New Framework Released to Reduce Opioid Overdose

By: HEAL Connections

The Opioid-Overdose Reduction Continuum of Care Approach (ORCCA): A Policymakers Guide to Implementing Evidence-Based Strategies that Address Opioid Overdose aims to help policymakers, communities and key stakeholders to develop comprehensive, multi-system strategies that address the opioid crisis. The science and evidence behind the framework was published in the Drug and Alcohol Dependence and outlines 19 essential evidence-based interventions to reduce opioid overdose deaths.

The 19 evidence-based interventions recommended in ORCCA across five domains include:

Prioritize Individuals at heightened risk for opioid overdose death: 

To prevent overdose deaths, a primary focus should be on reaching populations with the highest risk, especially those who do not currently engage in treatment or prevention services. Recommendations include:

      Prioritize delivery of services to those who need them most in criminal legal settings and other venues

      Implement field-based population detection methods

      Use data sources to target intervention to those who need services

      Engage individuals with lived experience in decision-making process

Opioid-Overdose Prevention and Naloxone Distribution (OEND) programs encompass training on recognizing and responding to overdoses, administering naloxone, and providing rescue kits. Recommendations include:

      Implement active overdose education and naloxone distribution (OEND) programs for people who use opioids and their social networks

      Implement active OEND at venues where overdoses are more likely to occur

      Include passive OEND strategies

      Build OEND capacity among first responders   

Enhance Delivery of Medications to Treat Opioid Use Disorder: 

Improved access to evidence-based Medications for Opioid Use Disorder (MOUD) significantly reduces the risk of overdose death. These medications stabilize brain chemistry, reduce opioid effects, and relieve cravings. Recommendations include:

      Expand medications for opioid use disorder (MOUD) capacity in healthcare, criminal legal settings, and through telemedicine

      Initiate on-site MOUD in community-based settings

      Create linkage programs and protocols

      Enhance MOUD engagement and retention

Remove Barriers to Critical Resources: 

Improving outcomes and treatment retention for individuals with OUD involves addressing the availability of external resources that support recovery and enhance treatment retention. Recommendations include:

      Expand peer recovery support and peer services

      Remove barriers to housing services

      Expand transportation initiatives for patients with opioid use disorder (OUD)          

      Address barriers to needed resources, including insurance coverage, food security, childcare, and employment

      Remove barriers to supplemental behavioral health services 

Safer Opioid Prescribing, Dispensing, and Disposal Practices: 

These strategies aim to reduce excess opioid supply, prevent access by vulnerable individuals, and improve overall opioid prescribing safety. Recommendations include:

      Ensure safer opioid prescribing

      Implement safe and effective opioid disposal

The HEALing Communities Study, a multi-site research study, tested the impact of ORCCA, an integrated set of evidence-based practices across healthcare, behavioral health, justice, and other community-based settings. HEALing Communities is funded by the National Institutes of Health (NIH) Helping to End Addiction Long-term (HEAL) Initiative®. To download the ORCCA Guide for Policymakers, click here.

HEAL Connections

The HEAL Connections Center was created by the NIH HEAL Initiative® to translate HEAL research into action. Learn more here.

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