Strategies to operationalize the prevention of overdose death (stop OD) - new york city (NYC), like the rest of the nation, continues to experience an increase in drug overdose deaths

The rate of unintentional drug overdose death in NYC has increased by 80% since 2019 and 25% since 2020, from 21.9 per 100,000 residents in 2019 to 39.4 per 100,000 residents in 2021. An opioid was involved in 84% of overdose deaths in NYC in 2021, compared to 75% nationally. If these trends continue, more overdose deaths will have occurred in 2022 in NYC than during any prior year on record. NYC's department of health and mental hygiene (NYC dohmh) has successfully implemented several interventions and programs to address the overdose epidemic. However, sustained high rates of overdose death in NYC warrant the expansion of current initiatives and the implementation of new strategies. In response to the funding opportunity CDC-RFA-CE-23-0003: overdose data to action: limiting overdose through collaborative actions in localities (OD2A-L), NYC dohmh will apply for funding for components a and B, as well as the ocme supplement with component B. NYC dohmh will not be applying for component C. To strengthen NYC's response to the overdose epidemic and reduce overdose deaths, we are proposing a portfolio of cross-cutting and innovative activities, including: component a enhance overdose prevention, education, and linkage to substance use treatment and care in HCV programs utilizing peer and patient navigators conduct overdose prevention and HCV data-to-care clinical capacity-building projects with NYC health care facilities provide nurse care manager navigator support and program support for occupational therapy training at an NYC organization that provides substance use and mental health treatment and harm reduction services conduct a needs assessment to describe recovery capital in a neighborhood with endemically high overdose rates and provide support to implement recommendations integrate harm reduction education and tools into outreach with people experiencing homelessness and provide appropriate linkage to care support overdose education training and naloxone distribution to people who use drugs and people who may witness and respond to overdose enhance fentanyl and xylazine test strip distribution to people who are not engaged with ssps and those who might be opioid naïve enhance NYC's existing infrared spectrometry drug-checking program support system's champions for SUD and pain care in healthcare systems strengthen real-time drug-related morbidity surveillance and enhance prescription drug monitoring program surveillance component B enhance drug product and paraphernalia testing for drug supply surveillance improve medical examiner and coroner investigation of drug overdose deaths NYC dohmh has been at the forefront of drug surveillance and research across the country for the past 20 years and has established a comprehensive public health surveillance system with broad and deep relevant expertise to monitor, track, and respond to drug-related harms in NYC. NYC dohmh has a long history of collaboration with stakeholders across multiple sectors and levels of government, which is a crucial tool in the agency's efforts to reduce overdose death and improve the wellbeing of people who use drugs.