Enhanced State Opioid Overdose Surveillance (ESOOS) Program Overview

These slides were presented at the Enhanced State Opioid Overdose Surveillance (ESOOS) Program Overview Partner meeting, led by CDC and organized by ASTHO in March of 2019. 

Presenters

Puja Seth, PhD – Lead, Epidemiology and Surveillance

Alana Vivolo-Kantor, PhD – Morbidity Lead

Christine L. Mattson, PhD – Mortality Lead

Objectives

March 27, 2019

Improving risk factor identification for opioid overdose deaths in Tennessee

Using death certificates alone to identify contributing substances in drug overdose deaths may result in misclassification and underestimation of the burden of illicit and prescription opioids and other drugs in drug-related deaths. To enable timely and targeted prevention in Tennessee (TN), the identification and monitoring of new drugs and trends in use should utilize toxicology and medicolegal death investigation data directly, as recommended by others 1-3. These data can inform mortality outcome definitions for improved surveillance and risk factor identification 4-7.

June 18, 2019

Enhancing Drug Overdose Alerts with Spatial Visualization

Since 2008, drug overdose deaths exceeded the number of motor vehicle traffic-related deaths in Indiana, and the gap continues to widen1. While federal funding opportunities are available for states, it often takes years for best practices to be developed, shared, and published. Similarly, local health departments (LHDs) may experience lengthy delays to receive finalized county health statistics.

June 18, 2019

Comparing Syndromic Data to Discharge Data to Measure Opioid Overdose Emergency Department Visits

Timely and accurate measurement of overdose morbidity using emergency department (ED) data is necessary to inform an effective public health response given the dynamic nature of opioid overdose epidemic in the United States. However, from jurisdiction to jurisdiction, differing sources and types of ED data vary in their quality and comprehensiveness. Many jurisdictions collect timely emergency department data through syndromic surveillance (SyS) systems, while others may have access to more complete, but slower emergency department discharge datasets.

June 18, 2019

Evaluation of Syndromic Surveillance for Opioid Overdose Reporting in Illinois

Accuracy in identifying drug-related emergency department admissions is critical to understanding local burden of disease and assessing effectiveness of drug abuse prevention and overdose-reduction initiatives. In 2018 the Illinois Department of Public Health (IDPH) began implementation of a mandatory opioid overdose reporting law, applicable to all hospital emergency departments (ED). The mandate requires reporting of patient demographics, causal substance and antagonist ED administration within 48 hours of presentation. This reporting is not name-based.

June 18, 2019

Beyond Overdose: Surveillance of Recreational Drug Use and Corresponding Toxicology Testing

Drug overdose deaths are increasing nationally and in Minnesota (MN). This is only a fraction of the overall burden that recreational drug use exacts on emergency departments (ED) and hospitals. In addition to opioids and other drugs, three outbreaks of synthetic cannabinoids and cathinones have occurred in MN recently. ICD codes do not adequately identify patients treated for drug use. Also, toxicology data for these patients are limited: routine toxicology testing is not performed at hospitals as results are not timely enough to be useful for clinical care.

June 18, 2019

Syndrome definitions for drug overdose: How far down the rabbit hole do we go?

State and local jurisdictions have been exploring the use of SyS data to monitor suspected drug overdose outbreaks in their communities. With the increasing awareness and use of SyS systems, staff from the Centers for Disease Control and Prevention (CDC) worked to develop several queries that jurisdictions could use to better capture suspected drug overdose visits. In 2017, CDC released their first two queries on heroin overdose and opioid overdose, followed in 2018 by stimulant and all drug overdose queries.

June 18, 2019

Identification and Assessment of Repeat Drug Overdose Visits at EDs in Virginia

The Virginia Department of Health (VDH) utilizes syndromic surveillance ED data to measure morbidity associated with opioid and heroin overdoses among Virginia residents. Understanding which individuals within a population use ED services for repeated drug overdose events may help guide the use of limited resources towards the most effective treatment and prevention efforts.

June 18, 2019

An Assessment of the EMS Drug Overdose to Death Pathway from 2011 to 2017

Drug overdoses are now the leading cause of accidental death in the United States, with an estimated 60,000 deaths in 2016. Nationally, EMS overdose responses with naloxone administration have nearly doubled from 2012 to 2016 from 573.6 to 1004.4 per 100,000 EMS events. Resuscitation using the opioid antagonist, naloxone is recommended in cases of suspected opioid ODs, and has been increasingly used by EMS agencies, law enforcement, healthcare providers, and Good Samaritans.

June 18, 2019

Identifying Persons Who Inject Drugs in Medical Examiner Data in Maricopa County, AZ

The rate of drug overdose deaths in the United States has increased steadily since 2000. Injection drug use, a practice associated with infectious disease transmission, has likely increased along with this upward trend in drug overdoses. Injection drug use surveillance is difficult to conduct at a public health department because there are no specific Internal Classification of Diseases codes to identify this risk behavior in hospital discharge or vital registration data.

June 18, 2019

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