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.