Overdose Anomaly Toolkit
Overdose Anomaly Toolkit
Empower your public health team with ready-to-use tools, resources, and guidance to enhance overdose anomaly detection, response, and evaluation. This Toolkit provides actionable strategies, templates, and real-world examples to help you respond quickly to emerging trends. Whether you are getting started or refining existing processes, this Toolkit supports your overdose anomaly activities every step of the way from preparation to evaluation.
Empower your public health team with ready-to-use tools, resources, and guidance to enhance overdose anomaly detection, response, and evaluation. This Toolkit provides actionable strategies, templates, and real-world examples to help you respond quickly to emerging trends. Whether you are getting started or refining existing processes, this Toolkit supports your overdose anomaly activities every step of the way from preparation to evaluation.
What is this toolkit?
This CSTE Overdose Anomaly Toolkit equips public health teams with strategies to quickly identify and respond to sudden changes in overdoses.
Who is this toolkit for?
This toolkit was created especially for epidemiologists, but any public health professional who is involved in an overdose anomaly response will find it useful. Public health partners are encouraged to review the toolkit together and collaborate on a response plan.
What is an overdose anomaly?
Broadly, an anomaly is something that differs from what is standard, normal, or expected. An overdose anomaly is a deviation in the frequency of non-fatal or fatal overdoses from what is expected within a specified time period or geographical area.
How do I define an overdose anomaly threshold within my jurisdiction?
When defining an overdose anomaly threshold – a numerical cutoff that triggers a closer look or response – it is important to consider the capacity and resources that your jurisdiction has available to respond if that threshold is reached. Too many alerts and you may not be able to respond in a meaningful way; too few, and significant overdose events and prevention opportunities may be missed. Navigate to Early Planning Steps to read about methods for defining an overdose anomaly threshold.
How was this toolkit developed?
This toolkit reflects insights and experiences identified and prepared through the CSTE Overdose Anomaly Workgroup, whose membership included CDC, state and local health department representatives, CSTE staff, and consultants.
What is this toolkit?
This CSTE Overdose Anomaly Toolkit equips public health teams with strategies to quickly identify and respond to sudden changes in overdoses.
Who is this toolkit for?
This toolkit was created especially for epidemiologists, but any public health professional who is involved in an overdose anomaly response will find it useful. Public health partners are encouraged to review the toolkit together and collaborate on a response plan.
What is an overdose anomaly?
Broadly, an anomaly is something that differs from what is standard, normal, or expected. An overdose anomaly is a deviation in the frequency of non-fatal or fatal overdoses from what is expected within a specified time period or geographical area.
How do I define an overdose anomaly threshold within my jurisdiction?
When defining an overdose anomaly threshold – a numerical cutoff that triggers a closer look or response – it is important to consider the capacity and resources that your jurisdiction has available to respond if that threshold is reached. Too many alerts and you may not be able to respond in a meaningful way; too few, and significant overdose events and prevention opportunities may be missed. Navigate to Early Planning Steps to read about methods for defining an overdose anomaly threshold.
How was this toolkit developed?
This toolkit reflects insights and experiences identified and prepared through the CSTE Overdose Anomaly Workgroup, whose membership included CDC, state and local health department representatives, CSTE staff, and consultants.
How to Use The Toolkit
How to Use The Toolkit
The process of preparing to detect an anomaly, responding to that anomaly, and evaluation of the response is similar to an iterative Plan-Do-Study-Act cycle. What is learned from one anomaly detection and response cycle will influence the ways in which your jurisdiction prepares and responds to another. For example, you may want to revise some communication, or alter a detection threshold, or include an additional partner in your response. While using this toolkit, keep in mind that the processes you develop are likely to change after continually gathering information through anomaly responses.
The process of preparing to detect an anomaly, responding to that anomaly, and evaluation of the response is similar to an iterative Plan-Do-Study-Act cycle. What is learned from one anomaly detection and response cycle will influence the ways in which your jurisdiction prepares and responds to another. For example, you may want to revise some communication, or alter a detection threshold, or include an additional partner in your response. While using this toolkit, keep in mind that the processes you develop are likely to change after continually gathering information through anomaly responses.
Prepare
STEP 1
Identify Anomalies
This section helps you to:
- Prepare for and detect an overdose anomaly
- Maintain situational awareness of drug overdose-related threats
- Generate hypotheses about likely causes using descriptive epidemiology
Respond
STEP 2
Strategize And Act
This section helps you to:
- Define and find related cases
- Evaluate hypotheses with additional analyses to identify a source of the anomaly
- Institute control and prevention measures
- Communicate findings
Evaluate
STEP 3
Evaluate
This section helps you to:
- Decide when the overdose spike, cluster, or outbreak is over and maintain surveillance
- Conduct an evaluation of the investigation
- Identify and develop a plan to address lessons learned
Resources
The resource links can be used to support public health teams in collecting data, informing public health messaging, and identifying overdose risk factors. It aids in targeting prevention, linking individuals to treatment, recovery and community-based programs, and guiding response like naloxone distribution. It also enhances situational awareness for toxicology partners and helps shape media communication during large-scale events.
All resources links in this toolkit were updated and active at the time of release. If you notice any broken links or missing files, please bring this to our attention by using the suggestions feature.
Prepare
STEP 1
Identify Anomalies
This section helps you to:
- Prepare for and detect an overdose anomaly
- Maintain situational awareness of drug overdose-related threats
- Generate hypotheses about likely causes using descriptive epidemiology
Respond
STEP 2
Strategize And Act
This section helps you to:
- Define and find related cases
- Evaluate hypotheses with additional analyses to identify a source of the anomaly
- Institute control and prevention measures
- Communicate findings
Evaluate
STEP 3
Evaluate
This section helps you to:
- Decide when the overdose spike, cluster, or outbreak is over and maintain surveillance
- Conduct an evaluation of the investigation
- Identify and develop a plan to address lessons learned
Resources
The resource links can be used to support public health teams in collecting data, informing public health messaging, and identifying overdose risk factors. It aids in targeting prevention, linking individuals to treatment, recovery and community-based programs, and guiding response like naloxone distribution. It also enhances situational awareness for toxicology partners and helps shape media communication during large-scale events.
All resources links in this toolkit were updated and active at the time of release. If you notice any broken links or missing files, please bring this to our attention by using the suggestions feature.
The resource links can be used to support public health teams in collecting data, informing public health messaging, and identifying overdose risk factors. It aids in targeting prevention, linking individuals to treatment, recovery and community-based programs, and guiding response like naloxone distribution. It also enhances situational awareness for toxicology partners and helps shape media communication during large-scale events.
All resources links in this toolkit were updated and active at the time of release. If you notice any broken links or missing files, please bring this to our attention by using the suggestions feature.
Toolkit Navigation
Toolkit Navigation
Next: Prepare >
Prepare
Respond
Evaluate
Resources
Suggestions or questions?
Submit them here.
Suggestions or questions?
Submit them here.
We invite you to share real-world examples of how you’ve implemented overdose anomaly detection activities in your jurisdiction and how the Toolkit has supported your efforts. Please send your stories to CSTE at overdose@cste.org.
Acknowledgement Statement
Acknowledgement Statement
This toolkit was supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $200,000 with 100 percent funded by CDC/HHS. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. Content was developed in collaboration with the CSTE Overdose Anomaly Workgroup, Kahuina Consulting, LLC, and partner subject matter expert contributors. Thought Bridge, LLC developed original website content.
This toolkit was supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $200,000 with 100 percent funded by CDC/HHS. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. Content was developed in collaboration with the CSTE Overdose Anomaly Workgroup, Kahuina Consulting, LLC, and partner subject matter expert contributors. Thought Bridge, LLC developed original website content.