components will positively impact the crisis. Among the aims are the development and establishment of a comprehensive Opioid Surveillance System that will generate specific data related nonfatal overdose and deaths, while strengthening Bureau of Forensic Sciences (BFS) Toxicology Laboratory efficiency. This antemortem and postmortem data will guide the planning, implementation, and evaluation of several prevention initiatives that will impact health professionals, youth population, pregnant women. Through training, educational strategies, linkage and access to available health services and increase the access of the Prescription Drug Monitoring Program (PDMP). Expected outcomes are identified and defined on a predominantly Hispanic population. These are: increase the knowledge regarding the real magnitude of the opioid epidemic, the report on nonfatal overdose events among ED, the identification of unintentional and undetermined-intent drug overdose, access to PDMP data and increase the knowledge among healthcare practitioners regarding opioid misuse and overdose management. In addition, develop a multidisciplinary platform to share public health data for an
integrated approach and improve the current policies and protocols. These activities are represented among the different strategies developed to meet the objectives of the project, divided into surveillance and prevention components. The strategies for surveillance components include initiatives (a) to establish a surveillance system with syndromic data; (b) develop and establish the morbidity / mortality component of opioid / opioid overdoses. The strategies for prevention components include initiatives (a) to maximize the monitoring system by extending its access to all licensed health professionals that prescribe controlled medications and establish health information exchange protocols; (b) the development and implement an interactive tool to have real time access and monitoring indicators and relevant information aim to understand the magnitude of the opioid crisis, actions and accurate decisions; (c) develop programs or protocols for pregnant patients who are addicted to opioid drugs and newborns who have abstinence syndrome (NAS); (d) training among healthcare professionals on different strategies and also develop interventions to increase healthcare professional competencies; and guidelines on best practices for pain management.
The evaluation and performance measurement of this funding opportunity will be based on determine if the program activities are being implemented as they are intended, obtain evidence-based data and assessment of outcomes achievements. The 5-step Data-to-Action rapid feedback cycle encouraged by the CDC will be adopted to assure early identification of data needs, timely data collection, analysis and debriefing to share findings that will support decision making; intended to assure the appropriate data collection for evaluation, implement activities, identifying barriers and challenges during implementation, and share data with stakeholders and adopting improvement strategy.