Screen Shots for SUDORS

Attachment F1

State Unintentional Drug Overdose Reporting System (SUDORS)

Introduction

This document displays the screens that abstractors use to enter required data elements for the SUDORS module. Each section of the module is shown separately, with a screenshot of the previous version on the left and the new version on the right. Variables that have not changed are indicated with black text with the same number on both the right and the left, and the corresponding variable name is given below the screenshot. Any new variables on the righthand side are flagged in red with additional numbers, and the corresponding variable names given below. Any changes are highlighted in a text box below both screenshots.

SUDORS Tab: Drug Overdose and Substance Abuse Sections

Previous SUDORS Version Proposed SUDORS Version

6

5

4

3

2

1

5

4

3

2

1

1 Typeofpoisoning

2 LastSeenAliveTime

3 LastSeenAliveMonth

4 LastSeenAliveDay

5 LastSeenAliveYear

1-5 Retained fields 6 SUDORSCase

3

2

1

2

1

4

2a

4

2c

2b

3

2d

5

1 PreviousOverdose

2e

2 TreatmentForSubstanceAbuse

2f

3 HistoryOpioid

2g

4 RecentOpioidUse

1 PreviousOverdose

2 TreatmentForSubstanceAbuse 2f SubsTx_NA

2a SubsTx_rehab 2g SubsTx_Other

2b SubsTx_MATcog 3 HistoryOpioid

2c SubsTx_MAT_nocog 4 RecentOpioidUse

2d SubsTx_MAT 5 RecentED

2e SubsTx_CogTherapy

Changes to Drug Overdose and Substance Abuse Sections:

• Additional data element added to Drug Overdose/Poisoning section (#6) that allows the abstractor to identify unintentional/undetermined drug overdose deaths. This facilitates preliminary counts of drug overdose deaths

• 1 additional question added to capture recent emergency department visit (#5). This identifies an opportunity for a public health intervention.

• 7 response categories added (#2a – #2g) that are designed to detect the type of substance abuse treatment the decedent received. This data can provide important data to treatment providers and public health officials tracking the effectiveness of different treatment approaches.

SUDORS Tab: Scene Indications of Drug Use Sections

Previous SUDORS Version Proposed SUDORS Version

1a

4

1a

4a

1b

4

1b

4a

4c

4b

4e

4d

4c

4b

4d

5v

2

6

3

5v

2

3e

3a

7

7

6

3

3f

3b

8

8

3e

3a

3g

3c

10

9

3g

3f

3c

3b

3d

9

13

10

3d

1a IndicationsDrugPara 1b IndicationsNone 2 RouteUnknown 3 RouteInjection 3a IndicationsTracks 3b HasEvidenceOfInjectionTourniquet 3c HasEvidenceOfInjectionCooker 3d HasEvidenceOfInjectionOther 3e HasEvidenceOfInjectionNeedle 3f HasEvidenceOfInjectionFilter 3g HasEvidenceOfInjectionWitnessReport 4 HasRapidOverdoseEvidence 4a IsTourniquetAroundArm 4b NeedleLocation 4c RapidOverdoseWitnessReport 4d RapidOverdoseOther 5 RouteSnorting 6 HasRouteSmoking 7 HasRouteTransdermal 8 RouteIngestion 9 RouteSuppository 10 HasRouteSublingual 11 HasEvidenceOfPrescriptionDrug 11a IsPrescribedToVictim 11b IndicationsRxDrugs 11c IsUnknownWhoPrescribed 11d IsPrescriptionPill 11e IsPrescriptionBottle 11f IsPrescriptionLozenge 11g HasEvidenceOfWitnessReportRxUse 11h IsPrescriptionOther 11i IsPrescriptionPatch 11j IsPrescriptionLiquid 11k IsPrescriptionVial 12 IndicationsDrugsatScene 12a HasEvidenceOfIllicitPowder 12b HasEvidenceOfIllicitWitnessReport 12c IsPrescriptionCounterfeit 12d HasEvidenceOfIllicitTar 12e HasEvidenceOfIllicitCrystal 12f IndicationsOther

1a IndicationsDrugPara 1b IndicationsNone 2 RouteUnknown 3 RouteInjection 3a IndicationsTracks 3b HasEvidenceOfInjectionTourniquet 3c HasEvidenceOfInjectionCooker 3d HasEvidenceOfInjectionOther 3e HasEvidenceOfInjectionNeedle 3f HasEvidenceOfInjectionFilter 3g HasEvidenceOfInjectionWitnessReport 4 HasRapidOverdoseEvidence 4a IsTourniquetAroundArm 4b NeedleLocation 4c RapidOverdoseWitnessReport 4d RapidOverdoseOther 4e BodyPosition 5 RouteSnorting 6 HasRouteSmoking 7 HasRouteTransdermal 8 RouteIngestion 9 RouteSuppository 10 HasRouteSublingual 11 HasEvidenceOfPrescriptionDrug 11a IsPrescribedToVictim 11b IndicationsRxDrugs 11c IsUnknownWhoPrescribed 11d IsPrescriptionPill 11e IsPrescriptionBottle 11f IsPrescriptionLozenge 11g HasEvidenceOfWitnessReportRxUse 11h IsPrescriptionOther 11i IsPrescriptionPatch 11j IsPrescriptionLiquid 11k IsPrescriptionVial 11L IsPrescriptionFentanyl 12 IndicationsDrugsatScene 12a HasEvidenceOfIllicitPowder 12b HasEvidenceOfIllicitWitnessReport 12c IsPrescriptionCounterfeit 12d HasEvidenceOfIllicitTar 12e HasEvidenceOfIllicitCrystal 12f IndicationsOther 12g HasEvidenceOfIllicitPackage 13 HasRouteBuccal

Changes to Scene Indications of Drug Use Sections:

• For rapid overdoses (#4), the response option “body position” (#4e) was added based on feedback from medical examiner/coroners and SUDORS abstractors that rapid overdose could be determined by the position of the body.

• Buccal was added to route of drug administration (#13) because it was identified as a route in opioid overdose deaths that was not on the previous list.

• For evidence of illicit drug use (#12), illicit drug packaging (#12g) was added because it occurred in a sufficient number of drug overdose deaths to track. This will also improve the identification of drug overdose deaths involving illicit drugs.

• Scene or prescription evidence of fentanyl (#11L) was added because SUDORS abstractors indicated this information was available and it is critical to determine whether the fentanyl contributing to the overdose was prescribed versus illicitly manufactured.

SUDORS Tab: Response to Drug Overdose and Medical History Sections

Previous SUDORS Version Proposed SUDORS Version

2

1

1

1l

1i

1f

1e

1a

1b

2

1m

1k

1j

1h

1g

1c

1d

13

9

3

18

14

10

4

20

19

16

15

11

5

17

12

6

7

21

8

23f

23e

23d

23c

23b

23a

30

29

28

27

26

25

24

22

8h

8i

8g

8l

8k

8j

8f

8e

8d

8c

8b

8a

8

BystandersPresent WitnessedDrugUse NaloxoneAdministered IsNaloxoneNotAdmin IsNaloxoneUnknown IsNaloxoneAdminUnknown NaloxoneTotalResponder TreatedforPain IsNaloxoneAdminLaw IsNaloxoneAdminEMS IsNaloxoneAdminHospital

IsNaloxoneAdminOther IsNaloxoneAdminBystander IsNaloxoneWhoPerson IsNaloxoneWhoPartner IsNaloxoneWhoStranger IsNaloxoneWhoOther IsNaloxoneWhoFriend IsNaloxoneWhoRoommate IsNaloxoneWhoOtherFamily NaloxoneTotalBystander

BystandersPresent 1a BystanderUser 1b BystanderPartner 1c BystanderFamily 1d BystanderFriend 1e BystanderStranger 1f BystanderRoomate 1g BystanderMedical 1h BystanderOther 1i BystanderCPR 1j BystanderBreathing 1k BystanderSternal 1l BystanderStim 1m BystanderIntOther WitnessedDrugUse NaloxoneAdministered IsNaloxoneNotAdmin IsNaloxoneUnknown IsNaloxoneAdminUnknown NaloxoneTotalResponder TreatedforPain 8a MedHx_COPD 8b MedHx_Asthma 8c MedHx_Apnea 8d MedHx_Heart 8e MedHx_Obesity 8f MedHx_Injury 8g MedHx_Migraine 8h MedHx_BackPain 8i MedHx_HepC 8k MedHx_OtherPain 8l MedHx_OtherBreathing

IsNaloxoneAdminLaw IsNaloxoneAdminEMS IsNaloxoneAdminHospital IsNaloxoneAdminOther IsNaloxoneAdminBystander IsNaloxoneWhoPerson IsNaloxoneWhoPartner IsNaloxoneWhoStranger IsNaloxoneWhoOther IsNaloxoneWhoFriend IsNaloxoneWhoRoommate IsNaloxoneWhoOtherFamily NaloxoneTotalBystander 22---HadPulse 23a FirstResponderCPR 23b FirstResponderBreathing 23c FirstResponderEpinephrine 23d FirstResponderED 23e FirstResponderOxygen 23f FirstResponderOther BystanderNotRecognize BystanderUsing BystanderPublic BystandernoOD BystanderSeparated BystanderUnaware BystanderReasonOther

Changes to Response to Drug Overdose and Medical History Sections:

• 8 additional data elements (#1a – #1h) capture more detail on the bystanders of the fatal overdose. This information can be critical in allocating naloxone and other training resources to people who are likely to be present during fatal opioid overdoses.

• 6 additional data elements (#1i – #1n) expand the list of bystander’s response to the overdose and emerge from state abstractors work on SUDORS. This will increase information on bystanders responses to fatal overdose and can inform training of bystanders likely to respond to overdoses.

• 12 additional data elements capture information on decedent’s pre-existing conditions that: 1) may have contributed to the fatal overdose (#8a – #8e and #8l), 2) be related to injection drug use (#8i and #8j), or 3) explain the decedent’s use and/or prescription of opioid pain relievers (#8f – #8h and #8k).

• 7 additional data elements (#24 – #30) capture reasons bystander’s response to an overdose were delayed. Identifying these reasons can provide critical knowledge in improving responses to potentially fatal drug overdoses.

• 1 additional data element (#22) was added to capture the condition of the decedent when first responders arrived. This informaiton is important because the appropriate medical response may vary depending on whether the decedent had a heart beat when first responders arrived.

• 6 additional data elements (#23a – #23f) were added to capture the full array of treatments first responders administred to drug overdose decedents. This can inform training for future responses to potentially fatal drug overdoses.

SUDORS Tab: Prescription Information Section

Previous SUDORS version Proposed SUDORS version

1

1

2

2

3

7

3

4

4

5

5

6

6

PrescriptionMorphine PrescriptionMorphineNarrative IndicationsBuprenorphine NumScripsPast30Days NumPharmaciesPast30Days NumDoctorsPrescribing30Days

PrescriptionMorphine PrescriptionMorphineNarrative IndicationsBuprenorphine NumScripsPast30Days NumPharmaciesPast30Days NumDoctorsPrescribing30Days 7- FentanylRx

Changes to Prescription Information Section:

• 1 additional variable added to capture evidence that the decedent was prescribed fentanyl. This information is critical in determining whether the death was most likely linked with prescription fentanyl versus illicitly manufactured fentanyl.

5