This entry features an interview with NACCHO Annual 2017 presenter and Substance Abuse Prevention Coordinator for the Tri-County Health Department in Colorado, Steven A. Martinez, MA. His session, “Tri-County Overdose Prevention Partnership: A Community-Led, Local Health Department-Facilitated, Collaborative Effort,” described the importance of partnerships to address prescription drug misuse in local communities. Below he shares his health department’s process for convening partnerships and assessing, planning, and implementing collaborative strategies.
What was the burden of overdose in your jurisdiction? How did your department assess the need for addressing prescription drug misuse in the community?
Over the past five years, opioid-related overdoses have been steadily increasing in Adams and Arapahoe Counties in Colorado. In Adams, Arapahoe, and Douglas Counties, opioid-related deaths have become more common than deaths caused by drunk driving. In 2010, Colorado was ranked number two in the United States among young adults ages 12–24 for self-admitted, non-medical use of prescription drugs. In all three counties between 2011and 2016, there were a total 522 opioid-related deaths. The need to address this issue was initially facilitated by the commissioners from Adams and Arapahoe counties. Communities within both counties were seeing opioid-related issues, including overdoses, as a concern. Originally, political will was the driving factor behind convening a tri-county partnership.
How did you build the Tri-County Overdose Prevention Partnership? What strategies did you use to engage public and private partners?
The Tri-County Overdose Prevention Partnership (TCOPP) is a community-based partnership that was initially called into place by Adams and Arapahoe County Commissioners, who requested that the Tri-County Health Department facilitate the efforts. Our main goals were to prevent overdose deaths in our three counties and increase awareness and education about the factors leading to an overdose. The strategic framework that was used to build the partnership was adopted from The Colorado Consortium for Prescription Drug Abuse Prevention, which consists of six overarching strategy areas: (1) youth prevention; (2) public awareness; (3) provider education; (4) safe disposal; (5) naloxone; and (6) treatment.
Tri-County Health Department has strategically identified needed partners and convened local partners through word of mouth. TCOPP consists of both public and private partners and has been formed to include state and local organizations as well as community members.
What are some of the outcomes that resulted from the partnership?
TCOPP saturated its six strategy areas at the local level. This includes public awareness of prescription drugs misuse and abuse and naloxone availability, implementation of additional medication safe disposal sites, provider education events, youth substance abuse prevention initiatives, and identification of treatment gaps at the local level. In addition, TCOPP conducted a town hall forum in Arapahoe County to engage the community in a panel discussion and to hear their concerns.
Together, we are taking steps to reduce the problem of opioid overdoses by safely prescribing prescription drugs. We encourage the public to use prescription drugs as directed by their physicians and to be wary of buying prescription drugs online. Educating youth about the dangers of opioid abuse is a vital step in curbing the epidemic. Two organizations, Speak Now Colorado and Rise Above Colorado, have been instrumental in providing resources to parents, educators, and youth about substance abuse. On the TCOPP website, we have provided downloadable step-by-step graphics on how to administer injectable and nasal spray naloxone.
To reduce the misuse of unused and expired medications, several permanent medication collection sites have been set up throughout the state. We also provide online instructions about how to properly dispose of unused medications at home. Our website contains a list of resources that can help the public access treatment and prevention services. Also, we have a comprehensive list of healthcare partners that the community can contact to seek treatment and a crisis hotline for those seeking immediate support.
What challenges did you encounter while convening this partnership and executing the initiative?
Because of the size of Tri-County Health Department’s service area, incorporating the aforementioned strategies in areas as large as Adams and Arapahoe counties has been a challenge. Implementation at the local level has been strategic and focused on communities within those counties that have higher rates of consumption and negative outcomes such as high overdose rates. Additionally, because the partnership is a multi-county initiative, convening all the necessary partners on a consistent basis has also been a challenge.
What value did you find in attending NACCHO Annual?
This was my first time attending NACCHO Annual and I really appreciated hearing what local level initiatives other city and county health departments were working on. Also, because the focus was on local level programs, I was most excited to see and learn about the different approaches to public health concerns at a community level.