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Introducing the NDEWS* HotSpotOpportunity for Assessing Opioid Overdose Inequities
in Minnesota
Presented by Erin Artigiani, Miigis Gonzalez, Brenna Greenfield, Melissa Walls
Center for Substance Abuse Research (CESAR)University of Maryland, College Park
* Eric Wish, PhD, NDEWS PI
NDEWS is supported by Cooperative Agreement DA038360 from NIDA/NIH to the CESAR at the University of Maryland. Opinions expressed in this presentation may not represent those of NIH or NIDA.
National Drug Early Warning System (NDEWS) Mission
• National early warning system that addresses substance use and misuse topics, with a focus on emerging trends, in the U.S. through a network of experts harnessing the power of evidence to generate educated and practical action
• Generates critically needed information about drugs and their public health consequences
• Leverages resources and collaborations to harmonize approaches to analyzing and presenting data
NDEWSComponents
NDEWS Coordinating
Center
(CESAR)
Scientific Advisory Group (SAG)
DETECTING & MONITORING
• Posts on NDEWS Network, Website, and Social Media Sites • NDEWS Presents Webinars • NDEWS Short Publications: NDEWS News, Notes from the Field • NDEWS Reports: Annual, Drug-Specific, Sentinel Community Site, HotSpot • Data Tables, SCS Snapshots, and Cross-Site Graphics • Conference Presentations & Other Publications • Website Links to Additional Resources
Information Exchange & Dissemination
FOLLOWING UP
National Institute on Drug Abuse (NIDA)
= Early Warning Component
SHARING
NDEWS Network• The NDEWS Network is a virtual community of 1600+
experts in medicine, toxicology, ethnography, epidemiology, law enforcement, and other fields as well as concerned citizens and others
• Use the NDEWS Network to:• Get rapid access to information on emerging drugs and drug trends• Join cross-disciplinary discussions• Learn about new resources and successful local solutions• Ask others about drugs/emerging trends in your area
• https://network.ndews.org
13 NDEWS Sentinel Community Sites
NDEWS HotSpot Approach• Detect acute or emerging problem• Review available data and research• Community Based Participatory Research: Work closely with
local experts and collaborators to identify the research questions and utilize methodologies most important to them
• Conduct focused research designed to:• Expand/Improve understanding of regional/local drug trends• Lead to an intervention to improve public health
NDEWS New Hampshire HotSpot Study1. Collect and review available data and information (May-June 2016)2. Identify core contacts – e.g. local experts in public health, law
enforcement, research, policy (May 2016)3. Convene Planning Committee (May 27, 2016)4. Conduct site visit (June 29 – July 1, 2016)5. Conduct 2 additional rapid studies to develop a more
comprehensive understanding of current user of fentanyl and the people who have died from fentanyl-related overdoses
Key Findings1. Many types of fentanyl mixtures of varying
potency2. Most fatal overdose victims were White, male,
20-39, and alone
3. Fatal overdose victims who were 40 or older, living alone, opiate naïve, or living in non-urban townships were less likely to have access to emergency services care, naloxone, or transport to hospital
5. Toxicology tests showed decedents were positive for multiple drugs
Sorg, Wren, & Stewart, 2017. Unintentional Fentanyl Overdoses in New Hampshire: An NDEWS HotSpot Analysis. Margaret Chase Smith Policy Center, University of Maine and Center for Geospatial Information Science, University of Maryland.
2 Types of Reports
Why Minnesota?• Clear evidence of an a
growing problem with opioid-related overdoses and of a racial disparity
• Local collaborators• Commitment to learning
more about their situation• Available data (in process
of identifying local goals)• Willingness to work with us
to develop a study to address local priorities
4.8
8.9
8.6
3.9
16.4
6
9.6
10.1
13
9.4
5.7
4.2
6.5
7.1
7.6
8.1
9.1
9.8
12.8
13.220.7
31.7
0 5 10 15 20 25 30 35
California
Arizona
Oregon
South Dakota
New Mexico
Montana
North Carolina
Alaska
Oklahoma
Washington
Minnesota
Rate of Drug Poisoning Deaths Involving Opioids, By Race and State, 2011‐2015
American Indian/Alaska Native All Races
Rate per 100,000Source: CDC/NCHS National Vital Statistics System, Mortality
4.88.9
8.63.9
16.46
9.610.1
139.4
5.7
4.26.5
7.17.6
8.19.1
9.812.8
13.220.7
31.7
0 5 10 15 20 25 30 35
California
Arizona
Oregon
South Dakota
New Mexico
Montana
North Carolina
Alaska
Oklahoma
Washington
Minnesota
Rate of Drug Poisoning Deaths Involving Opioids, By Race and State, 2011‐2015
American Indian/Alaska Native All Races
http://www.health.state.mn.us/divs/opi/gov/chsadmin/governance/tribal.html
11
14 14 14
22
13
20
12
20 14
16
35
21
25
33
15
0
10
20
30
40
50
60
70
80
90
100
Jan‐17
Feb‐17
Mar‐17
Apr‐17
May‐17
Jun‐17
Jul‐17
Aug‐17
Sep‐17
Oct‐17
Nov‐17
Dec‐17
Jan‐18
Feb‐18
Mar‐18
Apr‐18
Num
ber o
f Art
icle
Hits
per
mon
th
NDEWS News Scan of Reports About Opioids in MN 1st Nations, Jan. 2017 - Mar. 2018
NDEWS analysis of searches of the LexisNexis Academic ALLNEWS database for the terms "(opioid OR opiate OR opium OR narcotics OR naloxone OR naltrexone OR Analgesic OR Vivitrol) AND (((native w/1 american) OR (american w/1 indian) OR (first w/1 nation) OR Anishinaabe OR Chippewa OR Ojibwe OR Ojibway OR Sioux OR (Red w/1 Lake) OR (White w/1 Earth) OR (Little w/1 Earth) OR (Bois w/1 Forte) OR (Fond w/2 Lac) OR (Grand w/1 Portage) OR (Leech w/1 Lake) OR (Mille w/1 Lacs) OR (Prairie w/1 Island) OR Shakopee) AND (MN OR minnesota))." The ALLNEWS database contains articles from more than 2,400 English‐language newspapers and web news sources. Duplicates were removed with the "moderate similarity" filter in LexisNexis.
Note: Outbreaks of drug problems often come to public attention first via media reports. NDEWS conducts periodic reviews of published news articles and special scans for specific drugs. This graph represents a rough estimate of the number of news articles reporting on a drug or drug use issue. Not all newspapers and web news sources are catalogued in LexisNexis, and the sources may change at any time. Although a duplicate filter was used in the original LexisNexis search, duplicate articles may remain in the results. In addition, this is a count of articles not incidents, as many articles may report on the same incident.
Source:
93
107
134
168
163 136
132 107
113
175 144
191 149
140
199
243
0
50
100
150
200
250
300
350
400
450
500
Jan‐17
Feb‐17
Mar‐17
Apr‐17
May‐17
Jun‐17
Jul‐17
Aug‐17
Sep‐17
Oct‐17
Nov‐17
Dec‐17
Jan‐18
Feb‐18
Mar‐18
Apr‐18
Num
ber o
f Art
icle
Hits
per
mon
th
NDEWS News Scan of Reports About Opioids in Minnesota, Jan. 2017 - Apr. 2018
NDEWS analysis of searches of the LexisNexis Academic ALLNEWS database for the terms "(opioid OR opiate OR opium OR narcotics OR naloxone OR naltrexone OR Analgesic OR Vivitrol) AND (MN OR minnesota))." The ALLNEWS database contains articles from more than 2,400 English‐language newspapers and web news sources. Duplicates were removed with the "moderate similarity" filter in LexisNexis.
Note: Outbreaks of drug problems often come to public attention first via media reports. NDEWS conducts periodic reviews of published news articles and special scans for specific drugs. This graph represents a rough estimate of the number of news articles reporting on a drug or drug use issue. Not all newspapers and web news sources are catalogued in LexisNexis, and the sources may change at any time. Although a duplicate filter was used in the original LexisNexis search, duplicate articles may remain in the results. In addition, this is a count of articles not incidents, as many articles may report on the same incident.
Source:
Where do we go from here?
Pilot Study:Drug Outbreak Testing Service (DOTS)
Offers FREE state-of-the-art urine drug testing to identify the drug(s) behind your local outbreak (Supported by an NIH/NIDA grant to the University of Maryland)
Connect the
DOTS
1
2
3
Contact DOTS at [email protected] obtain submission instructions
Send 10-20 de-identified urine specimens for FREE testing for 240 licit and illicit drugs
Receive results in aggregate form (not for clinical or legal use)
A pilot study of the National Drug Early Warning System (NDEWS), funded at the Center for Substance Abuse Research (CESAR) at the University of Maryland, College Park, by the National Institute on Drug Abuse (NIDA).
