Pennsylvania's Community Coordination Strategy to Reduce Opioid Overdose Deaths.

Objective: The Pennsylvania Opioid Overdose Reduction Technical Assistance Center (ORTAC) was developed to provide community-level support across Pennsylvania with the goal of reducing the opioid-related overdose death (ODD) rate via coalition building/coordination and tailored technical assistance. This study evaluates the initial effects of ORTAC engagement on county-level opioid ODD reductions.

Method: Using quasi-experimental difference-in-difference models, we compared ODD per 100,000 population per quarter between 2016 and 2019 in the 29 ORTAC-implementing counties against the 19 nonengaged counties while controlling for county-level time-varying confounders (e.g., naloxone administration by law enforcement).

Results: Before ORTAC implementation, the average ODD/100,000 was 8.92 per 100,000 ( = 3.62) in ORTAC counties and 5.62 per 100,000 ( = 2.17) for the 19 comparison counties. Relative to the pre-study rate, there was an estimated 30% decrease in the ODD/100,000 within implementing counties after the first two quarters of ORTAC implementation. In the second year after ORTAC implementation, the estimated difference between ORTAC and non-ORTAC counties reached a high of 3.80 fewer deaths per 100,000. Overall, analyses indicated that ORTAC's service was associated with avoiding 1,818 opioid ODD in the 29 implementing counties in the 2 years following implementation.

Conclusions: Findings reinforce the impact of coordinating communities around addressing the ODD crisis. Future policy efforts should provide a suite of overdose reduction strategies and intuitive data structures that can be tailored to individual communities' needs.