Cele Fichter DeSando, MPM
In the 1970’s we entered into what is now known as the Information Age, a time period in which information has become a commodity that is quickly and widely disseminated and easily available through the use of the computer1. One of the consequences of the rapid influx of information can be information overload. “Studies have shown that when individuals are overloaded beyond capacity, adverse effects such as information avoidance, confusion in decision making, and lack of compliance with recommended behaviors may emerge”2. Information overload does not only affect individuals but can also impact organizations and health and prevention practitioners. Careful attention should be given to provide information in a manner that allows for solution-driven strategies and targeted responses.
We are eight months into 2021 and more health-related data from 2020 comes in every day. Last month, the CDC released provisional data that more than 93,000 people died of a drug overdose in the U.S. in 2020, an increase of 29.4% from 20193. At this time, this data is not broken down by race but previous trends show an alarming increase in opioid deaths among Black/African Americans compared to other populations4. The increase in overdose deaths comes at a time when the age-adjusted death rate increased for the first time since 2017, with an increase of 15.9% compared with 2019, from 715.2 to 828.7 deaths per 100,000 population. The age-adjusted death rate increased by 15.9% in 2020. Overall death rates were highest among non-Hispanic Black persons and non-Hispanic American Indian or Alaska Native persons. COVID-19 was the third leading underlying cause of death in 2020, replacing suicide as one of the top 10 leading causes of death5.
August 31, 2021, is International Overdose Awareness Day. International Overdose Awareness Day is the world’s largest annual campaign to end overdose, remember without stigma those who have died, and acknowledge the grief of the family and friends left behind6.
As public health professionals strive to use the recent overdose data and age-adjusted death data to plan effective prevention and intervention strategies for overdose awareness programs, other health disparity data has emerged. In a cohort study published in the Journal of American Medicine Association Psychiatry, of 83.7 million emergency medical system patient encounters, overdose-associated cardiac arrests rose about 40% nationally in 2020, with the largest increases among racial/ethnic minorities, in areas of socioeconomic disadvantage, and in Western states7. This new data follows previous reports that highlighted disparities in overdose deaths. An Agency Health Quality Research (AQHR) report highlights that since 2013, a sharp increase in drug overdose deaths involving synthetics other than methadone has occurred across ethnic populations. Non-Hispanic Whites had the highest mortality rate due to synthetic opioids other than methadone in 2017 but non-Hispanic Blacks experienced an 18-fold increase in mortality due to synthetic opioids other than methadone this was compared to a 12.3-fold increase among Hispanics and a 9.2 fold increase in non-Hispanic Whites8. At a time when overdose deaths are increasing among African Americans, AHRQ published a study in the New England Journal of Medicine study that found the average annual opioid dose prescribed to White patients by health systems was 36 percent higher than the average dose prescribed to Black patients. There was no evidence found of race differences in perception of pain or pain management preferences. The authors called for further research to investigate potential conscious and unconscious racial bias in prescribing patterns.
In preparation for this article, I was beginning to experience my own information overload. I was saddened and disturbed by the 2020 data and health disparities associated with it. I was having difficulty focusing and moving forward. I was reminded of a commentary by MSNBC journalist Joshua Johnson that aired in January. Johnson asked “What are you doing to let go of 2020”. In this powerful thought-provoking message, Johnson suggests that we need to acknowledge our sadness before we can move on and begin to heal.
Taking time to grieve and acknowledge the health disparities that exist is a necessary part of prevention programming. In planning for Overdose Awareness Day, one of the goals is to provide an opportunity for people to publicly mourn loved ones in a safe environment without guilt or shame. In planning community events for this day we can help individuals, families, and communities grieve and begin to heal.
Another goal of Overdose Awareness Day is to give information about the issue of fatal and non-fatal overdose9. How do we give this information and what are we to do with it? Information can overload us and be overwhelming but information can also provide guidance and direction to form strategic prevention responses that address disparities. One of my favorite Maya Angelou quotes is “Do the best you can until you know better. Then when you know better, do better.” In order to do better, we have to know better and this is where information from reliable sources is vital.
CDC Opioid Response
The CDC has developed strategies to prevent opioid overdose and opioid-related harms and provides timely data to inform prevention and response efforts. CDC data help improve coordination and promote readiness for regional or multiple state fatal overdoses10.
Opioid Response Network
In response to the Opioid Crisis, SAMHSA created The Opioid Response Network (ORN) to provide training and consultation to address the opioid crisis11.
The ORN has local consultants in all 50 states and nine territories to respond to local needs by providing free educational resources and training to states, communities, and individuals in the prevention, treatment, and recovery of opioid use disorders and stimulant use. The ORN can be contacted at [email protected].
In response to the racial disparities in the opioid crisis, SAMHSA developed a guide “The Opioid Crisis and the Black/African American Population: An Urgent Issue.”12 The guide provides evidence-based and community-informed population-based strategies for prevention, treatment, and community professionals.
The available resources can help us plan and strategize but they can’t help us avoid information overload. One way to do that is to follow the theme of International Overdose Awareness Day 2021 “Time to Remember. Time to Act.” Let’s take the time to do both.
Cele Fichter-DeSando, MPM (She, Her) is a consultant and trainer in substance use and gambling prevention and tobacco prevention and control. Cele has a Master’s degree in Public Management from Carnegie Mellon University and more than 35 years of experience in the management, training, and implementation of research-based prevention programs in Pittsburgh, Pennsylvania. In 2020, Cele started a certified woman-owned business, CFD Consulting LLC, and has provided consulting for numerous organizations including Tobacco-Free Allegheny, the PTTC Network, and the Danya Institute Central East ATTC. She is passionate about providing resources, materials, and practical applications for evidenced-based prevention programs and prevention science to prevention practitioners.
Cele Fichter-DeSando, MPM
CFD Consulting, LLC
[email protected]
412-580-3089
1. https://www.merriam-webster.com/dictionary/Information%20Age
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763334/
3. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
4. https://store.samhsa.gov/sites/pttc/files/SAMHSA_Digital_Download/PEP20-05-02-001_508%20Final.pdf
5. https://www.cdc.gov/mmwr/volumes/70/wr/mm7014e1.htm
6. https://www.overdoseday.com/
7. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2780427
8. https://www.ahrq.gov/sites/pttc/files/wysiwyg/research/findings/nhqrdr/dataspotlight-opioid.pdf
9. https://www.overdoseday.com/
10. https://www.cdc.gov/opioids/framework/index.html
11. https://opioidresponsenetwork.org/index.aspx
12. https://store.samhsa.gov/sites/pttc/files/SAMHSA_Digital_Download/PEP20-05-02-001_508%20Final.pdf
Ahmad FB, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2021.Designed by LM Rossen, A Lipphardt, FB Ahmad, JM Keralis, and Y Chong: National Center for
Health Statistics https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
Friedman J, Mann NC, Hansen H, et al. Racial/Ethnic, Social, and Geographic Trends in Overdose-Associated Cardiac Arrests Observed by US Emergency Medical Services During the COVID-19 Pandemic. JAMA Psychiatry. Published online May 26, 2021. doi:10.1001/jamapsychiatry.2021.0967
Hong, H., & Kim, H. J. (2020). Antecedents and Consequences of Information Overload in the COVID-19 Pandemic. International journal of environmental research and public health, 17(24), 9305. https://doi.org/10.3390/ijerph17249305
Morden, N. E., Chyn, D., Wood, A., & Meara, E. (2021). Racial Inequality in Prescription Opioid Receipt - Role of Individual Health Systems. The New England journal of medicine, 385(4), 342–351. https://doi.org/10.1056/NEJMsa2034159
Substance Abuse and Mental Health Services Administration: The Opioid Crisis and the Black/African American Population: An Urgent Issue. Publication No. PEP20-05-02-001. Office of Behavioral Health Equity. Substance Abuse and Mental Health Services Administration, 2020.
https://store.samhsa.gov/sites/pttc/files/SAMHSA_Digital_Download/PEP20-05-02-001_508%20Final.pdf
