Open Access Open Access  Restricted Access Subscription or Fee Access

A public health outbreak management framework applied to surges in opioid overdoses

Kieran Moore, MD, CCFP (EM), FCFP, MPH, DTM&H, FRCPC, Maximilien Boulet, BSc, Julia Lew, BSc, Nicholas Papadomanolakis-Pakis, BSocSc, MPA

Abstract


Objective: Over the past decade, Canada and the United States have been facing an epidemic of harms from prescription opioids. More recently, opioid-naïve individuals have been exposed to illicit opioids through adulterated combination products. This has resulted in sudden surges of opioid-related mortality. A proactive public health solution is needed to prevent further death. We propose examining these surges in opioid overdoses as outbreaks and investigating them in a similar way to an outbreak of an infectious disease. An epidemiologic investigation model for opioid overdose outbreaks, that could be modified by other public health agencies,

is discussed.


Keywords


public health, outbreak, overdose, opioid, fentanyl

Full Text:

PDF

References


Gomes T, Greaves S, Martins D, et al.: Latest Trends in Opioid-Related Deaths in Ontario: 1991 to 2015. Toronto: Ontario Drug Policy Research Network, 2017. Available at http://odprn.ca/wp-content/uploads/2017/04/ODPRN-Report_Latest-trends-inopioid-related-deaths.pdf. Accessed June 21, 2017.

Gomes T, Fernandes K, Paterson M, et al.: Opioid Prescribing and Opioid-Related Hospital Visits in Ontario. Toronto: Ontario Drug Policy Research Network, 2016. Available at http://odprn.ca/wp-content/uploads/2016/06/FINAL-UPDATED_Opioid-Hosp-Report-_May-2016.pdf. Accessed June 21, 2017.

Centers for Disease Control and Prevention: Steps of an outbreak investigation. Available at https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson6/section2.html. Accessed June 21, 2017.

Jafari S, Buxton J, Joe R.: Rising Fentanyl-related overdose deaths in British Columbia. Can J Addict. 2015; 6(1):4-6. Available at https://www.csam-smca.org/wp-content/uploads/2015/04/CJA-vol6-no1-2015.pdf. Accessed June 21, 2017.

Centres for Disease Control and Prevention: Increases in Fentanyl Drug Confiscation and Fentanyl-related Overdose Fatalities. Available at https://emergency.cdc.gov/han/han00384.asp. Accessed June 21, 2017.

Klar SA, Brodkin E, Gibson E, et al.: Furanyl-fentanyl overdose events caused by smoking contaminated crack cocaine - British Columbia, Canada, July 15-18 2016. Health Promot Chronic Dis Prev Can. 2016; 36(9): 200-201. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129780/. Accessed June 21, 2017.

Tomassoni AJ, Hawk KF, Jubanyik K, et al.: Multiple Fentanyl overdoses - New Haven, Connecticut, June 23, 2016. MMWR. 2016; 66(4):107-111. Available at https://www.cdc.gov/mmwr/volumes/66/wr/mm6604a4.htm. Accessed June 21, 2017.

Andrews TM. (2017, February 14). Louisville officials receive 52 overdose calls in 32 hours as country's addiction epidemic explodes. The Washington Post, Available at https://www.washingtonpost.com/. Accessed June 21, 2017.

Mettler K. (2016, August 29). ‘This is unprecedented’: 174 heroin overdoses in 6 days in Cincinnati. The Washington Post, Available at https://www.washingtonpost.com/. Accessed June 21, 2017.

Moore KM, Papadomanolakis-Pakis N, Hansen-Taugher A, et al. Recommendations for action: a community meeting in preparation for a mass-casualty opioid overdose event in Southeastern Ontario. BMC Proceedings. 2017;11(suppl 1):1.

World Health Organization. International Health Regulations (2005) 2nd ed. Geneva: WHO, 2008. Available at: http://apps.who.int/iris/bitstream/10665/43883/1/9789241580410_eng.pdf. Accessed June 23, 2017.

The Peter S. Sandman Risk Communication Website: Crisis Communication. Available at http://www.psandman.com/index.htm#column. Accessed June 22, 2017.

Kingston Frontenac Lennox & Addington Public Health Informatics: Ontario Opioid Surveillance Monitor. Available at https://public.tableau.com/profile/kflaphi#!/vizhome/OntarioOpioidSurveillanceMonitor/ACESEDVisits. Accessed June 22, 2017.

Public Health Ontario: Opioid-related morbidity and mortality in Ontario. Available at http://www.publichealthontario.ca/en/DataAndAnalytics/Pages/Opioid.aspx. Accessed June 22, 2017.




DOI: http://dx.doi.org/10.5055/jom.2017.0396

Refbacks

  • There are currently no refbacks.