PRP119: Learning from the past to make a better future: Development of the Erie County Opioid Mortality Review Board

Alexandrea Bentham, BS; Caroline Horrigan; Laurene Tumiel-Berhalter, PhD; Monika Wozniak, MA


Context: In 2016, opioid-related deaths (ORD) peaked (n=301) in Erie County, New York, resulting in the formation of the Erie County Opiate Task Force (ECOTF), a coalition comprised of stakeholders with vested interest in substance use treatment, education, and prevention. Since 2016, ORDs have steadily decreased, energizing the ECOTF, but also highlighting the need for further understanding of the biopsychosocial factors that lead to mortality. In order to develop data-driven recommendations for policy and system change, the Erie County Department of Health (ECDOH), in partnership with the University at Buffalo (UB), developed an Opioid Mortality Review Board (OMRB) to identify system gaps and opportunities for improvement.
Objective: To describe the development and implementation of the Erie County OMRB.
Design: Case review. Formative and process evaluation.
Setting: Erie County, NY
Participants: ECDOH, UB, Erie County Medical Examiner’s (ME)
Intervention: A working group was formed consisting of representatives from the ECDOH, UB, and the ME. Roles were clearly defined and delineated into 3 categories: implementation (ECDOH), evaluation (UB), and technical assistance (ME). The group met biweekly to determine program scope, data instruments and management, and OMRB meeting protocols and membership.
Primary & Secondary Outcome Measures: Identification of program scope, development of data collection instruments, program implementation, and recommendations for program modification.
Results: ORD that occurred in Erie County from 2016 to present were identified as eligible for data collection. Guides were created to interview the deceased’s family, friends, and social contacts. Topics related to development, environment, trauma, and addiction were addressed. Extraction forms were created for autopsy reports and medical records. To date, the ECDOH has collected extensive data for 23 ORDs and 3 cases have been presented to the OMRB. Initial recommendations for program modification include collection of criminal records, the addition of representatives from prisons and child welfare on the OMRB, and shorter, but more frequent meetings for case review.
Conclusions: The OMRB offers recommendations and proposed strategies to reduce ORDs and overdoses in Erie County, NY. Reviewing ORDs can shed light on patterns where the system failed and can provide insight on how to reduce addiction, overdose, and mortality.

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