Zero Overdose

Nature of the Problem

Data on overdose rates shows us that there are many pathways which can lead to accidental overdose: any patient who is actively using illicit or prescribed substances which put them at risk of overdose. Additionally, patients who are not actively using or prescribed substances with risk of overdose, but have known stressors associated with overdose risk such as: early recovery, suicidal ideation, history of overdose, or recent transition from incarceration or higher level of care like a residential rehab. Zero Overdose is advancing a model of care which represents best practices in overdose prevention. Zero Overdose has developed a safety plan that is specifically for providers and their patients with substance use disorder. OD Safety Plan is a tool that providers and patients can complete together. The OD Safety Plan offers language and a guide on the needed conversation about the reality of overdose risk between provider and patient. Through compiling tools and resources, leading trainings and webinars, hosting learning communities, and contributing to research, Zero Overdose unites a growing community of health professionals and member agencies aiming to reduce impact of alcohol, substance use and eliminate overdose deaths among those within their care.

Program Description

Zero Overdose is dedicated to helping patients manage their substance use disorders. Zero Overdose uses The Overdose Safety plan as a way to have an open dialogue about addition between patients and clinicians. The OD Safety Plan consists of 7 parts. Following completion of an overdose risk screening, the clinician and patient collaborate to complete the plan together. The process of completing an OD Safety Plan is a clinical intervention, not viewed separate from care. It requires clinical skill to balance the emphasis on eliciting patient’s ideas with psycho education on identified risk and available prevention strategies as needed. The 7 parts of the OD Safety Plan include the following: Step 1: Things which put me at risk of accidental overdose; Step 2: Actions I can take to reduce my risk of overdose; Step 3: Things I do regularly (or want to do more) to stay well; Step 4: People who support my wellness and I can ask for help; Step 5: Professionals and agencies I can call in a crisis; Step 6: The number one reason I want to live today; Step 7: The next step I am willing to take to reduce my risk.

Disruption

The OD Safety Plan is one-page template which a patient and provider use to develop a prioritized list of overdose risk factors, prevention strategies and sources of support. The plan is written using the patient’s own words, they are provided a copy to take with them and encouraged to use the identified prevention strategies, resources and supports to reduce their risk of overdose. After completing the OD Safety Plan, the patient keeps a copy, and the plan is also shared with their care team to be integrated into treatment. Use of the plan should be reviewed at upcoming appointments, revised as needed and barriers to its use addressed. Trainings around the OD Safety Plan have already been completed in FQHCs in New York, community health centers and tribal health centers in Montana.

Leadership

Zero Overdose is comprised of clinical and implementation specialists advancing a model of care which represents best practices in overdose prevention. Through compiling tools and resources, leading trainings and webinars, hosting learning communities, and contributing to research, Zero Overdose unites a growing community of health professionals and member agencies aiming to reduce the impact of alcohol and substance use, and to eliminate overdose deaths among those within their care. Zero Overdose continues to expand and connect with national behavior health organizations and provide trainings on the OD Safety Plans.

Scalability

The OD Safety plan is free and available online on the Zero Overdose website and accessible to any clinician. Hopefully, with the success of the Scattergood Foundation Innovation Award, the Zero Overdose name will be shared with other behavioral health organizations at the NatCon conference. With more visibility, we anticipate the scalability of the Zero Overdose program as well as the OD Safety plan. In addition to this award, Zero Overdose is actively applying to grants in order to evaluate the safety plan and gain funding mechanisms to launch the OD safety plan nationally. Zero Overdose is working with Zero Suicide on further analyze of safety plans and how we can make prevention techniques more sustainable.

Results/Outcomes

Preliminary survey data of the OD Safety Plan trainings have been successful. Based on the pre-training surveys, 100% of the participants believed it was important to screen for risk of overdose in the primary care settings. Participants also agreed that talking about overdose prevention can be beneficial to patients, however; 62% of the participants said they did not talk about overdose prevention with their patients. Of this total, 54% of the participants did not feel confident in their ability to discuss risks of overdose with their patients. Our training aims to address these feelings of comfortableness and lack of confidence for providers. Results from the post training survey showed that 100% of the attendees said the training was an effective way to learn about Overdose Safety Planning. Participants also said they would use the OD safety plan with their patients after the training.