Connecting state and local government leaders
COMMENTARY | States like New Jersey, Virginia and Massachusetts are moving forward with data-driven approaches to treating opioid addictions.
In an article published in Route Fifty last year just after the 2017 National Prescription Drug Abuse and Heroin Summit, I expressed hope that the conversation at the 2018 summit would evolve from one focused on monitoring the opioid epidemic, to one about the innovative steps taken to intervene in curbing this deadly epidemic.
Today, I am pleased to share that some states have moved forward, and are making great use of available data to act. And, thanks to an influx of new funding from Congress and the Trump Administration, states will continue the move from “observing” to “doing” to dramatically impact the lives of their citizens.
Glimmers of hope
Better data sharing between stakeholder agencies is at the heart of the recently announced New Jersey Coordinator of Addiction Response and Enforcement Strategies (NJ CARES) program. This first-in-the-nation program creates the Interagency Drug Awareness Dashboard (IDAD). The digital, information-sharing “dashboard” will exchange opioid-related data between state agencies, creating a holistic picture of New Jersey’s opioid situation.
In announcing the program, Attorney General Gurbir S. Grewal said, “The opioid crisis is unprecedented in its scope and devastating in its intensity, and our response must be equally broad in scope and intensity.”
The drastic spike in use of illegal, synthetic opioids like fentanyl and carfentanyl has magnified the importance of data sharing between public health and law enforcement agencies. NJ CARES will integrate information from the state’s Prescription Monitoring Program, law enforcement data on heroin, fentanyl and other opioid-related arrests, naloxone administrations, fatal and non-fatal drug overdoses, and treatment information.
The Attorney General’s Office believes that the IDAD’s “marrying of law enforcement data with public health data will refine resources and make responses to opioid overdoses more efficient and timely.”
The Virginia Department of Medical Assistance Services (DMAS), which administers Virginia’s Medicaid program and oversees addiction and treatment benefits, is improving access to care through innovative usage of data.
With emergency department and opioid and heroin abuse data flooding in, it is difficult to match patients with the best provider and services. This is particularly burdensome in rural counties, where there are fewer providers.
Last year, Virginia Medicaid began covering more community-based addiction recovery services, including medication-assisted opioid treatment and inpatient detoxification, which experts believe is more effective than outpatient or community detox. With help from analytics, DMAS can shepherd more people dealing with opioid and heroin addiction into those programs and increase positive patient outcomes.
DMAS reviews fresh provider network data each day and can visualize on a “heat map” any gaps in addiction treatment availability. Previously, data was updated only every few weeks – too late for someone in crisis.
In Massachusetts, lives are being saved thanks to an innovative data integration and analytics project.
By combining 10 data sources within 6 agencies, the state Department of Public Health found that recently released prisoners were 56 times more likely to suffer an overdose. This is not surprising, as parolees or probationers may believe that their bodies can handle drugs the way they did before prison. It’s often a fatal mistake.
By allowing data and analytics to drive policy, medication assisted treatment is now provided at release from a corrections facility and the time to follow-up was shortened to target the time when most overdoses occurred. These data driven changes have contributed to an 8.3 percent reduction in Massachusetts opioid deaths, the largest decrease in the nation.
New grants offer powerful opportunity
In late June, the Substance Abuse and Mental Health Services Administration (SAMHSA) will begin accepting grant proposals to fund efforts to combat the opioid epidemic. The vast majority of the money will go toward needed treatment for those suffering from substance use disorder. However, SAMHSA has directed that up to 15% of these new funds can be utilized to fund new and innovative uses of data and analytics. This is the opportunity to build on the examples above and unleash the power of analytics in this fight.
To those states ready to take a new approach, I have three recommendations:
- Use SAMSHA grants to optimize treatment efforts. With at least 80 percent of grant money going to treatment, it is imperative that data guide those efforts. Data analytics can help states evaluate which treatments and/or treatment providers are most effective, broken down by populations. By understanding what is creating the most positive outcomes, a state can amplify those best practices while steering resources away from less effective treatments or providers.
- Apply SAMHSA dollars to filling gaps in treatment availability. As Virginia has found, there are large numbers of people who must travel long distances to get the addiction care they need. Often, these people live in more rural and depressed areas, where the opioid problem tends to be worse. States should employ data analytics and mapping to identify current demand for treatment (by type), then identify gaps in availability by geography, sub-populations, types of treatment and other factors. This will guide the placement of new treatment centers and other services.
- SAMHSA grants are an opportunity to not just combat the current problem, but to plan for the future. By integrating and analyzing disparate data sources, like New Jersey will do, analytics can be used to forecast demand for opioid use disorder (OUD) treatment, by treatment type, substance type and geography. It’s not enough to just understand the current situation. This crisis is rapidly evolving and we need to understand opioid use trends and be prepared to have help in place for those who need it in the future.
Next year, I plan to return to the 2019 National RX Summit. The decisions we make right now give us our best opportunity to date to curb this horrible epidemic. I’m encouraged by states like Massachusetts, Virginia and New Jersey that are already at the analytics forefront in this fight. I look forward to listening to the next set of leaders as they share their successes in leveraging data through this year’s SAMSHA grants and, most importantly, share their stories of how they made a difference in the lives and families of their fellow citizens.
Dr. Steve Kearney is the Medical Director and Sr. Manager for Healthcare in the US Government Practice of analytics company, SAS. Formerly of Duke University and Pfizer Global Medical, Dr. Kearney now leads a team that helps solve complex healthcare challenges with advanced analytic solutions that can be applied across state, federal and local governments.