Drug Overdose Response Investigation Protocol Template

Attachment D

Drug Overdose Response Investigation Protocol Template

TITLE

Provide a title for the investigation.

LEAD INVESTIGATING OFFICER

List the lead Epidemic Intelligence Service (EIS) officer assigned to the investigation.

INTRODUCTION

Describe the need and circumstances of the drug overdose response investigation.

Specify which circumstances justify the DORI:

• Increased overdoses (e.g., increase in number of fatal or nonfatal overdoses or accelerating trends)

• Occurrence of a rare or unknown cause of morbidity or mortality related to drug overdose (e.g., inclusion of rare substances, such as in the case of fentanyl-laced heroin)

• Opportunity to identify new information, such as risk factors previously unassociated with drug overdose or a change in indicators of death (e.g., reports of changes in breathing function prior to death that could signal the need for intervention)

• Occurrence among a particular population (e.g., children)

• Public or political concern (e.g., state governor declaration of a public health emergency in a given state)

PURPOSE

Describe the objectives of the investigation, specify the state or local authority that requested the response and the type of CDC technical assistance requested. Describe the purpose of the data collection activities.

METHODS

Describe the proposed data collection methods.

Case Definition:

Study Population:

Variables:

Respondents:

Anticipated burden hours:

Data analysis plan:

RESULTS

Describe how results will be synthesized and reported to the requesting state or local health authority.

INVESTIGATIVE TEAM

List full investigative team, including CDC staff and state/local health authority staff.

CITATIONS

Provide references for works cited. 

ATTACHMENTS

Provide the draft data collection forms to be used in the investigation; specify respondents for each form.