16: Overdose Awareness and Action

Dr. Mark Levine, Vermont’s Commissioner of Health, outlines steps states and territories can take to address the alarming rise in the number of overdose deaths in the United States; Luke Tomsha, founder of The Perfectly Flawed Foundation, tells...

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Dr. Mark Levine, Vermont’s Commissioner of Health, outlines steps states and territories can take to address the alarming rise in the number of overdose deaths in the United States; Luke Tomsha, founder of The Perfectly Flawed Foundation, tells ASTHO members how they can help connect with those who know the most about overdose; ASTHO plans an event to examine preparedness lessons two decades after 9/11; and registration is open for an online COVID-19 bootcamp to boost your crisis leadership skills.

Website: International Overdose Awareness Day

Website: The Perfectly Flawed Foundation

Event: Two decades after 9/11

Learning: How to be prepared to serve during COVID-19


ASTHO logo



This is Public Health Review Morning Edition for Tuesday, August 31st, 2021. I'm Robert Johnson.

Here's today's news from the Association of State and Territorial Health Officials.


Today, people across the world pause to observe the 20th annual International Overdose Awareness Day. Last year, 93,000 people in the U.S. died from an overdose—that's 20,000 more than in 2019.

Dr. Mark Levine, Vermont's health commissioner, outlines steps states and territories can take to address the crisis.


One step is clearly to have harm reduction be real: make sure that Naloxone is available; make sure that it, literally, you can flood the streets with it; and that the financing system for providing Naloxone and other harm reduction efforts is robust even at a time like now when the cost of that actual medication is going up.

Second thing is really make sure that a treatment system is robust enough that there is rapid access to it. That can be through several mechanisms.

One is so-called rapid access to medication assisted treatment. That means that if you're brought in with an overdose to an emergency room and you're resuscitated appropriately, that you can have the opportunity to get your first prescription for buprenorphine right then and there in that setting.

It's sort of the concept of meeting people where they are and—whether it's in a hospital, whether it's at a syringe service program, whether it's in a doctor's office—making sure that there's treatment available.

And then having a medication assisted treatment system that doesn't have wait lists, because there may be a golden moment and someone's experience when they are ready for treatment. And you don't want to miss that opportunity. It could end up in tragedy if you miss that opportunity.



Luke Tomsha struggled 14 years with a heroin addiction. Now, he heads a group he created—The Perfectly Flawed Foundation—based in Illinois.

He tells us how Public Health can help in today's morning conversation.

What advice can you offer to health officials listening to this conversation right now if they're working to reduce stigma around overdose programs in their states and territories?


The first thing I can give them for advice is to follow the golden rule. Stigma kills, y'know, so treat people as you would like to be treated. And that's really the core behind meeting people where they're at and just making people feel heard.

I think it's important to find the voices in your state and empower them, listen to them, hire them, and put them at the table in a meaningful way at all levels of government, oftentimes even small—like we're in a smaller community.

You know, health departments are different throughout the state—some are more invested in the overdose death than others, some are political—and it's important that people with lived experiences, the harm reduction voices are centered. And by involving us at the highest levels of the state, that can help give us support for some of the more local community-based health departments.


What's the best way for a health department to find people who are qualified but also have this lived experience?


Well, that's the challenge because, you know, number one, you need to build trust with this group of people. We are very passionate, but we're also very sensitive. There's a lot of emotion, there's a lot of grief, there's a lot of anger.

So, it's important that, you know, you do your homework because there's also voices that can be harmful—some can be ego-driven, some can be driven by grief and not providing the right information. We don't have all the answers; but if you can find the right voices, we can be very important piece of the solutions to the overdose crisis.

As far as identifying them, I would start with the harm reduction groups. I would find the harm reduction groups—the syringe service programs and those types of organizations in your state. That's where I would start with.

I think the majority of treatment over the years has been based on abstinence-only, and we've seen that's not working. We're here to reduce overdose death, and it starts with the harm reduction groups.


All sorts of people struggle with these problems.

I would imagine that if you start looking around talking to people who are helping these folks, you'll find some real gems in the community.


You'll find some of the most brilliant people you'll ever talk to.

I mean, there's really some beautiful things that can happen when you empower the voices of anyone. We know how to serve ourselves. We have been down the road, we know what we need, and you can really find some innovative, hard chargers that are there to reduce overdose death.


If states and territories want to pursue this approach, can your organization help them with that?


Yeah, we can help build networks. We can help connect them to other advocates within their state. We do service delivery on a community-based level in Illinois.

We work with a lot of advocates throughout the state for policy work, but we also communicate with other advocates throughout the country.

We might not know the advocacy in your state, but we'll know an advocate that knows the advocates that are in your state. It's tough to build trust and we can help create that open door and really, you know, kind of coach on how to communicate and, you know, involve us in a meaningful way.



Also this morning, ASTHO makes plans to remember another anniversary—September 11th.

Leaders will convene September 9th to consider public health and preparedness two decades later. The virtual event features discussions about capacity, funding, and work to prepare for future challenges.

Registration is free. Sign up using the link in the show notes.


Finally, a crisis can test your leadership skills. ASTHO has an online learning module that can help you respond now during the pandemic and get you ready for the next emergency.

The Johns Hopkins Bloomberg School of Public Health partnered with ASTHO to develop the COVID-19 Bootcamp curriculum. Learn about incident command structures, data systems, crisis communication, and other topics.


Visit the show notes for a link to the online training and everything else mentioned this morning.

Also, remember to follow us on Apple Podcasts and Spotify, or listen on Alexa or Google assistant.

And, if you have a minute, please take time to leave us a rating and a review.


Join us tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition.

Luke Tomsha

Founder, The Perfectly Flawed Foundation

Mark Levine MD

Commissioner of Health, Vermont Department of Health