Reach of Community-Selected Strategies to Reduce Opioid-Related Overdose Deaths in the HEALing Communities Study

Despite recent declines, the U.S. opioid overdose crisis persists. The HEALing Communities Study (HCS) aimed to reduce opioid overdose deaths through community-level adoption of evidence-based practices (EBPs), including overdose education and naloxone distribution (OEND) and medications for opioid use disorder (MOUD). This paper describes the reach of OEND and MOUD strategies implemented by the 33 HCS wait-list control communities.

We conducted descriptive statistical analysis of reach data collected from July 2022 through December 2023 to (1) summarize overall EBP implementation and reach and (2) compare the demographic representation of individuals reached to community demographic population estimates.

Communities implemented 474 EBPs (251 OEND, 223 MOUD), reporting an average reach of 16,482 individuals monthly. For OEND, percent reached exceeded community population representation for individuals aged 18-34 years (40% vs 31%) and 35-54 years (41% vs 31%) and non-Hispanic Black individuals (20% vs 15%). For MOUD, percent reached exceeded the opioid use disorder population representation for individuals aged 35-54 years (58% vs 52%) and non-Hispanic White individuals (88% vs 80%); however, there was lower representation for individuals aged 18-34 years (28% vs 38%) and non-Hispanic Black individuals (6% vs 13%). Distributions by sex were comparable for OEND and MOUD.

Findings signal the promise of community-engaged interventions to reach diverse groups with OEND and reflect the challenges of overcoming longstanding barriers to MOUD access. This work provides practical examples for monitoring the reach of EBPs across multiple research sites and communities and for assessing representativeness, a valuable marker of equity.

Trial Registration: Clinical Trials.gov http://www.clinicaltrials.gov: Identifier: NCT04111939.