Overdose Measures Matter

Indicator Profile

Description of culturally and/or linguistically tailored overdose prevention programs

Category: Health Access

Audience: ConvenerFunderProgram Implementer

Data Type: Qualitative

Indicator Overview

Description:

Provide a brief description about each culturally and/or linguistically tailored overdose prevention program.

Community Conveners are encouraged to identify culturally and/or linguistically tailored overdose prevention programs in your service area, region or jurisdiction. For each program, describe how it aims to meet the specific needs of its identified priority population.

Program Implementers and Funders may prefer to narrow their focus to culturally and/or linguistically tailored overdose prevention programs provided by their organization, recipients, or grantees. Reviewing programs under their control may lead to more actionable insights for tailoring improvements, improving resource allocation and aligning programming to community needs.

To understand more about creating, supporting and maintaining culturally and linguistically appropriate programs, please see the National Cultural and Linguistically Appropriate Services Standards (CLAS) on the Think Cultural Health website.

Rationale:

In 2023, the overall overdose death rate decreased1. Researchers attribute the decrease to several factors that are still being studied. However, when looking more closely at the data, researchers noticed that overdose fatalities among Native and African American populations continued to rise.2

Unequal access and opportunity and their impacts on social determinants of health (SDOH) have resulted in disparities in access to, linkage to and retention in treatment for substance use disorders, compounding risk in marginalized populations.3 Furthermore, cultural and linguistic barriers, such as the absence of printed materials in a participant’s language, the lack of interpreter services and cultural norms not integrated into program design, may prevent people who use drugs (PWUD) from accessing overdose prevention programming.

To ensure that all people have access to services and resources, it is critical to address the needs of different populations in overdose prevention programming. Targeted implementation and evaluation activities that are culturally relevant and tailored for diverse populations can help to maximize their impact to address the unique needs of communities.

Indicator Details

Definitions:

Culturally and/or linguistically tailored refers to the adaptation of the design, materials and other components of the overdose prevention activity or intervention to reflect cultural (ideas, values or social behaviors) needs, language characteristics and other preferences at the population or community level.

Examples of culturally tailored programming include programs that are created within the norms of the target culture such as gender-specific and faith-based programs and those tailored to indigenous and tribal populations. One example of culturally tailored programming is the National Indian Health Board Tribal Opioid Response Resource Toolkit.

Examples of linguistically tailored programming include programs that are offered in languages other than English, for example, from SAMHSA and Next Distro

Priority populations may be different in every community and may also mean different things to different people. It may mean populations who have higher rates of overdose, populations who have been historically excluded from accessing healthcare and overdose prevention services or populations experiencing certain social or physical health conditions that may put them at higher risk for overdose. Examples of priority populations include but are not limited to tribal populations, racial and ethnic groups, people living in geographically underserved areas, groups experiencing consistent, higher than average overdose rates, people experiencing homelessness, people who are uninsured and people recently released from incarceration.

Overdose prevention programs include any intervention or program that aims to reduce overdoses and overdose deaths through a broad range of strategies stemming from primary prevention efforts to harm reduction and substance use disorder treatment.

Social determinants of health (SDOH) are the conditions people live in that affect their health. Examples of SDOH include having a stable income, access to a good education, living in a safe neighborhood, being part of a strong community and having quality healthcare.4

Ways to Examine the Data:

  1. Priority population (i.e., population for whom programs are tailored)
  2. Languages represented (for linguistically tailored programs)
  3. Region where programs are located (e.g., zip code, neighborhood, etc.)
  4. CLAS standards alignment (e.g., Which of the 15 standards have been adopted by your program?)

Data Sources:

  • Community partners and organizations implementing overdose prevention programming
  • Administrative or historical documents (e.g., annual or quarterly reports and/or evaluations)

Data Collection Methods:

  • Survey community partners and organizations
  • Conduct focus groups or interviews with community partners and staff
  • Document review of annual reports and/or evaluations

Application and Considerations

Suggested Use:

Program Implementer

  • To determine if programs are addressing the needs of populations/communities most impacted by overdose
  • To identify opportunities to tailor overdose prevention programs to the cultural and/or linguistic needs of those you serve

Community Convener

  • To determine if programs are addressing the needs of populations/communities most impacted by overdose
  • To identify gaps in culturally and/or linguistically tailored programming
  • To identify opportunities to partner with community organizations to establish, expand and improve culturally and/or linguistically tailored programming

Funder

  • To understand how grantees and recipients are addressing the needs of different populations in their community
  • To gain insight into whether programs are addressing the needs of different populations through culturally relevant overdose prevention programming
  • To encourage recipients and grantees to consider how to integrate health access into their overdose prevention efforts
  • To help inform future funding opportunities and/or requirements

Health Access Considerations:

You may want to consider:

  • Who are your priority populations? Do these programs align with the needs of the community?
  • Are programs appropriate according to CLAS standards?
  • Would clients/participants describe these programs as being more responsive to their needs?
  • What types of programs are these? What types of services are provided?
  • Are perspectives of priority populations included in the development of programming?
  • Are these programs accessible to the population it is meant to serve? Is it located in an area that is easily accessible by public transportation? Is it affordable?

For more information, visit the Centers for Disease Control and Prevention’s Health Equity and Drug Overdose website.

Evaluation Considerations:

Limitations:

  • Does not capture the experience of program participants
  • Does not address program outcomes or impact

Policy Considerations and Resources:

Additional Resources

Examples:

  • Milaney, K., Passi, J., Zaretsky, L., Liu, T., O’Gorman, C.M., Hill, L. and Dutton, D. (2021). Drug use, homelessness and health: responding to the opioid overdose crisis with housing and harm reduction services. Harm Reduction Journal 18 (92).
    https://doi.org/10.1186/s12954-021-00539-8
  • Winston, T. R., Reed, M., Roberts, M., Panjwani, A., Farfalla, J., Pless, V., ... & Underwood, N. L. (2024). Implementing a needs assessment to advance health equity in overdose prevention and surveillance initiatives. Public Health Reports,
    doi:10.1177/00333549241239905

References:

  1. National Center for Health Statistics. (2024). U.S. overdose deaths decrease in 2023, first time since 2018.
    https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm
  2. Volkow, N. and Dye, L.R. (2024). Groundbreaking research from NIDA addressing the challenges of the opioid epidemic. Journal of Medical Toxicology. Special article- 10/04/2024.
    https://link.springer.com/article/10.1007/s13181-024-01041-w
  3. Jegede O, Bellamy C, Jordan A. (2024). Systemic racism as a determinant of health inequities for people with substance use disorder. JAMA Psychiatry. 81(3):225–226.
    https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2814162
  4. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2030. Social Determinants of Health.
    https://health.gov/healthypeople/objectives-and-data/social-determinants-health
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