{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:46:12Z","timestamp":1777898772967,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Centers for Disease Control and Prevention Opioid Data to Action Grant"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Despite recent decreases in overdose deaths in the United States, an opportunity remains to connect with people who have had a nonfatal overdose. We analyzed data collected from the Maricopa County Department of Public Health (MCDPH) nonfatal opioid overdose case investigations program, highlighted findings from investigations conducted during the first 2 years of the program (September 1, 2021\u2013August 31, 2023), and compared findings across the 2 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We reviewed data collected through the MCDPH nonfatal opioid overdose case investigations program, wherein MCDPH staff members conduct telephone interviews with a sample of case patients with a recent nonfatal opioid overdose. During interviews, MCDPH staff asked questions about overdose event circumstances, knowledge and practice of harm reduction strategies, substances used, and interest in treatment. MCDPH staff offered harm reduction kits to all case patients and transferred case patients interested in treatment to the Arizona Opioid Assistance and Referral Line.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>MCDPH interviewed 529 of 2029 case patients (29.5%) who met sampling criteria. Among 354 case patients who self-reported recreational drug use, the number of cases reporting recreational fentanyl use increased from 117 of 179 (62.6%) in year 1 to 129 of 175 (73.7%) in year 2. Of 352 case patients, 187 (53.1%) reported access to naloxone. Smoking (208 of 295 case patients; 70.5%) was the most commonly reported route of consumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Practice Implications:<\/jats:title>\n                    <jats:p>MCDPH\u2019s novel nonfatal opioid overdose surveillance program identified trends in drug use and harm reduction among people who use drugs who are at the highest risk of a subsequent overdose. The program continues to operate, and survey questions are routinely evaluated to ensure data collected inform overdose prevention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00333549251374923","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T11:59:21Z","timestamp":1762171161000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics of Overdoses and Harm Reduction Behaviors From Case Investigations of Suspected Nonfatal Opioid Overdoses\u2014Maricopa County, Arizona, September 2021\u2013August 2023"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3267-0684","authenticated-orcid":false,"given":"Christina","family":"Mrukowicz","sequence":"first","affiliation":[{"name":"Maricopa County Department of Public Health, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary-Helen","family":"Wanat","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deanna","family":"Montano","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliana","family":"Bernal Gomez","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Valdez","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Carranza","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica R.","family":"White","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1891-919X","authenticated-orcid":false,"given":"AriellaP.","family":"Dale","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Maricopa County. Mental health and substance use data. 2022. Accessed April 1 2024. https:\/\/www.maricopa.gov\/5079\/Mental-Health-and-Substance-Use"},{"key":"e_1_3_3_3_2","unstructured":"Arizona Administrative Code. 9 AAC Ch 4. Title 9. Department of Health Services\u2014Noncommunicable Diseases. Vol R9-4-6. 2024. Accessed February 22 2024. https:\/\/apps.azsos.gov\/public_services\/Title_09\/9-04.pdf"},{"key":"e_1_3_3_4_2","unstructured":"Arizona Administrative Code. Title 9. Chapter 1. Department of Health Services\u2014Administration. Vol R9-01. Accessed June 24 2025. https:\/\/apps.azsos.gov\/public_services\/Title_09\/9-01.pdf"},{"key":"e_1_3_3_5_2","unstructured":"Arizona Revised Statutes. Article 15. 36-798.51. Overdose and disease prevention programs; requirements; standards. 15-36-798.51. Accessed June 24 2025. https:\/\/www.azleg.gov\/viewdocument\/?docName=https:\/\/www.azleg.gov\/ars\/36\/00798-51.htm"},{"key":"e_1_3_3_6_2","unstructured":"Council of State and Territorial Epidemiologists. Nonfatal opioid overdose standardized surveillance case definition. 2019. Accessed April 1 2024. https:\/\/cdn.ymaws.com\/www.cste.org\/resource\/resmgr\/ps\/ps2022\/19-CC-01_FINAL_appendices_up.pdf"},{"key":"e_1_3_3_7_2","unstructured":"Arizona Department of Health Services. Opioid assistance and referral line. 2009. Accessed April 1 2024. https:\/\/www.azdhs.gov\/oarline"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.02.024"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2019.04.020"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:122556"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-019-0195-4"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2020.02.013"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2018.8.38829"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f174"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14624"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-018-0117-1"},{"key":"e_1_3_3_17_2","unstructured":"Never Use Alone. US national overdose response line. 2019. Accessed April 1 2024. https:\/\/neverusealone.com"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1242795"},{"key":"e_1_3_3_19_2","unstructured":"National Harm Reduction Coalition. Fentanyl use and overdose prevention tips. 2024. Accessed April 1 2024. https:\/\/harmreduction.org\/issues\/fentanyl\/fentanyl-use-overdose-prevention-tips"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.17269\/s41997-019-00180-w"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7306a2"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103872"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.42676"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/add.13779"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13033-023-00601-x"},{"key":"e_1_3_3_26_2","unstructured":"Centers for Disease Control and Prevention. 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