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Tracking Community Naloxone Dispensing: Part of a Strategy to Reduce Overdose Deaths


The number of unintentional overdose deaths in New York City (NYC) has increased for seven consecutive years. In 2017, there were 1,487 unintentional drug overdose deaths in NYC. Over 80% of these deaths involved an opioid, including heroin, fentanyl, and prescription pain relievers.1 As part of a comprehensive strategy to reduce overdose mortality in NYC, the NYC Department of Health and Mental Hygiene’s (DOHMH) Overdose Education and Naloxone Distribution (OEND) Program makes naloxone kits available to laypeople free-of-charge through registered Opioid Overdose Prevention Programs (OOPPs). Naloxone kits contain two doses of naloxone and educational materials. The OEND Program distributes kits to registered OOPPs, which then dispense kits to individuals via community-based trainings. In this context, distribution refers to kits shipped to programs, whereas dispensing refers to kits given to individuals. Increased NYC funding has enabled recruitment of more OOPPs including syringe exchange programs, public safety agencies, shelters, drug treatment programs, health care facilities, and other community-based programs and greater dispensing of naloxone kits to laypeople. Naloxone distribution has undergone a dramatic expansion, from 2,500 kits in 2009 to 61,706 kits in 2017.2 In 2018, DOHMH aims to distribute more than 100,000 kits to OOPPs. In order to target naloxone dispensing to neighborhoods in NYC with the highest overdose burden, we developed a tracking system able to capture individual-level geographic data about naloxone kit recipients. Prior to the development of the tracking system, DOHMH collected quarterly, aggregate-level naloxone dispensing data from OOPPs. These data included only the OOPPs™ ZIP Codes but not recipient residence. OOPP ZIP Code was used as a proxy for kits dispensed to individuals. Without individual-level geographic information, however, we could not determine whether naloxone kit dispensing reached people in neighborhoods with high overdose mortality rates. To overcome these barriers, DOHMH developed a comprehensive but flexible individual-level data collection method.

Objective: Describe the development of an individual-level tracking system for community-based naloxone dispensing as part of New York City's (NYC) comprehensive plan to reduce overdose deaths. We present data from the first year of the initiative to illustrate results of the tracking system and describe the potential impact on naloxone dispensing program.

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