Mecklenburg County Overdose Data to Action: Using Surveillance Data to Affect Systemic Overdose Prevention and Response Efforts

Background and Purpose: Overdose Data to Action (OD2A) is a Center for Disease Control and Prevention cooperative agreement that provides funding to local and state jurisdictions to reduce drug overdoses. The purposes of the agreement are to build surveillance infrastructures to monitor the extent to which overdoses are occurring, community responses, and the causes and conditions that perpetuate opioid use disorders. Through developing the surveillance infrastructure, OD2A teams support systemic efforts to prevent overdoses, provide effective responses to overdoses, and mitigate the impact of overdoses in communities. The following presentation will outline the efforts of Mecklenburg County (i.e., Charlotte, North Carolina) OD2A team in developing its overdose surveillance infrastructure, its utilization of surveillance data to drive prevention and response efforts, and its evaluations strategies to ensure the attainment of short- and medium-term objectives.

Methods: To develop the surveillance infrastructure, the OD2A team identified public and private data sources including: the North Carolina Disease and Event Tracking and Epidemiologic Collection Tool for emergency department service utilization for overdoses; CDC Wide-ranging Online Data for Epidemiologic Research for drug overdose mortality data; North Carolina Controlled Substances Reporting System for prescription data; and Emergency Medical Services administrative data for medic responses to drug overdoses in the community. Data use agreements were developed to gain access to the public and private data records, and data were organized into a public-facing data dashboard, enabling all data sources to be partitioned by key demographics (i.e., age, race, sex, and zip code) and drug types (i.e., opioid, fentanyl, polysubstance, cocaine). Power BI was used to develop and publish the dashboard, while ArcGIS was used to develop the heatmaps for overdoses by zip code.

Results: From 2019 to 2023, the emergency department service utilization for overdoses increased by 49.6%, with an average annual increase of 10.8%. While opioid, fentanyl, and polysubstance rates have steadily increased, emergency department utilization for stimulant involved overdoses experienced a significant spike from 2022 to 2023, increasing from 21 to 30 per 100,000 residents. During this same timeframe, the overdose death rate increased by 70.4%, with an average annual increase of 15.4%. In terms of demographics characteristics, individuals who are male, Black, and aged 25-44 experienced the highest emergency department utilization and death rates relative to the other groupings. Regarding emergency medical service responses, due to transitioning to a new electronic health record system we currently have records from July-December 2024, and will have the historical data during the time of the presentation. During this time frame, the majority of calls for service involved individuals who were aged 25-44, male, and Black (46.6%) or White (39.7%).

Conclusions and Implications: Through developing the surveillance infrastructure to monitor overdose trends in Mecklenburg County, the OD2A team was able to identify hotspots and groups who were disproportionately impacted by the opioid epidemic. Through coordinating with local hospitals, behavioral healthcare organizations, harm-reduction agencies, law enforcement and criminal justice services, and local government, resources and new programs have been established to mitigate the deleterious effects of opioid use disorders.