Overdose Prevention
SAMHSA National Helpline: 1-800-662-4357
Confidential free help, from public health agencies, to find substance use treatment and information.
IN 211: Dial 211
or Text Your Zip Code to 898-211 (M-F, 8am – 5pm). A free, confidential service that connects Hoosiers to local resources and services for food, housing, utility bill support and more across Indiana.
National Domestic Violence Hotline: 1-800-662-4357
Hours: 24/7. Languages: English, Spanish and 200+ through interpretation service
Crisis Text Line: Text HOME to 741741
Free, 24/7 support from a trained crisis counselor.
The Basics
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What are Substance Use Disorders?
According to the 2020 National Survey on Drug Use and Health (NSDUH), 40.3 million Americans, aged 12 or older, had a substance use disorder (SUD) in the past year. Substance use disorders continue to be an important health issue in our country.
Substance Use Disorders (SUDs) are treatable, chronic diseases characterized by a problematic pattern of use of a substance or substances leading to impairments in health, social function, and control over substance use. It is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite harmful consequences. Patterns of symptoms resulting from substance use (drugs or alcohol) can help a doctor diagnose a person with a SUD or SUDs. SUDs can range in severity from mild to severe and can affect people of any race, gender, income level, or social class.
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How does substance use affect the brain?
When someone takes drugs, the brain is flooded with chemicals that take over the brain’s reward system and cause them to repeat behaviors that feel good but aren’t healthy.
The brain adapts to continued drug use by developing a tolerance, which means it takes more of a drug to feel the same result.
Not only does this lessen the brain’s ability to resist temptation, but it can also affect the amount of pleasure a person receives from normal, healthy activities like enjoying food or the company of others.
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One in 7 Americans reports experiencing a substance use disorder (SUD). There is not one single driving factor that leads to addiction. Some people may use substances to cope with stress, trauma, or mental health issues. Some may even develop opioid use disorder after misusing opioids they are prescribed.
Addiction is a disease, not a character flaw. Overcoming a SUD is not as simple as resisting the temptation to take drugs through willpower alone. Recovery may involve medication to help with cravings and withdrawal as well as different forms of therapy. It may even require checking into a rehabilitation facility. Recovery can be challenging, but it is possible.
Reference: https://www.cdc.gov/stopoverdose/stigma/index.html
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Recognizing the signs of opioid overdose can save a life. Here are some things to look for:
- Small, constricted “pinpoint pupils”
- Falling asleep or losing consciousness
- Slow, weak, or no breathing
- Choking or gurgling sounds
- Limp body
- Cold and/or clammy skin
- Discolored skin (especially in lips and nails)
- What to do if you think someone is overdosing:
It may be hard to tell whether a person is experiencing an overdose. If you aren’t sure, treat it like an overdose—you could save a life.
Step 1: Call 911 immediately.
Step 2: Administer naloxone, if available.
Step 3: Try to keep the person awake and breathing, administer rescue breathing if you are trained to do so.
Step 4: Lay the person on their side to prevent choking.
Step 5: Stay with the person until emergency assistance arrives.
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Signs and Symptoms of Drug Misuse
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Indiana Drug Overdose Dashboard
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Naloxone Distribution Program
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Reducing Stigma
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Opioid Prescribing Guidelines
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SHIELD
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Beyond Substance Podcast
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INSPECT (Indiana's Prescription Drug Monitoring Program)
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Health First Indiana
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Overdose Data to Action (OD2A) at IDOH
Through The Centers for Disease Control and Prevention (CDC) Overdose Data to Action grant in 2019, the Indiana Department of Health (IDOH) Division of Trauma and Injury Prevention was funded to implement 10 strategies to address surveillance and prevention of Substance Use Disorder and drug overdoses. IDOH used this funding to leverage comprehensive, high-quality data to inform prevention strategies across the state. In August 2023, IDOH was awarded once more as a part of a five-year cooperative agreement from CDC called Overdose Data to Action in States. The goals of this program are to:
- Address the evolving epidemiology of the drug overdose crisis.
- Close identified gaps in prevention activities.
- Apply lessons learned from the previous OD2A funding opportunity.
- Reflect the differing roles and spheres of influence state and local health departments and their partners have.
CDC has developed a framework to achieve these goals, the Overdose Data to Action Framework this framework and more information about the Overdose Data to Action program can be found here.
IN CAREs ECHO Program
Funded by the OD2A grant in 2019, IDOH collaborated with the Indiana University of Indianapolis (IUI) to develop the Indiana Communities Advancing Recovery Efforts (IN CAREs) Enhancing Community Healthcare Outcomes (ECHO).The ECHO model is an innovative framework that uses videoconferencing technology to increase the knowledge, skills, and performance of community stakeholders, particularly those located in rural and underserved areas. The IN CAREs ECHO connects a group of faculty experts (referred to as the “Hub”) who have experience in reducing overdose (OD) deaths with a set of community-based teams (referred to as “Spokes”) made up of leaders within each community. The Spoke teams are committed to working together to implement strategies and coordinate efforts to reduce substance misuse, reduce morbidity and mortality associated with substance use disorder (SUD), and increase linkage to care for those with SUD.The ECHO model requires Spoke teams to participate, virtually, in monthly, 90-minute sessions throughout their contract period. A session will consist of a short, expert-led lecture (didactic) presentation to improve content knowledge and share evidence-based best practices, followed by one community case presentation with clarifying questions and recommendations. As part of the community case presentation, Teams will identify and share stories that illustrate progress, successes, and challenges associated with their efforts. Each participating Spoke will be encouraged to have post-ECHO action meetings to ensure that participants are applying the knowledge learned in the virtual ECHO sessions to implement changes in their communities.
Funded Counties
To aid in the implementation of community changes, IDOH will fund each Spoke to carry out prevention activities including:
- Hiring a peer navigator
- Implementation or expansion of the county's Suicide and Overdose Fatality Review (SOFR) team.
- Implementation or expansion of the county's Overdose Response Plan (ORP)
- Implementation of the PulsePoint App as an overdose response strategy in partnership with Indiana University Citizen Opioid Responders (COR) program.
- General overdose prevention strategies/programs
- Staff support
To learn more about IN CAREs ECHO or any of the prevention initiatives in this program, select a button below.
County Name Here
Family Service of Bartholomew County, Inc.:
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
- General overdose prevention strategies/programs
- Provide evidence-based prevention material toolkits
- Connect families with Family Peer Recovery Specialists
Contact Information:
Denisea Nelson
Primary Contact, Grant Writer
dnelson@familyservicebc.org
Charlotte Barton Coombs
Secondary Contact, Executive Director
cbcoombs@familyservicebc.org
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
Contact Information:
Rick Hollering
Primary Contact, Executive Director
hollering@comcast.net
Lisa Hollering
Secondary Contact, Community Health Worker
lisa@ysainc.org
Clark County Health Department:
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
- PulsePoint for Overdose Response implementation
Contact Information:
Eric Yazel
Primary Contact, Clark County Health Officer
eyazel@dhs.in.gov
Doug Bentfield
Secondary Contact, Health Department Administrator - Clark County
dbentfield@clarkcounty.in.gov
Delaware County Prevention Council:
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
Contact Information:
Jenifer LaVelle Moore
Primary Contact, Executive Director
jenifer.moore@dcpreventionpartners.org
Rhonda Clark
Secondary Contact, Treasurer
rclark@bsu.edu
Floyd County Health Department:
- Hiring/training a peer navigator
Contact Information:
Charlotte Bass
Primary Contact, Administrator
cbass@floydcounty.in.gov
Brian Pahner
Secondary Contact, Assistant Administrator
bpahner@floydcounty.in.gov
Jay County Drug Prevention Coalition, Inc.:
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
- Overdose Response Plan implementation/expansion
- General overdose prevention strategies/programs
- Faith-Based Harm Reduction and Anti-Stigma Promotion
- Educate the community members on how substance use and mental health barriers impact their community, as well as the role stigma has in reducing access to care
Contact Information:
Kimbra Reynolds
Primary Contact, Executive Director
Kimbra@jcdpc.org
Jake Martz
Secondary Contact, Lead Prevention Professional
Jake@jcdpc.org
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
- PulsePoint for Overdose Response Implementation
- General overdose prevention strategies/programs
- Implementing Anti-Stigma training
- Continuation and expansion of Layperson Naloxone Training and distribution
- Creating of SMART Recovery Meetings in person
- Offering Mental Health First Aid to community organizations
Contact Information:
Kathleen Ratcliff
Primary Contact, Executive Director
kathleen@upstreamprevention.org
Rhonda Clark
Secondary Contact, Peer Recovery Coach
kaleb@upstreamprevention.org
Living In Transition Effectively, Inc.:
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
- General overdose prevention strategies/programs
- Extend NARCAN trainings to organization, churches, schools, etc.
- Educate the community on fentanyl, local and statewide statistics, and the increasing overdose cases
- Implementing an Anti-Stigma event series and SBIRT trainings
- Provide Mental Health First Aid trainings
- Host weekly All Recovery meetings
Contact Information:
Tammy Cotton
Primary Contact, Executive Director
tammy@liteinkcj.org
Heidi Blake
Secondary Contact, LCC Coordinator
heidi@kosciuskocares.org
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
- General overdose prevention strategies/programs
- Increase the frequency of Youth/Adult Mental Health First Aid, ACEs, QPR, and harm reduction/NARCAN trainings
Contact Information:
Thomas Kinnaird
Primary Contact, Marshall County Hope Coordinator
thomas.kinnaird@bowencenter.org
Lindie Leary
Secondary Contact, County Director, Marshall County Bowen Center
lindie.leary@bowencenter.org
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
- General overdose prevention strategies/programs
- Implement the Too Good for Drugs program in grade (3rd, 4th, and 5th) schools
Contact Information:
Macy Simmons
Primary Contact, Director of Addictions and Recovery Support Services
macy.simmons@inwell.org
Lynette Clark
Secondary Contact, Director
lynette.clark@inwell.org
Morgan County Substance Abuse Council:
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
- General overdose prevention strategies/programs
- Implement the Botvin LifeSkills program, focusing on middle and high schools students
- Expand Team Awareness trainings
Contact Information:
Barbara Dinwiddie
Primary Contact, Executive Director
barbara@morganprevention.org
Bridgett Morales
Secondary Contact, Community Coordinator
bridgett@morganprevention.org
Scott County Partnership, Inc.:
- Hiring/training a peer navigator
- Suicide and Overdose Fatality Review team implementation/expansion
- General overdose prevention strategies/programs
- Implement the Too Good for Drugs prevention curriculum in grades Kindergarten through 3rd
Contact Information:
Katrina Coryell
Primary Contact, Executive Director
katrina.coryell@scottcountypartnership.org
Carissa Miller
Secondary Contact, Community Services Director
carissa@stillwaterservices.org
County Map Legend
IUI ECHO Center
Learn MoreIN CAREs ECHO
Indiana Recovery Network
Learn MoreRegional Recovery Hubs
Overdose Response Planning Project
Learn MoreOverdose Response Planning Project
Indiana University
Learn MoreCOR Program
PulsePoint
Learn MorePulsePoint
Suicide and Overdose Fatality Review
Learn MoreSuicide and Overdose Fatality Review
Additional Prevention Strategies
- Clinician/Health System Engagement and Health IT/PDMP Enhancement
- IDOH partners with the Indiana Professional Licensing Agency (IPLA), the state agency that houses the state’s Prescription Drug Monitoring Program (PDMP) to maintain bidirectional connection for the exchange of PDMP data with other state systems
- IDOH will educate clinicians on opioid prescribing as described in the 2022 CDC Clinical Practice Guideline for Prescribing Opioids.
- IUPUI ECHO Center educates and supports health professionals to implement evidence-based pain management practices focusing on SUD prevention, screening, diagnosis, treatment, and linkage to care. ECHO is a web-based educational framework that builds communities of practice among multidisciplinary health professionals using case-based learning and peer knowledge sharing. It will build clinical capacity among established and new providers to offer SUD services. It will encourage providers to achieve patient-centered care aligned with the 2022 Guidelines. An interdisciplinary team of local experts, including peer navigators, will use their understanding of community needs and challenges to design a curriculum that addresses these complexities, and includes an audience of Indiana health providers that meet regularly to collaborate and discuss equitable care for patients living with chronic pain and SUD. The curriculum includes co-managing pain and SUD, screening and treatment, health equity and stigma, linkage to and retention in care for SUD, and peer navigation. IDOH will partner with Marion County Public Health Department to create and disseminate relevant resources on various platforms.
- Public Safety Partnerships/Interventions
- Law enforcement/justice system employee
- Northeastern University (NU) will expand Safety and Health Integration in Enforcement of Laws on Drugs (SHIELD) Training Initiative deployment curriculum for Indiana Law Enforcement (LE) by leveraging existing relationships between behavioral health professionals and local LE; using an enhanced train-the-trainer model; and further adapt the material for continuing and new sectors.
- Department of Trauma and Injury Prevention (DTIP)
- Under the Department of Trauma and Injury Prevention (DTIP) Overdose Response Plan (ORP) program, participating counties funded through the IN CAREs ECHO program will monitor Overdose (OD) Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) data, strengthen partnerships with stakeholders, develop an ORP using a template provided by IDOH in partnership with the Division of Emergency Preparedness and simulate virtual plans. Locally driven ORPs will address issues plaguing communities, including targeted education, naloxone trainings, and improved mass communication for fatality reviews. Law Enforcement (LE) will provide reports to inform Suicide/Overdose Fatality Review (SOFR) and identify gaps in justice involvement where linkage to care may be necessary. Implementing ORPs encourages Emergency Department (ED) doctors to prescribe buprenorphine, refer to outpatient Medically Assisted Treatment (MAT) and other treatment options, establish reporting mechanisms, and establish/maintain insurance coverage for patients.
- IDOH/IUPUI ECHO Center/DOC/Step-Up, Inc.
- The Indiana Peer Education Program (INPEP) ECHO uses an evidence-based peer education model to mitigate substance use disorder (SUD) and connect to harm reduction program (HRP) services for incarcerated people. From 2018 to 2023, the program was implemented in eight Indiana Department of Correction (DOC) facilities. Over 200 peer health educators (PHE) have been trained, and more than 3,000 individuals have been educated. INPEP is implemented by a team from IDOH; IUPUI ECHO Center; DOC; and Step-Up, Inc., a re-entry focused non-profit. Supported by DOC, individuals apply and are selected to train as PHE through an intensive 40-hour training that includes naloxone administration, HRP, SUD, and professional skills. PHE host health education workshops and provide support to DOC residents. The ECHO team hosts monthly virtual sessions and monthly administrative site visits which include additional training, continuing health education, skill and knowledge development, and troubleshooting implementation challenges. Site visits also serve to encourage communication between PHE, wardens, unit managers, site liaisons, and Central Office leadership. After release from incarceration, PHE are connected to reentry support services and treatment as needed. PHE who are released may become a member of Outside Peer Education Program (OutPEP) to teach SUD topics in their community and hold workshops at various targeted locations.
- Overdose Response Strategy (ORS) Public Health Analyst
- IDOH DTIP collaborates with CDC Foundation’s Overdose Response Strategy to reduce fatal and non-fatal drug ODs by connecting public health and public safety agencies, sharing information, and supporting evidence-based interventions with support from a Public Health Analyst.
- Law enforcement/justice system employee
- Harm Reduction
- Certified Peer Recovery Coach (CPRC)/Syringe Service Programs (SSP)
- Increased equitable delivery and improved access to care/services (e.g., harm reduction services such as SSPs, treatment services, warm hand-off programs, post-overdose outreach, support services such as transportation assistance, and recovery services), especially among Persons Who Use Drugs (PWUD) as well as those previously underserved by overdose prevention programs and the healthcare system overall
- Increased linkages to care (e.g., use of navigators to link people to evidence-based treatment and promote access and link PWUD to harm reduction services) and engagement in care (e.g., peer support groups or linkages to community-based self-help groups, increasing access and retention to care through strengthened telehealth infrastructure and resources) across various settings including community, healthcare, and public safety settings
- Certified Peer Recovery Coach (CPRC)/Syringe Service Programs (SSP)
- Community-Based Linkage to Care
- Marion County Public Health Department (MCPHD)/Department of Trauma and Injury Prevention (DTIP)
- The MCPHD will collaborate with Indiana Department of Health (IDOH) to expand the Beyond Substance Podcast statewide. Monthly episodes will showcase key topics such as: Overdose (OD) prevention work within local communities and select sub-populations of Persons Who Use Drugs (PWUD), the 2022 Guidelines, treatment/Medications for Opioid Use Disorder (MOUD), Harm Reduction Programs (HRP), and linkage to care best practices, peer recovery, etc.
- Suicide/Overdose Fatality Review
- The Fatality Review and Prevention (FRP) division at IDOH coordinates and supports local Overdose Fatality Review (OFR) teams in the implementation of OD case review. The FRP has adopted the child fatality review model for OFR, engaged key local stakeholders in the process, and shared state-level data such as hospital records, toxicology analysis, Indiana's Prescription Drug Monitoring Program (INSPECT) data, and county-level hospital discharge information to identify trends. OFR enhances data and adds qualitative analysis of risk factors and circumstances for events where drugs or alcohol may have been a contributing factor. Based on the findings gathered through OFR case review, teams can identify areas requiring intervention and provide outreach and social service referrals to loved ones of those who suffered a fatal OD.
- IDOH and IN CAREs ECHO Spoke
- IDOH will partner with ECHO recipients to carry out the following campaigns: CDC Stop OD, CDC Rx Awareness, and DHMA Know the Facts. IDOH Community Outreach Coordinators will work with communities across the state to implement and disseminate toolkits and advertisement materials. IDOH will recommend ECHO communities to incorporate these campaigns in their awareness and marketing efforts.
- Marion County Public Health Department (MCPHD)/Department of Trauma and Injury Prevention (DTIP)