Prevention of Opioid Overdoses: the Massachusetts SPF SIG

1. Prevention of Opioid Overdoses: the Massachusetts SPF SIG Wayne M. Harding, Ed.M., Ph.D. Social Science Research & Evaluation, Inc. Burlington, Massachusetts 01803 781-273-4206, wharding@ssre.org

2. The MassCALL Priority To reduce unintentional, fatal and non-fatal opioid overdoses.

3. Learning Objective To identify some of the program and evaluation decisions that followed from selection of this priority, including implications for T/TA.

4. Why Opioid Overdoses? Poisonings are the leading cause of injury death in Massachusetts. The proportion of poisoning deaths that were opioid-related increased from 28% in 1990 to 68% in 2005 (surpassing deaths from motor vehicle crashes). From 1999 to 2007, there was a 90% increase in opioid related fatal overdoses. There was a 19% increase from 2002 to 2005 in the rate of emergency department visits for non-fatal opioid overdoses, and a 63% increase from 1999 to 2005 in the rate of inpatient hospitalizations for non-fatal opioid overdoses. Interpreting past success

5. Challenge of Political Opposition From primary preventionists From communities ineligible for funding From communities not funded From community coalitions

6. Challenge of Educating Local Evaluators and Program Staff Summary of the state/local evaluation plan Standardized protocols for reporting data (e.g., ICD and E-codes for hospital data and medical examiner reports) Community profiles Annotated bibliography (and source documents) about interventions and intervening variables

7. Challenge of Educating Local Evaluators and Program Staff: Use of a “Guidance Document” Instructions for conducting the local needs and resources assessment Sample community logic model Guidance about organizing and analyzing qualitative data Suggestions for prioritizing intervening variables Discussion about data quality and access to data Protocols for key informant interviews and focus groups List of approved and disapproved interventions Annotated bibliography on interventions

8. Challenge of Educating Local Evaluators and Program Staff: Monitoring Progress Required and reviewed local strategic and evaluation plans Conducted annual site visits Required and reviewed annual progress reports

9. Challenge of Educating Local Evaluators and Program Staff: Cross-site Communication Convened the local sites to share their experiences Posted each site’s strategic and evaluation plans online Encouraged posting of instruments and other evaluation materials

10. Many decisions flow from the selection of novel State funding priorities. These decisions can be facilitated by CAPT T/TA.