Characteristics of Overdoses and Harm Reduction Behaviors From Case Investigations of Suspected Nonfatal Opioid Overdoses-Maricopa County, Arizona, September 2021-August 2023

Despite recent decreases in overdose deaths in the United States, an opportunity remains to connect with people who have had a nonfatal overdose. We analyzed data collected from the Maricopa County Department of Public Health (MCDPH) nonfatal opioid overdose case investigations program, highlighted findings from investigations conducted during the first 2 years of the program (September 1, 2021-August 31, 2023), and compared findings across the 2 years.

We reviewed data collected through the MCDPH nonfatal opioid overdose case investigations program, wherein MCDPH staff members conduct telephone interviews with a sample of case patients with a recent nonfatal opioid overdose. During interviews, MCDPH staff asked questions about overdose event circumstances, knowledge and practice of harm reduction strategies, substances used, and interest in treatment. MCDPH staff offered harm reduction kits to all case patients and transferred case patients interested in treatment to the Arizona Opioid Assistance and Referral Line.

MCDPH interviewed 529 of 2029 case patients (29.5%) who met sampling criteria. Among 354 case patients who self-reported recreational drug use, the number of cases reporting recreational fentanyl use increased from 117 of 179 (62.6%) in year 1 to 129 of 175 (73.7%) in year 2. Of 352 case patients, 187 (53.1%) reported access to naloxone. Smoking (208 of 295 case patients; 70.5%) was the most commonly reported route of consumption.

MCDPH's novel nonfatal opioid overdose surveillance program identified trends in drug use and harm reduction among people who use drugs who are at the highest risk of a subsequent overdose. The program continues to operate, and survey questions are routinely evaluated to ensure data collected inform overdose prevention strategies.