OD2A Case Study: Linkage to Care in Non-Public Safety Settings

At a glance

Learn about linkage to care in non-public safety settings from Overdose Data to Action in Massachusetts.

How can linkage to care in non-public safety settings work to reduce drug overdose?

Case Studies: Linkage to Care in Non-Public Safety Settings - Full Report

The rate of drug overdose deaths continues to increase in the United States.1

Access to care and services for persons who use drugs is critical to addressing the current overdose epidemic. Linkage to care, or the process of connecting people at risk of overdose to evidence-based treatment, services, and supports, is an integral overdose prevention strategy.2 Warm handoffs by peer support navigators can help people better navigate systems of care. Events that may prompt an individual being linked to care include:

  • An overdose event
  • A visit to syringe services program
  • Diagnosis of HIV or viral hepatitis
  • Interactions with public safety

Individuals can be linked to treatment/services3 including:

  • Medications for opioid use disorder (MOUD) (buprenorphine, methadone, naltrexone)4
  • Behavioral health therapy (e.g., contingency management, motivational interviewing)5
  • Wrap around services such as mental health care, transportation, peer support, infectious disease care, obstetric care, or harm reduction services that can address barriers to care

Overdose education and naloxone distribution (OEND) is an important service that is commonly linked to overdose prevention. OEND aims to reduce harm and risk associated with an opioid-involved overdose and includes access to naloxone,6 education, and training on how to prevent and recognize an opioid overdose and how to administer naloxone.4

Case study snapshot

Case 1: Linkage to Care and Overdose Education & Naloxone Distribution Program – Massachusetts

  • The Massachusetts Department of Public Health (MDPH) funded agencies to provide HIV/hepatitis C (HCV)/sexually transmitted infection (STI) testing and linkage to care services for persons who inject drugs (PWID); these services facilitate access to HIV/HCV/STI medical care and treatment, MOUD, and harm reduction services. In addition, several agencies offer overdose education and naloxone distribution (OEND) services.
  • Services are provided in a range of settings, including but not limited to service center locations, street outreach, and mobile service venues.
  • The Massachusetts Bureau of Infectious Disease and Laboratory Sciences worked with several population health advisory groups and a committee of providers and consumers to solicit input from community partners.
  • A combination of data (overdose death, HIV surveillance, HIV/HCV/STI diagnoses, and OEND program), monthly group calls with OEND providers, and agency-level calls with each provider allow MDPH to coordinate rapid responses to evolving needs.

For more information about Massachusetts's Linkage to Care and Overdose Education & Naloxone Distribution Program, check out the full report Case Studies: Linkage to Care in Non-Public Safety Settings.

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Content Source:
National Center for Injury Prevention and Control
  1. Hedegaard, H., Miniño, A. M., Spencer, M. R., Warner, M. (2021). Drug overdose deaths in the United States, 1999–2020. NCHS Data Brief, no 428. Hyattsville, MD: National Center for Health Statistics. https://dx.doi.org/10.15620/cdc:112340
  2. Mace, S., Siegler, A., & Wu, K. C. (2021). Overdose Response and Linkage to Care: A Roadmap for Health Departments. National Council for Mental Wellbeing. https://www.thenationalcouncil.org/wp-content/uploads/2022/02/Overdose-Response-and-Linkage-to-Care-Roadmap-1-November-2021-1.pdf
  3. Carroll, J.J., Asher, A., Krishnasamy, V., Dowell, D. (2022). Linking People with Opioid Use Disorder to Medication Treatment: A Technical Package of Policy, Programs, and Practices. Centers for Disease Control and Prevention.
  4. Korthuis, P., McCarty, D., Weimer, M., Bougatsos, C., Blazina, I., & Zakher, B., Grusing, S., Devine, B., & Chou, R. (2017). Primary Care–Based Models for the Treatment of Opioid Use Disorder. Annals Of Internal Medicine, 166(4), 268-278. https://doi.org/10.7326/m16-2149
  5. National Institute on Drug Abuse. (2018, January) Behavioral Therapies. https://nida.nih.gov/sites/default/files/podat-3rdEd-508.pdf
  6. Lambdin, B. H., Bluthenthal, R. N., Wenger, L. D., Wheeler, E., Garner, B., Lakosky, P., & Kral, A. H. (2020). Overdose Education and Naloxone Distribution Within Syringe Service Programs — United States, 2019. Morbidity and Mortality Weekly Report, 69(33), 1117-1121. https://dx.doi.org/10.15585/mmwr.mm6933a2