National Intervention Plan for Decreasing Opioid Overdose Deaths in the USA

Population of Opioid Users in Need of Intervention

Task:

This intervention plan relates to opioid users nationwide. Our intervention is on a national policy level, therefore, we hope that it has a positive effect on decreasing deaths due to overdose in the entire country. The population of people that are currently using opioids is a very vulnerable population. While we are targeting all individuals addicted to opioids it should be stated that there is an overwhelmingly high rate of overdose deaths in the white community as compared to black and latinx communities. The other group targeted by this intervention is the community of friends, relatives, and even strangers that surround someone who is using or abusing opioids. In the MSNBC clip, we saw that this cohort of people was actively forming coalitions to help their friends/relatives escape opioid addictions. Their high motivation and willingness to help makes them a perfect target for our intervention. According to the CDC, the states that are most affected are those in the midwest and southwest parts of the country. West Virginia and Ohio are the states with the highest overdose deaths per 100,000 people yet, these are states with relatively low prescribing rates. We are able to deduce that our target is not necessarily doctor’s offices as much as it is street dealers, narcos, manufacturers, and users.

Problem Analysis

From 1997 to 2019, more than 702,000 people have died from a drug overdose. 53 million people worldwide used either opioids or opiates in 2016; among the 27 million suffer from opioid use disorders. Globally, 450,000 people died from drug overdoses in 2015, of those 118,000 people had opioid use disorders. In the United States, of the 70,000 people who died from a drug overdose in 2017, 68% of people were involved in a prescription or illicit opioid, making it the leading cause of injury related death in the United States. According to the US Department of Health and Human Services, more than 130 people died everyday between 2016 and 2017 from opioid-related drug overdose. Since 2000, the national rate of death from accidental overdoses has increased by 173% and the rate of opioid overdoses has increased by 200%. Although most are using illicitly obtained opioids, an increasing proportion are using prescription opioids.

People who are likely to witness an opioid overdose are those at risk of an overdose themselves, friends and family of a user, and people whose work brings them in contact with users (healthcare workers, police, emergency medical services).  However, the prospect of arrest or prosecution as a bystander with illicit drugs averts people from calling 911 when witnessing an overdose.  To avoid these very preventable deaths by overdose, states began to protect bystanders with Good Samaritan Laws (GSLs).

GSLs aim to protect everyone who seeks medical attention for themselves or another person experiencing drug overdose. The intentions of GSLs are to encourage bystanders to call for help by providing legal incentive of immunity from prosecution for drug possession. Lifetime prevalence of witnessed overdose among drug users is 70%. 40 states and the District of Columbia have enacted GSLs in hopes increased communication between bystanders and 911 will save the lives of overdose victims.

After Washington state enacted a GSL in 2010, 88% of people who use opioids said they would be more likely to call 911 in the event of a future overdose.  In New York and New Jersey, after 911 GSLs were implemented, emergency department visits and inpatient hospital admissions for accidental heroin overdoses increased with an incidence rate ratio of 1.34 (95% CI 1.00-1.86). A June 2017 CATO Institute study showed that in combination with naloxone access laws, GSLs led to a 9 to 11% decrease in opioid related deaths, with no evidence in increased recreational use.