An Introduction to the Opioid and Substance Use Framework

What Are Data Frameworks?


Dynamics driving health and well-being are complex. In the field of public health and more broadly among those working to advance equitable well-being, frameworks—a basic structure underlying a system, concept, or text—are a powerful tool that aid in understanding and sense-making. Frameworks provide conceptual infrastructure and help us understand the complex nature of health and well-being. “Framing” is a way of structuring or presenting a problem or an issue; it involves explaining, describing, and adding context. 


A framework provides a holistic view and approach to community change work, and prompts users to consider relevant upstream factors they might not otherwise. Importantly, frameworks are not mutually exclusive—in fact, using multiple frameworks offers a way to explore an issue from different perspectives.


Frameworks can be applied to quantitative data to help us more-effectively use data to inform our work. Data frameworks are arranged into a simple series of “domains” (or categories) that categorize a set of indicators that measure community health and well-being. Learn more about data frameworks and how they can be leveraged to improve community health and well-being.


What is the Opioid and Substance Use Framework?


The National Center for Wellness and Recovery (NCWR) at Oklahoma State University and the Institute for People, Place, and Possibility (IP3) collaborated to develop the two-part Opioid & Substance Use data framework to measure community burden and risk of opioid and other substance use, as well as more upstream contributing factors. The two-part framework allows identification of priorities for addressing and preventing substance use—while advancing well-being broadly—with an aim to address the Nation’s opioid crisis. The framework is designed for use by practitioners and community change-makers looking to advance a holistic approach to addressing substance use disorders at the population level. 


This framework is made up of 14 domains in 2 categories: 

History of the Opioid and Substance Use Framework 


It is well known that there is an opioid epidemic in the U.S. In 2017, the U.S. Department of Health and Human Services declared the U.S. Opioid Epidemic a public health emergency. Although increased funding and awareness has come from this declaration, the impacts of opioid and substance use continue to be felt in communities nationwide. 


Drug overdoses have risen over the last few decades—the rate of drug overdose deaths nearly quadrupled from 8.2 deaths per 100,000 in 2002 to 32.6 in 2022, though preliminary data indicate some progress on this front—the first decline in the number of total overdose deaths for the first time in five years in 2023! Data show that since the coronavirus pandemic began, more Americans are in crises, population mental health has worsened, there is more substance use, and higher rates of drug overdoses. The overall drug overdose rate rose by 50% from 2019 to 2021, with communities of color experiencing larger increases in overdose rate than their white counterparts. These data highlight the urgent need to decrease opioid and substance use and address upstream factors that contribute to these behaviors, like poor mental health, trauma, and lack of access to Vital Conditions we all need to thrive. 


This framework was developed by the IP3 team in response to myriad partners expressing interest in an opioid-focused organization of indicators to identify ways to curb and prevent substance misuse.


Equity Considerations


When using any data framework, it is important to take into account what the data can and cannot tell us about health disparities. For example, although the overall age-adjusted rate of drug overdose deaths did not significantly change between 2021 (32.4) and 2022 (32.6), American Indian and Alaska Native people experienced a 15.0% increase in overdose death rate from 56.6 deaths per 100,000 in 2021 to 65.2 per 100,000 in 2022. If we aim to use Opioid and Substance Use data to drive community change and improve health in a truly equitable way, exploring data by population groups where available—and seeking more information through local data and community engagement—to evaluate equity outcomes is essential.

Navigating the Opioid and Substance Use Data Landscape: Strategies to Assemble Data and Bridge Gaps 


Many groups struggle to identify and source the data indicators they need to measure conditions in their communities and advance data-driven actions. This is especially true for communities, collaboratives, and task forces working to address opioid and substance use disorders. Locally relevant and timely information can be found in a variety of sources and formats. Here are some examples of data sources from national, state, and local levels that can be used to assess community conditions related to opioid and substance use.


National Sources


Data from national sources is a great place to start. There are numerous datasets available at useful geographic extents (e.g., county) from national sources. Below are a few particularly useful sources for opioid and substance use data:


A screen grab of CDC WONDER webpage
CDC WONDER
Dataset
Brought to you by CDC
Screen grab of Medicare Part D Opioid Prescribing Rates - By Geography
Medicare Part D Opioid Prescribing Rates - By Geography
Dataset - Geographic
Brought to you by CMS
Screenshot of the front page of Opioid Treatment Program Directory
Opioid Treatment Program Directory
Resource - Data Bank/repository

State Sources


National data only tells part of the story. State-specific data can fill in gaps and may be more recent and localized. State data availability and accessibility varies widely between states. Below are common indicators that can often be accessed from state sources.


Local Sources


For many community-based groups, national and state level data leave something to be desired. The time delay, coarse geography, and lack of local and cultural context can create a disconnect between lived experiences and data on the page (or screen). In that case, more locally relevant data are important to drive local action. Addressing the gaps using locally sourced data—where that data is not already collected—is a question of time, capacity, and resource allocation. Collaboratives can bridge this gap to advance a more vibrant local data ecosystem. Through partnership and engagement of local stewards, data availability and capacity increases and a more robust local data landscape takes shape. Below are examples of datasets that local network partners may be able to provide in support of addressing local opioid and substance use issues.


Additional Resources

First page of
Navigating the Opioid and Substance Use Data Landscape: Strategies to Assemble Data and Bridge Gaps
Resource - Guide/handbook
Brought to you by IP3
Published on 03/07/2022
Photo of a large quantity of pills of different sizes, shapes, and colors
Navigating the Opioid Crisis
Story - Original
Brought to you by Community Commons
Screen grab of Reducing Teen Substance Misuse: What Really Works
Reducing Teen Substance Misuse: What Really Works
Resource - Report
Brought to you by Trust for America's Health
Cover page of Overview of Opioid Treatment Program Regulations by State
Overview of Opioid Treatment Program Regulations by State
Resource - Policy Brief
Brought to you by The Pew Charitable Trusts
First page of A Systems Approach to The Opioid Epidemic brief
A Systems Approach to The Opioid Epidemic
Resource
Brought to you by Georgia Health Policy Center
Screenshot of the front page of Pain in the Nation 2023
Pain in the Nation 2023
Resource - Report
Screen grab of Drug Use Among Youth: Facts & Statistics
Drug Use Among Youth: Facts & Statistics
Resource - Website/webpage
Brought to you by NCDAS
Cover page for Pain in the Nation report
Pain in the Nation
Resource
Brought to you by Well Being Trust
Screen capture of Opioid Prescriptions Dashboards - ACH
Opioid Prescriptions Dashboards - ACH
Tool - Data/mapping Tool
Brought to you by Washington State Department of Health
Staff Pick!
Cover of Alcohol and Drug Misuse and Suicide an the Millennial Generation - a Devastating Impact
Alcohol and Drug Misuse and Suicide an the Millennial Generation - a Devastating Impact
Resource - Policy Brief
Brought to you by Well Being Trust

 Related Topics


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Substance Use

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U.S. Opioid Epidemic