Using GIS to Tackle the Opioid Crisis Industry Perspective
Executive Summary The United States is in the midst of a prescription drug epidemic. Every day, dozens of people die as a result of opioid overdose. In fact, among people 25-65 years old, drug overdoses from opioids caused more deaths than motor vehicle crashes. Clearly, addiction to opioids – drugs like fentanyl, heroin and pain relievers – is a problem facing hundreds of thousands of communities in America today. As such, government has a key role to play in quelling this epidemic. State and local governments in particular have the authority, resources and local knowledge to make a significant impact on the way opioid abuse is addressed. Yet many community governments continue to struggle with combating addiction. Why? Simply put, many communities lack a clear understanding of the opioid crisis and its impact. The scope of drug use and abuse is often hard to capture, especially in communities unaware of the problem. Moreover, treatment of opioid problems must be community-specific in order to effectively combat addiction.
Using GIS to Tackle the Opioid Crisis
Governments needs a way to better capture and relate the scope of this problem. Mapping and analysis has emerged as the preferred method to capture and relate the scope of the problem. Specifically, geographic information systems (GIS) can help organizations gain a clearer understanding of local dynamics that lead to drug addiction. That’s why GovLoop partnered with Esri for this industry perspective about using GIS to tackle the opioid epidemic. This industry perspective was informed by interviews with state and local government leaders, as well as conversations with thought leaders from the Esri community. Read on to learn how GIS can help put a face on this crisis to better inform and engage the public; how to better collaborate with other departments in your organization and make data-driven decisions; and about the role that GIS plays in exchanging data with stakeholders in the community.
The Opioid Epidemic With 78 Americans dying every day from an opioid overdose, drug-related deaths in the United States have hit an all-time high. The number of prescription opioids sold in the U.S. and the number of prescription opioid deaths have both quadrupled since 1999. Since then, over 165,000 people have died from prescription opioid overdoses. In many areas of the United States, this epidemic is only escalating in scope as state and local governments struggle to prevent the abuse.
But there is a solution that can address all of these complexities as well as increase awareness and connect opioid victims to help: geo-enabled data.
The complexity of the problem can’t be overstated. Opioid addiction can have many different causes, from overprescribing opioids for pain to improper disposal methods of unused drugs and limited treatment and rehabilitation resources.
The National Association of Counties (NACO), in partnership with the National League of Cities, created a National City-County Task Force on the Opioid Epidemic that’s based on this idea of using GIS to inform and combat the drug crisis. In addition to compiling the “A Prescription for Action” report on local leadership’s role, the task force used Esri’s ArcGIS platform to create an interactive map and story of the nationwide impact of opioid abuse.
As a result, effective methods to combat the epidemic are also incredibly diverse. While some communities simply need more education on the issue, others require more resource-intensive prevention strategies like more treatment centers or prescription drop-off locations. Determining the best prevention strategy in your community requires an in-depth understanding of how the crisis is playing out in your population. However, this understanding is often lacking. Many communities are unaware of the crisis happening in their backyards. Because opioid abuse has often been linked to low socioeconomic groups, many victims in more affluent or isolated communities suffer without treatment, and government officials may not understand the true scope of the issue. Others lack the resources or knowledge to seek help.
“GIS lets you visualize the epidemic. It shows you the intensity of the issue and that you can’t hide from this,” said Matt Chase, Executive Director at NACO. “Using GIS analytics, our members are finding that this isn’t something happening in one neighborhood. It’s a whole community. This issue is everywhere.”
The Role of Geography in Addressing Drug Abuse The role of geography is obvious in many community emergencies, like wildfires, hurricanes or flooding. Data from the field must be collected in real time to create an accurate portrait of conditions on the ground. That geo-enabled data is then sent to responders, allowing them to assess the situation and deploy resources to the areas most in need without wasting time culling through raw datasheets. Ultimately, GIS allows responders to make better decisions and save more lives. The same is true with the opioid crisis. In reality, tackling drug addiction is similar to tackling any other community emergency. Geography has a crucial role to play. First, GIS allows community leaders to gain an accurate picture of how and where opioid abuse is impacting their citizens. “Some people can’t really full comprehend and believe the scale when you just talk about it, so the best way to have conversations is through data,” said Matt Chase of NACO.
Using GIS to Tackle the Opioid Crisis
GIS also allows communities to better understand the issues at hand by painting a more holistic picture of drug abuse and its correlations to other community factors. Leaders can combine data from health care, human services and law enforcement to cover all aspects of opioid abuse and treatment. Then, they can map that data using location tags. Attaching locations to data regarding opioid prescriptions, abuse and mortality helps create a variety of visual and interactive maps of the crisis that can be used in a multitude of ways.
Some possible maps a government could create to help visualize, document and address the opioid crisis include:
Knowing where opioid abuse is most prevalent is the first step to understanding community-specific triggers. It can also paint a visual picture of how widespread the epidemic is, especially in communities that lack awareness about the crisis.
Providers and prescriptions.
While pharmaceutical opioids are necessary in some medical scenarios, mapping providers and prescription frequency can help identify where opioids are overused or abused as treatment options.
Prescription drop-off locations.
Mapping prescription drop-off events and locations helps citizens know where to discard of unused and/or expired prescriptions.
It is important to provide treatment and overdose prevention to people struggling with addiction. Medication-assisted therapy combines the use of medication with counseling and behavioral therapies. To prevent death from an overdose, naloxone may be administered to reverse the effects of the overdose. Mapping locations that provide medical and/or behavioral therapy helps victims receive treatment faster.
Esri provides a number of tools to help government agencies quickly create these resources. With ArcGIS, these maps can be published for leaders and other community stakeholders to interpret and use. Moreover, Story Maps let organizations combine authoritative maps with narrative text, images and multimedia content to paint a personal picture of drug abuse. Additionally, these maps can be updated regularly. Health care professionals and first responders can send real-time information on abuse and treatment from within the community, using tools like Esriâ&#x20AC;&#x2122;s Survey123 for field data collection. That ensures maps are updated in real time to keep track of the epidemic and keep leaders informed. That real-time, geo-enabled data lets community leaders, as well as other stakeholders, make better decisions regarding responses and treatment plans for communities suffering from the opioid epidemic. By combining disparate data sources to create a more comprehensive picture of the crisis, they can determine where resource allocations would have the most impact. Then, with Esriâ&#x20AC;&#x2122;s Executive Operations Dashboard, leaders can monitor the effectiveness of programs and policies. Ultimately, GIS can help communities identify causes of drug epidemics that are specific to their area; predict where drug abuse is likely; better allocate resources, including treatment centers and prescription drop-off locations; and increase outreach to the public, media and other government bodies.
GIS in Action State and local governments are already using GIS to inform and share their efforts to decrease drug abuse.
Arizona The Arizona Department of Health Services has created a series of static and interactive maps to help citizens and local providers tackle the opioid crisis. The department began by creating community profiles based on unique primary care areas, rather than traditional county or city lines. The interactive maps allow users to compare area data to statewide averages for a number of drug-related mortalities. To help users, the department also created a number of video tutorials that explain various data points and how to interpret them. More recently, the department also incorporated maps of prescription drug drop-off locations into the interactive portal. Citizens can reference these maps to locate and get directions to the nearest drop-off for opioid prescriptions, rather than keeping them at home where they are more susceptible to abuse. Now, the department is focused on keeping these maps’ data up to date with the quickly evolving demographics and health needs of Arizona constituents.
Using GIS to Tackle the Opioid Crisis
“We created maps as tools for citizens and providers. You can quickly go through and look at your community and get an idea of how they’re doing. If they’ve got a lot of red indicators, you know that there’s a lot of progress to make.” Wesley Kortuem, Senior GIS Analyst at the Arizona Department of Health Services
Colorado After losing his younger brother to an OxyContin overdose in 2007, Jeremiah Lindemann was hesitant to share his family’s struggle with others in the community. He recognized a stigma associated with drug overdose and felt his brother’s death would be ill-received by others in his community. After reaching out to the Colorado Health Department for more information on drug abuse in the area, however, Lindemann found that his brother’s situation was not a rarity. Many other people, of a variety of backgrounds, were suffering from opioid addiction and overdoses. Because others were similarly unaware of the widespread nature of opioid abuse, however, no one was talking about the people they’d lost to the crisis. Lindemann began using Esri’s Story Maps to show victims’ stories and normalize conversations about opioid abuse in Colorado. His most prominent map, Celebrating Lost Loves Ones, not only highlights data on deaths in communities; it also allows members of the public to contribute their own stories about the real-life impact of opioid-related deaths. In just over two years, the map has received over 530 submissions nationally.
“People already have the data but it’s typically in spreadsheets. If this problem’s really going to be addressed, you have to understand it first. People will only understand and pay attention if they start to actually see what’s happening in their own area.” Jeremiah Lindemann, Solutions Engineer at Esri
Lancaster, Pa. Through community meetings and forums, the District Attorney’s Office of Lancaster County discovered that constituents didn’t understand the scope of the epidemic. They turned to GIS to help relate the true nature of the problem. Lancaster County-Wide Communications collected emergency response data which allowed Lancaster County IT and GIS units to track and map accidental drug overdoses between January 2014 and Nov. 1, 2016. The map is published online as an interactive educational tool to promote awareness of drug abuse, specifically heroin and opioids, prevalent in Lancaster County. It provides visual evidence that drug abuse has impacted almost every neighborhood in Lancaster County. Following the release of the map, county officials have seen a significant uptick in awareness. Community and school district leaders have particularly reached out for more information, as well as prevention tools, related to drug abuse in their communities. Due to that outreach, the county is now also mapping and publishing activities that offer alterative outlets for children’s free time in the area.
Using GIS to Tackle the Opioid Crisis
“We’re using this map to open the eyes of Lancaster County, specifically in those communities where individuals don’t have a personal interaction with the epidemic.” Brett Hambright, Media Specialist, Lancaster County District Attorney’s Office
Northern Kentucky In 2015, Northern Kentucky lost an average of one person to drug overdose every 40 hours. To increase awareness of the epidemic, and relate the complexity of its causes, the Northern Kentucky Health Department published drug-related incident data across the eight counties of the Northern Kentucky Area Development District in a dynamic online portal. Along with geo-enabled data on morbidity, opioid prescriptions and current response efforts, the Northern Kentucky Health Department provides narrative text to explain the insights revealed with GIS. Northern Kentucky has developed a six-pillar heroin impact response plan that includes prevention, harm reduction, treatment, recovery, supply reduction and advocacy. As community partners work to update the plan, the GIS data, published on a public ArcGIS platform, will be a key resource. It can also provide information for individual citizens to support government efforts against the drug epidemic. As response efforts change conditions, the maps and associated reports are updated every six to 12 months.
“Most people didn’t know where to find help in the area. Actually showing people what treatment is available and connecting them with that treatment is a huge step in the right direction.” Debbie Young, Public Health Informatics Manager
Getting Started With GIS GIS has the power to transform the way communities combat drug abuse, but real progress won’t happen overnight. Especially for state and local governments that are new to GIS, unlocking the power of mapping will take time and planning. Follow these steps to get started:
Gather data and geo-enable it.
Enrich your data with demographics.
Your first step is to gather data, including health care, law enforcement and social services records, from disparate sources. Specifically seek data that has geographic tags, and create locational tags for that data that doesn’t have it already. Then, you can use ArcGIS to begin mapping your data and create a visual of what’s happening in your community.
Next, combine your data with demographic information like population density, morbidity, age, income and mortality. This demographic data will help you understand how your specific population is interacting with the opioid epidemic, and help you compare your findings to other demographics.
Analyze your data to uncover patterns of abuse, crime and mortality. Once you have your data consolidated and mapped, start looking for patterns. Where is abuse most prevalent? What other indicators, like excessive opiate prescriptions or a lack of prescription drop-off centers, are also prevalent in that area? Use your visual data to determine patterns that are contributing to the opioid epidemic in your area, so that you can allocate the right resources to the right locations. Esri’s Business Analyst can help inform your location-driven analysis.
Using GIS to Tackle the Opioid Crisis
Use your analysis to bring partners and other stakeholders on board. Once you determine the best strategies to begin tackling opioid use in your community, use your mapped data to explain your logic and bring others on board. Tackling drug abuse often requires other stakeholders to provide treatment or other resources. Show how and where those partners can contribute with maps.
Make your community aware of the issues and proposed actions. Finally, make your findings public. Use Story Maps to publish personal stories of how opioid abuse is impacting your community. Explain your strategies for combatting drug problems with maps that show clear cause and effect on a local scale.
The opioid epidemic is happening in nearly every community, among all demographics. In fact, more Americans now die every year from drug overdoses than they do in motor vehicle crashes and the majority of those overdoses involve prescription medications. With a drug abuse problem that is only escalating in intensity and reach, it’s critical that government intervene. That’s where GIS comes in. Geographic intelligence plays an integral role in helping cities meet the challenges of opioid addiction and overdose deaths. Integrating health data with geographic information gives health service managers an understanding of who, where, when and why the epidemic is occurring and who it is impacting. It also lays the foundation for effective policy- and decision-making. With GIS, state and local leaders can quickly understand and begin addressing the opioid epidemic in their own communities. In the same way that they rely on mapping to inform responses to natural disasters, public servants can use real-time, visual data to effectively combat this drug crisis – and save the lives of countless Americans.
When Esri was founded in 1969, we realized even then that geographic information system (GIS) technology could make a difference in society. Working with others who shared this passion, we were encouraged by the vast possibilities of GIS. Today our confidence in GIS is built on the belief that geography matters - it connects our many cultures and societies and influences our way of life. GIS leverage geographic insight to ensure better communication and collaboration. Explore our website to discover how our customers have obtained the geographic advantage by using Esri software to address social, economic, business, and environmental concerns at local, regional, national, and global scales. We hope you will be inspired to join the Esri community in using GIS to create a better world. go.esri.com/GIS4Opioid @esri_health
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