CSTE Overdose Anomaly Toolkit: Harm Reduction Data

Harm Reduction Data

Last Updated: March 2022

Syringe Services Programs (SSPs) 

Syringe services program (SSP) clients are valuable resources for timely information regarding new substance use trends. SSPs are also great mechanisms through which information can be disseminated to the populations who need it most. Michigan has a platform through which SSP services are logged and uses that same system to generate push alerts which get information out to clients as well as to obtain information (e.g., on new substance use trends) via temporary surveys. Also consider learning more about the National Harm Reduction coalition

Swift Toxicology for Opioid Related Mortalities (STORM) 

The STORM system is a rapid death toxicology testing program that operates out of the Western Michigan University Medical School that leverages post-mortem biological samples submitted by participating medical examiner offices. New data are available on a weekly basis. A 4-week rolling average and standard deviation for fentanyl, heroin, xylazine, cocaine, amphetamine, and methamphetamine are calculated by county. If a given county is three standard deviations above the mean for that rolling average, an alert will be generated. Especially lethal substances such as carfentanil generate an alert for one or more associated fatalities in the state.  

Michigan staff run SAS code every week based on updated data to generate alerts.  

Partner Systems/Systems External to the Health Department

The poison control center will be especially useful in working with these data as you are likely to have some drug-specific questions that only a toxicologist can adequately answer. Law enforcement and drug seizure data, if possible, should be used to add context. Changes in drug seizure data, in some states, have been shown to correlate with fatal overdoses (New Drug Threats: Latest on the Stimulant Crisis PPT).  

How to modify parameter settings if results are not useful
In addition to the modification described in the first section, the adjustments below can be made to STORM alerts:

  1. Multiple ICD codes may be assigned to a single visit, using patient visits for use rather than counts of ICD codes will provide a more robust threshold.
  2. Consider drug lethality when setting an alert to ensure that you do not receive more alerts than desired for less lethal substances.

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