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The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county, & community efforts.

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Program Components

FL-ESOOS Program

Dr. Karen Card - Principal Investigator

Non-Fatal Opioid Overdoses 

Key Strategy: Increase the timeliness of aggregate non-fatal opioid overdose reporting with enhanced surveillance using Florida’s Emergency Medical Services Tracking and Reporting System (EMSTARS).

Using incident level data from EMSTARS, the Bureau of Emergency Medical Oversight (Bureau) tracks all suspected drug overdoses and suspected opioid overdoses, including pain relievers, heroin, and illicitly made fentanyl. The Bureau analyzes the non-fatal opioid overdose surveillance data and generates reports on more rapid, reliable, and geographically-specific changes in non-fatal opioid overdose rates. The Bureau generates state- and county-level reports on a quarterly basis on the selected two indicators. The reports provide the number and rate of any-drug and any-opioid overdoses, as well as analyses by demographic and contextual factors.

Fatal Opioid Overdoses 

Key Strategy: Increase the timeliness of aggregate fatal opioid overdose reporting by using the Department’s Bureau of Vital Statistics Death Certificate (DC) data, and establishing data partnerships with the Medical Examiner (ME) community to access risk factor and toxicology data.

The Bureau initially targeted a subset of ME districts, and planned to increase the scope over time. The initial subset accounted for approximately 82 percent of all 2015 unintentional and undetermined drug overdose deaths based on data from the Centers for Disease Control and Prevention’s (CDC’s) WONDER database.

Available reports (e.g., toxicology, autopsy, investigator) are then requested monthly from the ME districts based on a list of decedents meeting the CDC’s case definition according to DC data. Bureau staff abstract risk factor, toxicology, and other CDC-requested data elements from the DC and ME reports into the CDC’s National Violent Death Registry System’s State Unintentional Drug Overdose Reporting System module.

The Bureau facilitates analysis of the fatal opioid overdose surveillance data to compare the following characteristics of the decedents with the Florida general population: 1) Demographic Information: age, sex, race and ethnicity, area of residence, and place of death; 2) Co-Morbidities: drug dependency, chronic pain conditions, and mental health disorders; and 3) Personal Characteristics: prior rehabilitation treatment, previous overdose, and prescription history. The Bureau analyzes the other substances in the decedents’ system at time of death, and whether the opioid was prescription, non-prescription, and/or illicit. Semi-annual reports containing this information are made available.

In addition, the Bureau assists participating MEs by providing them with access to supplemental grant funds should they not have adequate local funding. The funding helps to:1) Increase the frequency of comprehensive toxicology testing performed for all suspected opioid overdose deaths; and 2) Increase the frequency of specialized toxicology testing to identify specific fentanyl analogs and other synthetic opioids in suspected opioid overdose deaths. This facilitates more complete toxicology findings received from the participating ME districts. The Department accepts proposals from the ME districts for alternative uses of the funding to enhance the timeliness and quality of ME investigations of suspected opioid overdose deaths if they have adequate local funding for toxicology testing.

Data Dissemination 

Key Strategy: Comprehensively disseminate data to key stakeholders working to prevent or respond to opioid-involved overdoses by using multiple tools and communication vehicles.

The Bureau performs environment and stakeholder analyses to properly develop its dissemination plan. The Bureau implements the dissemination plan to share actionable insights from surveillance data findings and reports with key stakeholders.