Could Biosurveillance Help Fight The Opioid Epidemic?

The United States continues to grapple with the devastating opioid crisis, as evidenced by the staggering number of drug overdose deaths that continues to grow in 2023.

While forensic and crime laboratories offer valuable data on fatal opioid overdoses, solely focusing on these fatalities neglects crucial information that could safeguard communities. Public health laboratories possess the analytical capabilities and knowledge of public health surveillance systems which can play a vital role in combatting this crisis.

In 2018 alone, opioids, primarily synthetic variants, were implicated in 70% of the drug overdose deaths in the United States, amounting to nearly 450,000 fatalities between 1999 and 2018, according to the US Centers for Disease Control and Prevention (CDC). And those numbers haven’t improved between 2018 and 2022.

Although forensic laboratories excel at characterizing fatal overdoses, this information often arrives too late for communities, as drug trends shift before authorities can respond effectively.

To address this issue, public health laboratories, working in collaboration with other stakeholders, can contribute significantly to battling the opioid crisis by leveraging their analytical capabilities and expertise in public health surveillance systems. Recognizing this potential, the Association of Public Health Laboratories (APHL) convened the Opioids Biosurveillance Task Force in early 2019, aiming to further develop the role of public health laboratories in this domain.

While implementing robust opioid biosurveillance programs may require additional resources, such as equipment, staff, and partnerships, the benefits of strengthening public health interventions to curb drug use far outweigh the associated costs.

Several public health laboratories across the country have already made substantial progress in opioid biosurveillance. For instance, the Minnesota Department of Health’s Response Network for Chemical Threats (LRN-C) laboratory capitalized on its existing capabilities to establish a biosurveillance program for drugs of abuse.

By leveraging their surge capacity and collaborating with hospitals, which treat most non-fatal overdose cases, the laboratory could collect and test specimens, thereby identifying emerging drug trends and facilitating prompt interventions.

In addition to LRN-C laboratories, other public health laboratories, like the forensic laboratory at the Wisconsin State Laboratory of Hygiene, have embraced opioid biosurveillance. By analyzing specimens from impaired drivers and receiving reports of fatal overdoses, these laboratories serve as critical sources of community-specific data, offering insights into emerging drug trends and enabling effective public health responses.

Despite the progress made, there are challenges to overcome. Adequate funding remains a common obstacle, but federal grants are becoming available to support opioid biosurveillance programs. Building partnerships between public health and forensic laboratories, often unaware of each other’s capabilities, is crucial.

Reinforcing collaborations with hospitals is also essential, as these institutions play a vital role in supplying the necessary samples for testing. Hospitals need to understand the value of opioid biosurveillance programs and develop processes for collecting specimens from non-fatal overdose cases.

The data generated through opioid biosurveillance programs can inform public health efforts and interventions. Analyzing drug trends can help disseminate information to drug users, making them aware of more dangerous substances in their area and potentially reducing their risk of overdose.

Furthermore, public health laboratories can contribute to developing standardized testing algorithms and methods to ensure comparability of results nationwide.

What this means for you: the opioid crisis necessitates the involvement of public health laboratories to address the multidimensional challenges it poses. This could be accomplished if those laboratories expanded their role into opioid biosurveillance.