No single institution or sector can solve illicit substance use and misuse. Improving communication and collaboration among public health, public safety, and behavioral health systems can help coordinate a more timely and effective response to illicit substance use and misuse, overdoses, and deaths. Cross-system partnerships that facilitate information sharing can help stakeholders identify key gaps, as well as opportunities to build collective solutions that maximize limited resources and enhance overall response efforts. One of the earliest public health and public safety projects funded by BJA was the RxStat initiative that was established in New York City. RxStat is housed at the New York City Department of Health and Mental Hygiene (Health Department) and is co-led by the New York/New Jersey High Intensity Drug Trafficking Area (NY/NJ HIDTA) Program. The goal of RxStat is to reduce overdose deaths and to elevate the message that drug overdose deaths are preventable. RxStat involves timely analysis of drug misuse indicators from multiple data sources, including emergency department, fire, and EMS personnel, the medical examiner, state prescription data, the Drug Enforcement Administration, and the Manhattan District Attorney’s Office. These data are used to identify high-risk populations and places and direct the rapid deployment of public health and public safety resources. The Bureau of Justice Assistance (BJA) funded a technical assistance manual for New York City’s RxStat program to provide a road map for communities interested in replicating this model.
BJA also supports the development of local overdose fatality review (OFR) teams which are multiagency, multidisciplinary teams that meet regularly to share, review, and analyze data associated with drug overdose descendants. Similar to RxStat, the focus is on prevention through multistakeholder information sharing at the descendant level. The OFR process uses a problem-solving framework to review the overdose event, as well as the days, weeks, and years preceding the event, to identify missed opportunities for prevention. Stakeholders include public health, law enforcement, prosecution, medical examiner/coroner, EMS, jails, corrections, schools, child welfare, behavioral health, health-care, and substance use treatment providers. Overdose fatality reviews are effective at informing strategic prevention planning, improving quality of services provided to people at risk, and strengthening public safety and community-based responses to illicit substance use and misuse.