Tracking non-fatal opioid overdose — time to get ahead of the curve

Every non-fatal opioid overdose represents an opportunity to help curb Connecticut’s opioid crisis, but we know little about the number and location of such poisonings. By mandating confidential data collection for suspected prehospital opioid overdose, Senate Bill 511, An Act Concerning Opioids, aims to address this issue. Since 2012, Connecticut has witnessed a 400 percent increase in opioid overdose deaths, and the number of non-fatal overdoses is certainly greatly increased too. Targeting opioid interventions to groups and communities experiencing high rates of non-fatal overdose may prevent future deaths.

Yet just where, when, and how many Connecticut residents suffer a non-fatal opioid overdose is not known. Why? Connecticut lacks a unified emergency medical response reporting system, making the creation of a statewide public health database impossible. As both a health services researcher and a former volunteer firefighter, I know first-hand the importance of public health data to address the opioid epidemic, and I know how easily this data might be collected by Connecticut firefighters and EMTs. Other states, including Maryland, already use prehospital emergency medical reporting to obtain such information.

Many patients who receive the opioid antidote naloxone are addicted to opioids. After receiving naloxone, some will accept transport to their local emergency department, where they can be connected to care. Yet others, following naloxone revival, may refuse an ambulance ride and stay where they are, increasing their odds of another overdose, and perhaps death. We simply don’t know how many patients receive antidote treatment but refuse transport to a hospital. Studying these near misses will help public health officials target outreach efforts.

Collecting overdose information does come with risks. Opioid addiction is a stigmatizing disease, both for the individuals and the communities suffering from its effects. Maintaining individual confidentiality within a statewide reporting system is obviously essential. Emphasizing that this information is for public health planning, and for not law enforcement, will also be needed.

Understanding where and when prehospital opioid overdoses occur is necessary for providing effective community-based treatment for opioid use disorder. Senate Bill 511 will develop a statewide uniform data reporting system to capture data on opioid overdose, naloxone use, and opioid reversal outcome. The benefits of such a system are many, including the collection of essential public health data and the potential for real-time identification of opioid overdose outbreaks.

Support SB-511’s mandate for opioid overdose reporting. It’s time we get ahead of the curve.

John McDougall is a physician and health services researcher with the Yale National Clinician Scholars Program.