Stakeholder Analysis/Partner Identification 

Internal stakeholders will include those who have named responsibilities in the plan (e.g., epidemiologists who are validating data), those who have accountability for the plan or its communication to the public, and anyone else within the internal agency with a “need to know.” A particular byproduct of the opioid crisis has been novel collaborations of syndromic surveillance division staff with other divisions such as Injury Prevention, Behavioral Health, Substance Abuse, and others, depending on the public health organization.  For efficient investigation and response, these internal relationships need to be sustained within the constraints of shareable information. 

External agency stakeholders will vary depending on whether a local, regional, or state health department is leading. There will be a need to either report upstream or share downstream to impacted partners. It would also be mutually beneficial to overcome traditional barriers to information sharing with public safety and law enforcement as opposed to considering these entities as community stakeholders. For example, the National Emerging Threats Initiative (NETI) has published several studies showing how drug seizure data and drug overdose data overlap at the same time points.1  Other external agency stakeholders can include EMS, healthcare and emergency departments, behavioral health providers, harm reduction services, syringe service providers and prevention organizations. 

Community stakeholders can be as broad or as narrow depending on capacity or local conditions to develop and maintain these relationships. Cultural awareness and competency are applicable at this level – inclusion of faith-based, LBGTQ+, persons who speak languages other than English, and Black, Hispanic, and Native American or other special populations when developing a communication network. Applying an equity lens to the work at this juncture can be important to the overall successful implementation of the plan being created.  

In addition to identifying stakeholders, it is important to identify actionable steps that may be taken in community or state during an overdose response. These actionable steps can be as simple as reminding everyone about stigma and how to destigmatize their use of language and images when discussing the event. This has been cited by clinicians, treatment specialists, and social workers as essential for mitigating the opioid epidemic at the grass roots level. The steps may include disseminating local or state hotline numbers, enhancing access to naloxone or naloxone training, and reminding the public of the signs and symptoms of overdose and Good Samaritan Laws. When working with stakeholders, media, and the public, try to identify all their actionable items, creating an easily referred to document that can be leveraged in the future when it is needed again.