Warrant checking practices by post-overdose outreach programs in Massachusetts: A mixed-methods study

Tori, Marco; Cummins, Emily R.; Beletsky, Leo; Schoenberger, Samantha F.; Lambert, Audrey M.; Yan, Shapei; Carroll, Jennifer; Formica, Scott W.; Green, Traci C.; Apsler, Robert; Xuan, Ziming; Walley, Alexander Y.

doi:10.1016/j.drugpo.2021.103483

Cited by 17 publications

(14 citation statements)

References 43 publications

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“…Researchers have proposed that public health workers can bridge this gap of law enforcement distrust through building relationships with community members and disseminating evidence-based education about public health initiatives, to promote health-supporting programs such as post-overdose interventions (Fleming et al, 2021 ). Further, staff training needs to consider how practices such as warrant checking prior to outreach may be experienced as traumatizing by prospective participants, delay outreach efforts, and function as a barrier to care that disproportionately affects justice-involved individuals (Tori et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

A scoping review of community-based post-opioid overdose intervention programs: implications of program structure and outcomes

2023

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Background An emergent intervention to address the opioid epidemic is the use of multidisciplinary outreach teams which connect an individual in the community to healthcare resources after the experience of an opioid overdose. While these interventions are receiving federal funding, less is known empirically to inform future interventions. Understanding the process and outcomes of these interventions is advisable due to the novel partnerships of public health and law enforcement agencies who sometimes hold divergent goals. The objective of the present review was to describe program structure and evaluated outcomes of community-based post-overdose interventions. Results A search of PubMed, PsycInfo, and Web of Science yielded 5 peer-reviewed articles that detail the implementation and outcomes of interventions delivered in the United States published from 2001 to July 2021. Most interventions used a multidisciplinary outreach team and referenced first responder data to contact individuals who recently experienced an overdose at their residence. Services offered often included referral to substance use treatment, recovery coaches, and social services. Method of outreach, evaluation measures, and outcomes varied. From the available literature, facilitators of program engagement included communication, information sharing, and leadership buy-in among multidisciplinary partners. Conclusions Future studies could benefit from exploration of service provision in rural areas, for family affected by overdose, and for minoritized populations. Community-based post-overdose interventions utilizing a law enforcement partnership are emergent with promising yet limited examples in empirical literature.

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Section: Discussionmentioning

confidence: 99%

A scoping review of community-based post-opioid overdose intervention programs: implications of program structure and outcomes

2023

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“…Although POST sites that partnered with police departments reported that police participation can be an asset, it does not necessarily mean that this is an optimal or desired approach. Concerns have been raised, for example, about warrant checking practices 17 and other blending of the criminal legal system during a public health outreach visit. 18 The POST sites reported feeling that there were many times when police were not needed as part of an outreach visit but felt that they would not receive contact information data if police were not on the visit.…”

Section: Discussionmentioning

confidence: 99%

The Massachusetts Department of Public Health Post Overdose Support Team Initiative: A Public Health–Centered Co-Response Model for Post–Overdose Outreach

Formica

Reilly

Duska

et al. 2022

Journal of Public Health Management and Practice

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Context: Post-overdose outreach programs have emerged in response to surging overdose deaths amid fentanyl contamination of the illicit opioid supply. Predominantly centered in police departments in collaboration with public health providers, these programs conduct home-based outreach with survivors and their social networks following an overdose. Approach: We describe implementation of the Post Overdose Support Team (POST) initiative, an ongoing public health funded and centered approach. Post Overdose Support Team is a person-centered model led by harm reductionists in health and human services agencies in collaboration with municipal first responders. The goal of POST is to engage overdose survivors and their social network to improve general health, connect people to services (including access to treatment, if desired), and reduce risk of subsequent overdose. Implementation: Nine agencies in Massachusetts that are part of the state's overdose education and naloxone distribution network implemented POST programs, covering 28 municipalities. The POST teams conduct home-based outreach with individuals who experienced an opioid-related overdose to provide a menu of services, including naloxone rescue kits, overdose response and risk reduction planning, referral to treatment for substance use disorders, including medication for opioid use disorder, and referral to recovery and family supports. Evaluation: From October 2017 to October 2021, the POST teams attempted to reach 5634 overdose survivors via 10 536 outreach visits. Teams successfully engaged 3014 survivors, either directly or through contact with their social network (53.5% success rate). Using data from a real-time encounter-level database, monthly peer-sharing calls with program sites, and annual site visits, we describe the implementation of the POST initiative and provide practice-based recommendations and lessons learned. Discussion: Early evidence suggests that the POST initiative is meeting its goal to engage overdose survivors, improve general health, and reduce subsequent overdose risk. Future evaluations should examine long-term outcomes among participants, including service linkages and incremental behavior change.

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“…Outreach program establishment data were collected from a 2-phase survey conducted between February and November 2019 in all 351 municipalities in Massachusetts . Survey methods and characteristics of these programs were described in previous publications …”

Section: Methodsmentioning

confidence: 99%

Association of Implementation of Postoverdose Outreach Programs With Subsequent Opioid Overdose Deaths Among Massachusetts Municipalities

et al. 2023

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ImportanceNonfatal opioid overdose is the leading risk factor for subsequent fatal overdose and represents a critical opportunity to reduce future overdose and mortality. Postoverdose outreach programs emerged in Massachusetts beginning in 2013 with the main purpose of linking opioid overdose survivors to addiction treatment and harm reduction services.ObjectiveTo evaluate whether the implementation of postoverdose outreach programs among Massachusetts municipalities was associated with lower opioid fatality rates compared with municipalities without postoverdose outreach programs.Design, Setting, and ParticipantsThis retrospective interrupted time-series analysis was performed over 26 quarters (from January 1, 2013, through June 30, 2019) across 93 municipalities in Massachusetts. These 93 municipalities were selected based on a threshold of 30 or more opioid-related emergency medical services (EMS) responses in 2015. Data were analyzed from November 2021 to August 2022.ExposuresThe main exposure was municipality postoverdose outreach programs. Municipalities had various program inceptions during the study period.Main Outcomes and MeasuresThe primary outcome was quarterly municipal opioid fatality rate per 100 000 population. The secondary outcome was quarterly municipal opioid-related EMS response (ambulance trips) rates per 100 000 population.ResultsThe mean (SD) population size across 93 municipalities was 47 622 (70 307), the mean (SD) proportion of female individuals was 51.5% (1.5%) and male individuals was 48.5% (1.5%), and the mean (SD) age proportions were 29.7% (4.0%) younger than 25 years, 26.0% (4.8%) aged 25 to 44 years, 14.8% (2.1%) aged 45 to 54 years, 13.4% (2.1%) aged 55 to 64 years, and 16.1% (4.4%) aged 65 years or older. Postoverdose programs were implemented in 58 municipalities (62%). Following implementation, there were no significant level changes in opioid fatality rate (adjusted rate ratio [aRR], 1.07; 95% CI, 0.96-1.19; P = .20). However, there was a significant slope decrease in opioid fatality rate (annualized aRR, 0.94; 95% CI, 0.90-0.98; P = .003) compared with the municipalities without the outreach programs. Similarly, there was a significant slope decrease in opioid-related EMS response rates (annualized aRR, 0.93; 95% CI, 0.89-0.98; P = .007). Several sensitivity analyses yielded similar findings.Conclusions and RelevanceIn this study, among Massachusetts municipalities with high numbers of opioid-related EMS responses, implementation of postoverdose outreach programs was significantly associated with lower opioid fatality rates over time compared with municipalities that did not implement such programs. Program components, including cross-sectoral partnerships, operational best practices, involvement of law enforcement, and related program costs, warrant further evaluation to enhance effectiveness.

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Warrant checking practices by post-overdose outreach programs in Massachusetts: A mixed-methods study

Cited by 17 publications

References 43 publications

A scoping review of community-based post-opioid overdose intervention programs: implications of program structure and outcomes

A scoping review of community-based post-opioid overdose intervention programs: implications of program structure and outcomes

The Massachusetts Department of Public Health Post Overdose Support Team Initiative: A Public Health–Centered Co-Response Model for Post–Overdose Outreach

Association of Implementation of Postoverdose Outreach Programs With Subsequent Opioid Overdose Deaths Among Massachusetts Municipalities

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