Lab Matters Summer 2025 | Page 30

ENVIRONMENTAL HEALTH

By Kelsey Granger, MHS, specialist, Environmental Health organizations use their data to adjust community resources, improve patient care, and reduce the likelihood of fatal overdose.

Vermont

Overdose biosurveillance, a public health practice where public health laboratories test residual blood and urine specimens from patients presenting to emergency departments( ED) with symptoms of nonfatal overdose to identify causative substances, expanded to 20 jurisdictions under the US Centers for Disease Control and Prevention( CDC) Overdose Data to Action in States( OD2A-S) cooperative agreement in 2023. To successfully launch an overdose biosurveillance program, laboratories must implement multifaceted outreach strategies to develop broad community networks working collectively towards an urgent common goal: preventing overdoses. While fatal overdoses declined nationally by almost 24 % in 2024, overdose continues to be the leading cause of death in Americans aged 18 – 44.

Missouri

The Missouri State Public Health Laboratory( MSPHL) works closely with the Missouri Hospital Association( MHA) in a unique partnership which facilitates rapid onboarding of and fosters continuing relationships with hospital partners. After MSPHL tests specimens received from partner hospitals, aggregate data about the prevalence of specific drugs, as well as drug trends clustered within demographic groups or geographic areas, is shared with hospital and community partners focused on certified peer specialists and community coalitions on a quarterly basis. Since

collaborating with participating hospitals, biosurveillance has positively impacted patient care: ED staff now receive additional information about drug overdose symptoms and substance use in their hospital populations, facilitating frequent discussion on best practices and clinical quality improvement. Armed with high-quality biosurveillance data,“ Providers are more likely to provide timely screening, effective intervention, and referrals to connect patients to further treatment or support” says Hannah Prince, director of Substance Use Programming at MHA. MSPHL and MHA anticipate that biosurveillance data, when combined with medical examiner and law enforcement data, will enable Missouri to reduce overdose morbidity and mortality across the state.

Florida

By providing a clear understanding of the substances contributing to non-fatal overdoses in the community, Florida’ s overdose program plays a vital role in their efforts toward effective prevention of fatal overdoses. Since 2022, Florida’ s Bureau of Public Health Laboratories has tested over 3,000 non-fatal overdose specimens submitted by their partner hospital, Tampa General Hospital. Results are shared with the partner hospital, hospital coordinators, county health departments, and other local agencies, including fire and rescue paramedicine, law enforcement, and mental and behavioral health centers. These

The Vermont Department of Health Public Health Laboratory( VDHL) prioritized internal and external partnerships when launching its overdose biosurveillance program. With partner hospital laboratories and Vermont Health Statistics and Informatics( VHSI) they developed a workflow to streamline the often-challenging specimen acquisition process. When a patient is treated for a non-fatal overdose, Drug Overdose Surveillance and Epidemiology( DOSE) epidemiologists at VHSI receive electronic health record information from syndromic surveillance systems. VHSI then uses this data to determine eligibility of residual clinical samples associated with overdose cases for inclusion in biosurveillance testing. If specimens are eligible, VHSI relays a specimen request list to hospital laboratories who then pull and de-identify specimens. To protect patient privacy( especially with respect to the small population size of Vermont), VHSI washes specimens of select demographic data and submits them to VDHL, where comprehensive testing for substances commonly indicated in non-fatal overdoses is performed. Jill Warrington, VDHL laboratory director, emphasizes,“ Vermont’ s biosurveillance program has increased interconnectivity among previously disparate toxicology-based initiatives across the state, enabling a more comprehensive understanding of Vermont’ s overdose patient population and insight to potential behavioral patterns that affect drug use.” g