Abstract：
Overdose mortality in the United States continues to climb, with Maryland being one of the hardest hit states. We summarized implementation of overdose prevention and response programs in Maryland and identified associations between opioid overdose deaths by jurisdiction in 2019 and implementation of overdose programs by 2021. Data on program implementation are from Maryland\'s Opioid Operational Command Center (OOCC) Program Inventory. OOCC coordinates the state\'s response to overdose, and their Program Inventory tracks implementation of 145 programs across 12 domains (e.g., public health, education, and judiciary), including 10 programs designed to broaden naloxone access. The level of program implementation was dichotomized as substantial implementation versus other levels (i.e., partial, planned, and none). We estimated associations between per capita opioid overdose deaths and substantial implementation of: all 145 programs in the Inventory, programs within each of 12 domains, and 10 naloxone programs. Data on program implementation and overdose mortality are summarized at the jurisdiction level. Across jurisdictions, the median proportion of programs with substantial implementation was 51% across all programs and 70% among naloxone programs. Overdose mortality was associated with subsequent substantial implementation of programs within the public health domain (p = .04), but not in the other 11 domains. We did not find evidence that per capita overdose deaths in 2019 spurred overdose program implementation by 2021, with the exception of public health programs. The OOCC Program Inventory is a novel way to track implementation across jurisdictions. Findings can inform the implementation and evaluation of overdose programs in other jurisdictions across the United States.
摘要：
美国的过量死亡率继续攀升，马里兰州是受灾最严重的州之一。我们总结了马里兰州过量预防和应对计划的实施情况，并确定了2019年辖区阿片类药物过量死亡与2021年过量计划实施之间的关联。有关计划实施的数据来自马里兰州阿片类药物作战指挥中心（OOCC）计划清单。OOCC协调国家对过量用药的反应，他们的程序清单跟踪跨12个域的145个程序的实施(例如，公共卫生,教育,和司法机构)，包括10个旨在扩大纳洛酮准入的项目。程序实现的级别被分为实质性实现与其他级别(即，局部,计划,也没有）。我们估计人均阿片类药物过量死亡与大量实施之间的关联：清单中的所有145个项目，12个域中的每个域中的程序，和10个纳洛酮方案。在辖区一级总结了有关计划实施和过量死亡率的数据。跨司法管辖区，在所有计划中,实质性实施的计划的中位数比例为51%,在纳洛酮计划中,中位数比例为70%.过量死亡率与随后在公共卫生领域的计划的实质性实施有关（p=.04），但不是在其他11个领域。我们没有发现证据表明，2019年的人均用药过量死亡刺激了2021年的用药过量计划的实施，公共卫生计划除外。OOCC计划清单是跟踪跨司法管辖区实施的一种新颖方法。调查结果可以为美国其他司法管辖区的过量用药计划的实施和评估提供信息。
