The cuyahoga county medical examiners office (ccmeo) proposes to implement the cuyahoga county overdose fatality review counteractive initiative (ccofrci)

The purpose of this effort is to enhance cuyahoga countys overdose fatality review (OFR) to promote cross-system coordination within the criminal justice and behavioral health systems for the identification and implementation of preventable risk factors and missed opportunities for intervention in order to reduce overdose deaths in cuyahoga county, particularly for those historically marginalized, underserved, and adversely affected by inequality in cuyahoga county, ohio (metropolitan cleveland). The OFR is a 20+ member, multidisciplinary body established in 2013 that shares identified cross-agency data to conduct intensive case reviews of exemplar overdose deaths, to identify systems gaps, and create recommendations, all with the purpose of learning from fatal overdose deaths and working towards decreasing deaths. This process and access to cross-agency information is uniquely distinctive to ofrs. The OFR is under the purview of the ccmeo and CO-led by the cuyahoga county board of health. Project activities include enhancing the OFR, with the addition of desk reviews and increasing the number of reviews from 18 to 54. Subrecipient activities include (1) 54 next-of-KIN interviews conducted by the alcohol, drug addiction and mental health services board; (2) the university of kentucky institute for pharmaceutical outcomes and policy will pilot and develop a natural language processing (NLP) plug-in for the cossap OFR data system (cossap DS) for use by all ofrs who utilize this data system; and (3) the case western reserve university (cwru) begun center for violence prevention research and education will conduct survey and focus group/interviews with OFR stakeholders to evaluate the utility of OFR recommendations and apply risk terrain modeling to findings from the OFR to inform a county-wide educational outreach program in year three. Expected outcomes include: (1) increasing the pool of OFR cases to substantiate findings from previous reviews; (2) oversampling of populations of interest to understand variability of characteristics not captured due to the limited sample (priority 1A); (3) implementation of a county-wide community outreach education campaign to share emerging overdose trends and promote public health strategies to reduce overdoses; and (4) create a resource guide that describes the OFR model of cuyahoga county and its application of the cossap DS that can benefit and assist other ofrs.