Merging statewide data in a public/university collaboration to address opioid use disorder and overdose.
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ABSTRACT: Objective
Describe methods to compile a unified database from disparate state agency datasets linking person-level data on controlled substance prescribing, overdose, and treatment for opioid use disorder in Connecticut.Methods
A multidisciplinary team of university, state and federal agency experts planned steps to build the data analytic system: stakeholder engagement, articulation of metrics, funding to establish the system, determination of needed data, accessing data and merging, and matching patient-level data.Results
Stakeholder meetings occurred over a 6-month period driving selection of metrics and funding was obtained through a grant from the Food and Drug Administration. Through multi-stakeholder collaborations and memoranda of understanding, we identified relevant data sources, merged them and matched individuals across the merged dataset. The dataset contains information on sociodemographics, treatments and outcomes. Step-by-step processes are presented for dissemination.Conclusions
Creation of a unified database linking multiple sources in a timely and ongoing fashion may assist other states to monitor the public health impact of controlled substances, identify and implement interventions, and assess their effectiveness.
SUBMITTER: Becker WC
PROVIDER: S-EPMC7780404 | biostudies-literature | 2021 Jan
REPOSITORIES: biostudies-literature
Publications
Merging statewide data in a public/university collaboration to address opioid use disorder and overdose.
Becker William C WC Heimer Robert R Dormitzer Catherine M CM Doernberg Molly M D'Onofrio Gail G Grau Lauretta E LE Hawk Kathryn K Lin Hsiu-Ju HJ Secora Alex M AM Fiellin David A DA
Addiction science & clinical practice 20210104 1
<h4>Objective</h4>Describe methods to compile a unified database from disparate state agency datasets linking person-level data on controlled substance prescribing, overdose, and treatment for opioid use disorder in Connecticut.<h4>Methods</h4>A multidisciplinary team of university, state and federal agency experts planned steps to build the data analytic system: stakeholder engagement, articulation of metrics, funding to establish the system, determination of needed data, accessing data and mer ...[more]
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Project description:Background: This study sought to explore whether intervening in suspected cases of opioid overdose alters interest in treatment for opioid use disorder (OUD). Data were collected as a part of a trial comparing the effects of different overdose education and naloxone distribution (OEND) training curricula on overdose outcomes. Methods: Following OEND training, participants completed four in-person follow-up visits at 1-, 3-, 6- and 12-months. Participants were also regularly contacted to inquire about overdose events they responded to, witnessed, or experienced themselves. Other assessments included the Addiction Severity Index that queries participants' perceived importance of drug treatment on a scale of: 0 (Not at All) to 4 (Extremely). For the current secondary data analysis, treatment importance was assessed at the time points most immediately preceding and following participant intervention in an overdose event using naloxone. Results: The sample reported a mean duration of opioid use of 14.9 (± 11.5) years, with 67% having witnessed an overdose event prior to the study. Of the 321 enrolled, 92 participants used naloxone in response to 166 suspected cases of an opioid overdose. For the entire sample, mean treatment importance did not significantly change throughout the study. Among participants who utilized naloxone, treatment importance increased following the event (Before: 3.03, After: 3.39, p = 0.02). Due to the amount of time between the overdose event and assessment of post-event treatment importance (40.5 days, ±40.2), the current study most likely underestimates this effect. Conclusions: The current study suggests that responding to an overdose event increases interest in OUD treatment. Currently only considered an acute intervention to reduce overdose morbidity and mortality, OEND may have the potential to increase enrollment in medications to treat OUD. However, a prospective investigation needs to determine if the impact of an overdose event could be utilized to increase treatment engagement.
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Project description:BackgroundThe United States (U.S.) is experiencing an ongoing opioid crisis. Economic burden estimates that describe the impact of the crisis are needed when considering federal and state resources devoted to addressing overdoses. In this study, we estimate the societal costs for opioid use disorder and fatal overdose from all opioids in 2017.MethodsWe estimated costs of fatal overdose from all opioids and opioid use disorder based on the incidence of overdose deaths and the prevalence of past-year opioid use disorder for 2017. Incidence of fatal opioid overdose was obtained from the National Vital Statistics System; prevalence of past-year opioid use disorder was estimated from the National Survey of Drug Use and Health. Costs were estimated for health care, criminal justice and lost productivity. Costs for the reduced quality of life for opioid use disorder and life lost due to fatal opioid overdose were valued using U.S. Department of Health and Human Services guidelines for valuing reductions in morbidity and mortality.ResultsCosts for opioid use disorder and fatal opioid overdose in 2017 were estimated to be $1.02 trillion. The majority of the economic burden is due to reduced quality of life from opioid use disorder and the value of life lost due to fatal opioid overdose.ConclusionsThese estimates can assist decision makers in understanding the magnitude of opioid use disorder and fatal overdose. Knowing the magnitude and distribution of the economic burden can inform public policy, clinical practice, research, and prevention and response activities.
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