Massachusetts Uses Data Sharing to Combat the Opioid Epidemic

August 17, 2017|4:43 p.m.| ASTHO Staff

Monica BharelSubstance misuse and abuse is becoming increasingly prevalent in the United States. In response to a growing opioid overdose rate in Massachusetts, Monica Bharel, MD, commissioner of the Massachusetts Department of Health, has made it a priority to utilize data sharing and assessment to combat the epidemic.

The opioid-related death rate in Massachusetts surpassed the national average, with a particular rise from 2014-2017. In response to this crisis, Massachusetts Gov. Charlie Baker signed into law Chapter 55 of the Acts of 2015 in August 2015. This law permits analysis of 10 data sets from five different government agencies, all relating to opioid overdose and death. Increased partnerships and data sharing between private and public organizations has allowed for the analysis of statewide data and development of policy decisions relating to the opioid epidemic.

Data sharing has played a strong role in fighting the opioid epidemic in Massachusetts. Can you briefly describe how it began?

When I think about an effective public health system in the 21st century, I think about “precision public health.” This concept is about using the power of big data – existing data that we already collect – to develop effective public health responses to complex health issues by focusing on areas of inequity and greatest need. Then, you bring about improvements in the social determinants of health which are so central to each individual’s health and well-being.

Specifically regarding the current opioid epidemic, [in Massachusetts] we were able to bring together dozens of data sets across different state agencies that had never been linked before. The legal framework to help expedite this work came from a groundbreaking law titled Chapter 55, and we are thankful to the state legislature and Gov. Charlie Baker for making this law a reality. This data linkage work has been critical for us to better understand the current opioid epidemic and devise the most effective interventions with our partners at the state and local level.

How does data sharing lead to decreased substance misuse among various populations?

Substance use disorder is a complex medical disease which manifests in so many different ways. Understanding that complexity requires close attention to various sets of data both on the individual and population level. Our Prescription Drug Monitoring (PDMP) program has played a key role in that effort. In reviewing PDMP data linked to overdose death toxicology data as part of our Chapter 55 effort, we found a compelling association between first-time prescriptions for benzodiazepines and subsequent opioid overdose. Access to multiple data sets helped confirm this association and using the PDMP system is now mandated by law for first time opioid prescriptions and benzodiazepines.

Another related example of the power of data sharing to curb the opioid epidemic is our recently launched Massachusetts Prescriber Awareness Tool (MassPAT), our new Massachusetts PDMP. This online tool allows healthcare providers to access information about which opioids their patient has received over the past year, by whom they were prescribed, and where prescriptions were filled. 

On the micro-level, MassPAT is a clinical tool that assists doctors, other prescribers, and dispensers to safely care for their patients, helping to paint a picture for the provider that can become an important tool for them in the clinical encounter with a patient.

On the macro-level, MassPAT is a powerful analytical tool that allows us to look at trends so that we can understand different patterns of prescribing and abuse. We can then use that data to make evidence-based decisions on public health policies and interventions.

How have you tailored your findings to meet the needs of other partners (e.g. those in clinical healthcare or criminal justice)?

There are multiple ways in which new associations have created opportunities to partner across different sectors in order to address this epidemic. To give you an example, one of the key findings of the Chapter 55 report is that the risk of opioid overdose death following incarceration is 56 times higher than for the general public. This is a stunning and remarkable statistic, and served as the impetus for our developing an even stronger partnership with the criminal justice system in Massachusetts. Working together, our goal is to provide a stronger set of community-level treatment and recovery supports for individuals with a history of addiction who are released from correctional facilities. Again, this partnership and the life-changing potential that it represents for people emerging from incarceration would simply not have been possible without the Chapter 55 law and the data sharing model that it created.

Do you think you will be able to expand this work to address other health or health-related social issues?

Yes, that is our goal. The implementation of Chapter 55 enabled us to bring together a wide range of data points to help us truly understand the impact of substance use disorder in Massachusetts. Our work in this critical area continues as we are now “going upstream” of opioid overdose deaths to use predictive modeling tools to understand what populations are at highest risk and which treatments are most effective in which individuals. Additionally, these tools of big data and precision public health have wide implications to help us address other complex health issues. In the future, we can see ourselves taking a similar approach in using data sharing to achieve a deeper understanding of the impact of other public health issues in our state, such as maternal and child health outcomes, and letting that data guide us in developing effective interventions to improve those outcomes.

Given your experience in Massachusetts, what are key actions other state or territorial health official can take to raise awareness, as well as combat and prevent rising rates of substance abuse and misuse in their jurisdictions?

For us, Chapter 55 has been a true catalyst in bringing down siloes and driving collaboration across the entire spectrum of our state’s response to the opioid epidemic.  Other states might benefit from having a similar leverage point to bring about the elimination of data siloes wherever they exist in their states. The power of data sharing is not just in the access to the richness of the data itself – it’s also in the newly invigorated partnerships which result from that sharing.