The data source is CDC WONDER, an interactive dataset from CDC. This includes all the ICD-10 codes where the death was related to drugs: 1) accidental death (based on drug type), 2) murder by drug, and 3) intent was unknown.

In Arkansas, for accidental, it went from 11.1 (2019) to 16.1 (2020), an increase of almost 50%. We went from 388 total drug-overdose deaths in 2019 to 546 total drug overdose deaths in 2020. (There was almost no difference in the other two categories)

The data is age-adjusted and so it is comparable across years. The national data also shows a similar type of increase from 2019 to 2020. Non-opioid-related drug overdose deaths were the main contributors on a national level (i.e. Fentanyl, etc.)

The number one drug that Arkansas will overdose on is Methamphetamines. With Fentanyl, we are seeing that is poly drug-related death.

Methamphetamines were the leading cause up til 2019, but it has now been overtaken by Fentanyl.

When asked how Arkansas adults are doing relative to the trendline data for the indicator, the stakeholders stated the following:

• It's getting worse over time with a very sharp spike from 2019 to 2020.
• The data dipped in 2019. The data also dipped in 2014.

Stakeholders identified the following negative factors contributing to drug-related overdose deaths amongst adults in Arkansas. 

• Perfect storm during COVID-19
  • Increased importation of Methamphetamine and Fentanyl (evidenced by a large increase in seizures at state borders)
  • Decrease in services
  • Shift in focus and efforts to address COVID-19 also meant a shift away from focusing on drug-related issues in the state
  • Increased isolation and stress might have contributed to increased use
    • More people forced to be alone while using and not able to save each other in the even of an overdose
• Ever increasing potency of the drugs that are available mean that there is no such thing as "safe use"
  • Older strategies to mitigate overdose may not be effective
• Poly-drug addiction and/or use will require a different type of counteracting measures
  • When we look at deaths as an outcome, we don't have anything like Narcan for Fentanyl or Methamphetamine
• Stigma related to drug ensures that the issue is not addressed in a positive, sympathetic transparent way that promotes treatment
• Undercounts are likely due to the illicit nature of abuse

Stakeholders identified the following positive factors restriciting drug-related overdose deaths amongst adults in Arkansas.

• Under reporting
  • Shame connected to drug use
  • Rural communities are close-knit
• Narcan promotion and Narcan utilization
• First responders are trained
• Expanding capacity in community Narcan
• Outreaching/engaging with communities that typically shy away from first responders

Stakeholders identified the following potential partners to strengthen the positive factors or address the negative factors influencing the rate of drug-related overdose deaths amongst adults in Arkansas.

• Families, especially those that are struggling with addiction
• School districts
• Public libraries
• Businesses such as bars and nightclubs
• Faith-based Facilities
• City leaders
• Drug courts
• Food banks
• Homeless shelters

Stakeholders identified the following solutions to strengthen the positive factors or address the negative factors influencing the rate of drug-related overdose deaths amongst adults in Arkansas.

• Destigmatizing substance use as a moral failure
• Ensure everyone is released from treatment with Narcan
• Family engagement, education, and training
• Free or low cost Narcan to chronic opioid users
• Mental health support 
• Peer recovery counselors in every emergency room in the state
• Place Narcan in community locations like where defibrillators are located
• Rapid detection of potential clusters using surveillance practices
• Stop and/or disrupt the supply chain to prevent the ready access to these drugs
• Wound care/Safe Syringe programs/recovery

Stakeholders prioritized the following strategies because they ranked highest across four criteria: Impact, Feasibility, Specificity, and Value.

• Conduct outreach, education, training and engagement for families of substance users that help them to understand how to support their loved ones and also maintain family safety
• Design and deliver (traditional and social media) that destigmatizes substance use as a moral failure in order to alleviate the shame associated with seeking treatment
• Ensure everyone who participates in and is released from treatment has a supply of Narcan (targets treatment and what happens when people discharge from treatment/incarceration)

Strategy: Broaden the distribution of Narcan (Naloxone) to at risk individuals

• Ensure everyone who participates in and is released from treatment has a supply of Narcan (targets treatment and what happens when people discharge from treatment/incarceration) 
• Co-locate Narcan with facility first aid boxes (defibrillator boxes) 
• Adjust the law so Narcan can be made available after hospital discharge (ED and in patient) 

Strategy: Conduct outreach, education, training and engagement for families of substance users that helps them to understand how to support their loved ones and also maintain family safety

Strategy: Design and deliver (traditional and social media) that destigmatizes substance use as a moral failure in order to alleviate the shame associated with seeking treatment.