About the Data: Nonfatal Overdoses per 100,000 Population

Data Description

• Data Source(s): ODMAP

• Prior Use on EBCI THIP: No

• Measure Definition: Per 100,000 Population (Number of Nonfatal Overdoses * 100,000 / EBCI user population that lives on the Qualla Boundary and serviced by Tribal EMS)

  • Note: Qualla Boundary is the service area of Tribal EMS = 8,296

• Baseline (Annual):

  • 2018: 627 per 100,000

• Target: 564 per 100,000

• Target-Setting Method: 10% improvement

Annual Data Overview

Measure Components

• Numerator: Number of nonfatal overdoses as recorded by ODMAP

• Denominator: EBCI user population that lives on the Qualla Boundary (8,296)

• Conversion Factor: 100,000

Comparable National Data

• Unknown

Data Collection Frequency

• Annual

Story Behind the Curve

The significant reduction in nonfatal overdoses within the Eastern Band of Cherokee Indians (EBCI) community—from 500 per 100,000 in 2020 to 24 per 100,000 in 2024—highlights the effectiveness of a comprehensive and targeted response. This success is rooted in the implementation of multiple strategies aimed at prevention, education, and community engagement.

A cornerstone of this effort was the installation of 10 public health vending machines strategically placed throughout the community, providing free access to life-saving resources such as Naloxone (Narcan) and fentanyl test strips. These machines ensured that critical tools were available 24/7, removing barriers to access and empowering individuals to act during overdose emergencies.

Community engagement played a vital role in reducing stigma and fostering recovery. Events like the Recovery/Wellness Rallies exceeded expectations, drawing 476 participants in 2023 and 637 in 2024. These rallies highlighted recovery stories, increased awareness of available resources, and strengthened connections among community members.

Training programs such as the Recovery Coach Academy provided essential knowledge and skills to healthcare providers, community leaders, and others to support individuals in recovery. Data collected through the Overdose Detection Mapping Application Program (ODMAP) allowed for targeted interventions and real-time tracking of overdose hotspots, further enhancing the community's response capabilities.

Partners

The collaborative efforts of diverse partners have been instrumental in achieving this progress. These include:

• EBCI Public Health and Human Services (PHHS): Coordinated implementation of prevention and recovery strategies.
• Cherokee Indian Hospital Authority (CIHA): Delivered medication-assisted treatments (MAT) and facilitated recovery programs.
• Sunrise Community for Recovery and Wellness: Provided Recovery Coach Academy training and peer-led recovery initiatives.
• Community Groups: Actively engaged in planning and executing recovery events, including rallies and educational campaigns.
• Tribal Emergency Medical Services: Supplied critical data for tracking overdoses and targeting interventions through Overdose Detection Mapping Application (ODMAP).

While these collaborations have driven success, the absence of certain partners, such as housing services and law enforcement, has been noted as an area for improvement.

What Worked

Several elements contributed to the remarkable success in reducing nonfatal overdoses:

1. Public Health Vending Machines: These machines provided free, 24/7 access to Narcan and fentanyl test strips, significantly increasing the community's capacity to respond to overdoses.
2. Recovery/Wellness Rallies: The rallies served as a platform for reducing stigma and showcasing recovery success stories, achieving a high level of community engagement.
3. Training Programs: The Recovery Coach Academy trained healthcare workers, board members, and community participants in recovery support, fostering a strong peer-led network.
4. Data-Driven Approaches: ODMAP data allowed for precise targeting of resources and interventions, ensuring the most at-risk areas were addressed effectively.
5. Community Ownership: Prioritizing individuals with lived experiences in the planning and implementation phases ensured culturally relevant and impactful strategies.

Strategy

The strategies employed under the THIP to address nonfatal overdoses included:

1. Increasing Access to Overdose Reversal Tools:

   • Installed 10 public health vending machines stocked with Naloxone and fentanyl test strips.
   • Conducted community education on how to use these tools effectively.

2. Community Engagement and Stigma Reduction:

   • Organized two annual Recovery/Wellness Rallies, exceeding participation goals.
   • Developed and shared the "Faces & Voices of Recovery" digital storytelling series to highlight recovery stories and reduce stigma.

3. Training and Capacity Building:

   • Partnered with the Sunrise Community to deliver the Recovery Coach Academy training to CIHA staff, community members, and other stakeholders.
   • Focused on cultural awareness and the importance of peer-led recovery support.

4. Leveraging Data for Impact:

   • Used ODMAP to track and map overdoses, enabling targeted interventions.
   • Developed a framework for data collection and analysis to inform ongoing efforts.

These strategies, rooted in collaboration, education, and accessibility, have been instrumental in reducing nonfatal overdoses and fostering a safer, healthier community.