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New Framework Released to Reduce Opioid Overdose

Updated: May 18

December 5, 2023

Bethesda, MD - The Opioid-Overdose Reduction Continuum of Care Approach (ORCCA) guide was released today to help implement system and practice-level changes to reduce opioid overdose deaths. The HEALing Communities Study, a multi-site research study, tested the impact of an integrated set of evidence-based practices across healthcare, behavioral health, justice, and other community-based settings.

The ORCCA framework and guide were designed to aid policymakers, communities, and key stakeholders in developing comprehensive multi-system strategies that address the opioid crisis. The science and evidence behind the framework were published in the Journal of Drug and Alcohol Dependence and outlined 19 essential evidence-based interventions to reduce opioid overdose deaths.

“The ORCCA menu represents evidence-based practices with years of research demonstrating their ability to reduce overdose deaths and improve other outcomes. Investing in these practices represents the best opportunity for policymakers to save lives, reduce substance use, support recovery, and strengthen communities,” shared Dr. Redonna K. Chandler, Director of the HEALing Communities Study at the National Institute on Drug Abuse (NIDA).

ORCCA outlines the priority populations and 19 essential evidence-based interventions to reduce opioid overdose deaths:

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

  2. Implement field-based population detection methods

  3. Use data sources to target intervention to those who need services who are likely in need of intervention

  4. Engage individuals with lived experience in decision-making process

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

  6. Implement active OEND at venues where overdose is more likely to occur

  7. Include passive OEND strategies

  8. Build OEND capacity among first responders

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

  10. Initiate on-site MOUD in community-based settings

  11. Create linkage programs and protocols

  12. Enhance MOUD engagement and retention

  13. Expand peer recovery support and peer services

  14. Remove barriers to housing services

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

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

  17. Remove barriers to supplemental behavioral health services

  18. Ensure safer opioid prescribing

  19. Implement safe and effective opioid disposal practices

“Providing services to people at the greatest risk for overdose, for example those with a prior overdose or reduced opioid tolerance, is the best investment for communities seeking to reduce overdose deaths,” explained Dr. John Winhusen, Professor at the University of Cincinnati College of Medicine. “These individuals can most efficiently be engaged by providing interventions at venues where high-risk populations are likely to be encountered, for example emergency departments and jails. Engagement in medication for opioid use disorder, particularly buprenorphine or methadone, and the provision of naloxone to these individuals and their loved ones should be a priority.”

The Addiction Policy Forum is a part of the HEAL Connections Center, created by the NIH HEAL Initiative® to translate HEAL research into action. The center’s goals are twofold: to create pathways to further build and sustain community partnerships, and to support HEAL researchers in meaningfully sharing results with communities and stakeholders that will benefit most from research findings. Learn more here.

To access the ORCCA Policymakers Guide, please visit this link.


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