Public health leaders today are facing “wicked” health problems that require multifaceted, multi-organization responses. Ideally, partnerships bring together the strengths of multiple entities to create something better and yield results greater than could be achieved by any single organization alone. RTI International is partnering with the University of Texas at Austin (UT Austin) and the Texas Health and Human Services Commission (TXHHSC) to address the overdose crisis in Texas.
The Public Health Problem: Drug Overdose
Nationally, in the early 2000s, drug overdose deaths started to increase dramatically. Provisional data suggests that overdose deaths in the United States surpassed 107,000 in 2021, the highest number ever recorded. Opioids continue to be the main driver of drug overdose deaths, with 75% of all overdose deaths involving an opioid.
In Texas, opioids are involved in more than 50% of drug overdose deaths, in part because of a historically lower prevalence of synthetic opioids in the state than in other parts of the country. However, from 2018 through 2020, the largest increase in synthetic opioid-related overdose deaths occurred in the Western region of the country, suggesting synthetic opioids are “moving West.” Provisional data from the Centers for Disease Control and Prevention suggest that overdose deaths in Texas are accelerating. Overall, drug overdose deaths increased 64% from January 2019 to January 2022, any opioid overdose deaths increased 95%, and synthetic opioid-related deaths increased 464%.
One Response: Texas Targeted Opioid Response (TTOR) Program
In response to the growing public health crisis, TXHHSC established the Texas Targeted Opioid Response (TTOR) program in 2017 with funding from the Substance Abuse and Mental Health Services Administration. According to TTOR, the program is designed to “address the opioid crisis by increasing access to medications for opioid use disorder and reducing opioid-related overdose deaths through its evidence-based programming.” The program has several aims: developing prevention programming; raising awareness about opioid misuse; distributing naloxone; integrating prevention, treatment, and recovery services; expanding treatment capacity; and expanding access to supportive services (e.g., housing, employment).
To achieve program aims, TXHHSC funds special projects through university partners, including UT Austin. The TTOR special projects based at UT Austin focus on access to timely data, education, and training for providers; support for those in recovery; and public education and awareness.
Academic–Research Organization Partnerships to Support Texas Researchers and Agencies
Professionals at state agencies and academic institutions often have competing demands, which makes raising awareness about their work and implementing tertiary supportive activities more challenging. Dr. Lucas Hill at UT Austin's PhARM Program established a partnership with RTI to provide a range of supportive services to maximize the reach of their work. RTI’s collaboration with UT Austin and TXHHSC has translated into rapid support to address the overdose crisis in Texas. Since RTI has a breadth of capacity, we have pulled from a wide range of experts and developed tailored responses or products quickly to meet stakeholder needs. To date, through this partnership, RTI has performed multiple activities across the following broad areas:
- Acquisition and analysis of administrative data. For example, RTI is currently analyzing Texas hospitalization data to assess the prevalence of injection-related infections.
- Evaluation support, including development of programmatic logic models, questionnaire development, and training of data collection teams.
- Qualitative and quantitative data analysis.
- Communications science and implementation science consultation.
- Dissemination support, including peer-reviewed publications and conference presentations.
RTI has also implemented ad-hoc projects as needed. We conducted an environmental scan of data dashboards and other visualization products created by other states and hosted a series of community expert meetings on how the Texas Department of State Health Services could improve the dissemination of opioid-related data to community partners. The RTI team conducted a two-phase environmental scan of Texas’s Outreach, Screening, Assessment, and Referral (OSAR) programs. The first phase, including in-depth interviews with 30 OSAR and TXHHSC staff and a literature review of evidence-based outreach strategies, was completed in less than 2 months. In the second phase, we conducted an online survey with providers throughout the state. The resulting reports from these special projects provided actionable recommendations for the agencies.
Our ongoing collaboration has made our efforts not only feasible but successful because each organization provides unique strengths. Addressing public health challenges, such as the overdose crisis, can benefit from such partnerships.
Learn more about RTI’s research on the prevention, intervention, and treatment of opioid misuse here.