Death by drug overdose in the United States continues to rise according to the National Institute on Drug Abuse (NIDA). Staten Island, New York, or Richmond County is home to 480,000 individuals and is significantly representative of the United States demographically and socio-economically. Staten Island has disproportionately suffered from the overdose crisis. The number of overdose deaths per 100,000 on the island is much higher than the national rate and it maintains the second highest borough rate of death due to overdoses in NYC. Staten Island has emerged as a center of overdose treatment innovation.

This session will examine how one such innovative program - The Hotspotting the Overdose Epidemic Program (The Hotspotting Program) - was conceived and implemented and can be a promising approach to save lives.

The Hotspotting program is a paradigm-shifting, evidence-based, data-driven overdose prevention and outreach initiative led by the Staten Island Performing Provider System. The initiative aims to leverage predictive analytics to identify individuals at the highest risk of overdose and engage them before an adverse event in a peer-led (CRPA), person-centered care management model supported by contingency management. Contingency management is an evidence-based approach to supporting an individual in recovery financially and tactically with reminders and nudges for meeting goals and milestones. The program emphasizes Harm Reduction, assessing and meeting individuals' Social Determinants of Health, and addressing justice involvement as needed. It also utilizes value-based incentive compensation to participating organizations. At the end of the first year, the Hotspotting program demonstrated an 81% reduction in non-fatal overdoses for the 643 clients engaged. More importantly, there were two overdose-related deaths vs 11 in the non-engaged group.