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The purpose of the CT Project to Prevent Opioid Overdose Deaths is to support 5 communities that are shouldering a disproportionate burden of the state's opioid epidemic, in developing and implementing prevention and response strategies that reduce overdose deaths in individuals age 18 and older. Building on the numerous efforts afoot within the state, communities will raise public awareness about the risks of opioid misuse, provide education on preventing and managing opioid overdoses to firs responders and other stakeholders, distribute naloxone to community members in need, and publish, distribute and train on a local directory of opioid overdose prevention, treatment and recovery resources. A subcommittee of the statutorily mandated CT Alcohol and Drug Abuse Policy Council, with its broad representation of agencies and individuals with interests and resources in prescription drug/opioid overdose prevention issues, will serve as the advisory council for the project. A mixed methods approach will be used to assess whether progress is being made towards goals, objectives and outcomes and improvements need to be made. It is anticipated that 4,300 individuals will be trained and measurable reductions in opioid overdoses are achieved in funded communities.

The goal of the NJ Division of Mental Health and Addiction Services' (DMHAS) PDO-NJ initiative is to reduce the number of prescription drug/opioid overdose-related deaths and adverse events among individuals 18 years of age and older by training first responders and other key community sectors on the prevention of prescription drug/opioid overdose-related deaths and implementing secondary prevention strategies, including the purchase and distribution of naloxone to first responders and other target groups. DMHAS in partnership with Rutgers University, Robert Wood Johnson Medical School (RWJMS) will implement a training program for individuals who use opioids, their families and significant individuals on how to recognize and respond to an overdose with the use of naloxone and rescue breathing. NJ-PDO training will include referral and care management procedures to connect individuals, their families and loved ones to treatment and recovery support services. The project will also help to advance the use of best opioid prescribing practices among health care providers. Although DMHAS has developed a number of treatment and prevention initiatives to reduce opioid-related deaths, including the Opioid Overdose Prevention Network funded by SAMHSA's PDO grant, NJ ranks 8th in the nation in overdose deaths (CDC Wonder). DMHAS' administrative data system indicates that few persons who undergo a naloxone reversal access treatment. This project will serve as a conduit to increased access to substance use disorder (SUD) treatment. All PDO-NJ training attendees will be provided with: information on referral to treatment, the website link to the DMHAS treatment directory, the Interim Managing Entity's (IME) toll free number and information on DMHAS' recovery support services. DMHAS' IME operated by Rutgers University Behavioral Health Care will serve as a coordinated point of entry/no wrong door for individuals served by this project who seek SUD treatment. Training will be targeted to first responders, high need areas identified by the PDO-NJ initiative, and other target groups including: agencies and organizations working with justice involved populations and offender re-entry programs; healthcare professionals; pharmacists; syringe access programs; community health centers; women's SUD providers; the Opioid Overdose Recovery Program that serves high risk individuals who have undergone a naloxone reversal; colleges; and outreach to the National Guard, military bases and construction trades in adopting opioid overdose response programs as part of their standard workplace safety protocols. Trainings will include virtual, in-person when permitted, webinars and development of on-line training materials. Using a combination of in-person and virtual training, PDO-NJ will train an estimated 3,600 individuals annually, with a total of 18,000 over the five-year grant period.

The Tribes of Wisconsin Prescription Drug/Opioid Overdose-Related Deaths Prevention Project (TWI-PDO) plans to serve and train over 5,100 people, with 700 people in Year 1, and then 1,100 each year thereafter. TWI-PDO will use a comprehensive, culturally appropriate approach focusing on two main goals: 1) Reduce the number of opioid overdose-related deaths and adverse events by 10% among individuals' ages 18 years and older; and 2) Develop and implement a comprehensive secondary prevention campaign to address opioid overdose-related deaths and adverse events in high risk communities. Activities will focus on the reduction of deaths and adverse events by training first responders (Emergency Medical Services [EMS], law enforcement, fire & rescue, and crisis workers) and other key community sectors on the prevention of overdose-related deaths and implementing secondary prevention strategies, including the purchase and distribution of naloxone to first responders. Funding will go to three federally-recognized tribes in three high need counties in Northern Wisconsin: the Menominee Tribe, Lac Courte Oreilles Tribe, and an additional Tribe to be determined later, in coordination with the Tribal Affairs Office in the Department of Health Services (DHS). Wisconsin has been experiencing a surge in opioid pain reliever prescriptions and its harmful consequences since the early 2000's. Since the start of the increase, the age-adjusted death rate from opioid overdose has increased over five-fold. The combined needs assessment indicators highlight the health and economic disparities of highest percentage outlined the need for support of the Native American/Indigenous (NA/I) residents in Wisconsin. State level data reveal racial/ethnic disparities for opioid-related deaths are more than two times the rate for NA/I residents than White residents. The same is true for synthetic opioids. Overall, these statistics, in part, help to explain the life expectancy gap the Indian Health Service reports for American Indian and Alaska Natives as 5.5 years less than all other racial-ethnic groups in the United States. The needs assessment for this proposed application identified an initial group of high risk tribal nations to engage in project activities focused on access to services, urban/rural classification, risk indicators based on opioid poisoning deaths, hospital admissions, emergency room visits, and naloxone EMS runs. Utilizing an algorithm based on risk and protective factors, DHS has received commitments from two tribal nations, with one to be determined, that are in high need of prevention efforts to reduce deaths from prescription opioid drugs and/or illicit opioids (i.e. heroin) among persons ages 18 and older. These proposed activities in counties with tribal lands and peoples also support Governor's and the DHS' effort to provide public health solutions to address health disparities across the state.