Experts Call for Real-Time, Comprehensive Data to Address Opioid Crisis

Researchers argue that current issues around opioid overdose data prevent public health officials from getting a clear picture of the opioid crisis, leading them to fight the epidemic “blindfolded.”

In an opinion piece published in Addiction last month, researchers from the National Institute of Drug Abuse at the National Institutes of Health (NIH) posited that the only way to effectively address the opioid crisis is to use real-time, disaggregated data to identify which groups of individuals are most at-risk and use that information to target prevention and treatment at the local level.

The Centers for Disease Control and Prevention (CDC) report that in 2020, 75 percent of the 92,000 drug overdose deaths involved an opioid. Synthetic opioids are currently driving most of these deaths, with 82.3 percent of opioid-involved overdose deaths involving synthetic opioids.

Currently, administrative data surrounding the opioid crisis are being collected at the national and local levels, but severe constraints in availability, timeliness, and sharing limit that data’s usefulness for developing effective response strategies, the researchers noted.

They argue that real-time data would allow public health officials to understand the impact of various mitigation strategies on factors like drug use, medications for opioid use disorder (OUD), access to lifesaving interventions, recovery support services, and overdose deaths.

However, real-time data on the opioid crisis is nearly impossible to gather because of reporting lags, especially during the COVID-19 pandemic. Access to this data is a challenge because it relies on multiple processes that can take weeks or months to complete, such as toxicology testing, medicolegal investigations, and death certifications. Because of this, public health officials typically rely on data from previous years to develop current response strategies.

The authors argued that this is insufficient because the drug market is constantly evolving to produce more potent substances, leading to more overdose deaths and an increased need to implement initiatives to prevent them.

The data currently being collected to create these initiatives is lacking not only in timeliness but also in quality and access, the researchers stated. For example, much of this data lives in unlinked data siloes and lacks basic information such as patient demographics.

To drive innovation in collecting opioid overdose data, the authors proposed multiple strategies.

First, to increase data volume and quality, they suggested gathering data from non-traditional sources, such as homeless shelters and the justice system, where high numbers of people who use drugs can be found. The use of rapid drug testing by first responders, and in emergency departments and jails can help support this data collection effort.

Second, to enhance data timeliness, the authors pointed to policy shifts that have been shown to improve drug surveillance in the US. In Arizona, first responders and healthcare facilities must report all suspected opioid overdose events and deaths to the state health department within five days. Kentucky state law mandates that all death investigations utilize toxicology testing for controlled substances. As a result of such laws, these states have improved their overall fatal opioid overdose data significantly.

The authors also noted that linking individual-level records across public health data systems and improving population-level data quality is necessary for community-based research studies. These studies help test whether community-based interventions can help reduce overdose deaths at the local level, but data issues usually limit them.

The researchers concluded that addressing the opioid crisis will require a data-driven approach similar to the one created to address COVID-19. A parallel system, they argue, would allow states and municipalities to track real-time overdoses and deaths, including the type of drug involved, medications for OUD, utilization of naloxone, and recovery support services with necessary demographic information about those impacted attached.