Withheld: The potentially life-saving map that most can’t see

Imagine a weather radar that shows batches of dangerous drugs instead of storms. As with weather forecasts, not everyone will heed the warnings, but some might get out of harm’s way or take precautions.

One overdose-specific program, the Overdose Detection Mapping Application Program, or ODMAP, is a little like that hypothetical radar system: On-the-ground personnel voluntarily upload information to show where drug overdoses are happening in almost real time around the country. 

Together, those data can paint a striking picture of what’s happening on the front lines of the opioid epidemic, giving first responders a desperately needed edge in their fight.

Across most of the country, officials use ODMAP to monitor and respond to the spread of deadly drug batches. But in Wyoming, not everyone who could access or benefit from ODMAP knows about it.

In part three of a four-part series investigating Wyoming’s limited access to drug overdose data, WyoFile looks into what information this tool could provide, what that information would mean for those on the front lines and what’s holding it back.

ODMAP origins

Discussions started in 2015 during a spike in fentanyl overdoses in Baltimore, according to Ali Burrell, ODMAP’s program manager.

Burrell was working with the Washington/Baltimore High Intensity Drug Tracking Area, or HIDTA, which aims to stem the flow of illicit drugs. They were in talks with city officials, she said, and were “acknowledging that there was not a lot of data sharing … And so because of our space, and where our program lies, we provided an opportunity to create what is now ODMAP.”

In about 30 days, officials created a data map for Baltimore, which went live in January 2016. 

“That’s how things have evolved with the overdose epidemic, we’re always several steps behind. And so thinking outside the box, and being creative, knowing that you have a really small window to make big changes, you have to be flexible in how you approach things,” Burrell said. 

As fentanyl and overdose spikes spread across the country, so too did ODMAP’s reach.

Agencies from every state now report data to ODMAP. That includes Wyoming, which is one of only a handful of states reporting information from every county.

The program is federally funded through HIDTA, according to Burrell, but she didn’t disclose how much it costs.

The nation’s 33 HIDTA regions — including the Rocky Mountain HIDTA, which serves Wyoming — pass ODMAP information to local groups and first responders, she said. 

“So they can bring that to the boots on the ground, to the communities and say ‘here’s a tool for you,’” Burrell said. 

While HIDTAs have worked to spread the word about ODMAP, Burrell said access is limited to “local, state, federal and tribal public safety and public health agencies working within the overdose response, reduction and prevention space.

“So your emergency departments, your EMS providers, your fire and rescue, your law enforcement, your behavioral health or your departments of health,” she added.

That also applies to school nurses and coroners, a few of which have access in Wyoming. Natrona County Coroner James Whipps is one of the “data-contributing agencies” for ODMAP, and said he uses the tool to predict when he might see more deaths.

But much like a deadly storm system spotted by radar, Whipps said ODMAP won’t help him stop the overdoses, only plan for them. 

“It doesn’t help me in the end, because I can’t stop it,” he said.

Those with ODMAP access can see the approximate time of an overdose, whether someone survived and whether the opioid reversal drug naloxone was administered, Burrell said.  

Direct access is rarely — if ever — extended to nonprofit advocacy groups, journalists or local elected officials, however. That’s not due to the inclusion of personal or identifying information: exact locations are only available for the agency that imports the data. Other users see only approximate locations decoupled from demographics or names, according to Burrell. 

There are still concerns, though, about data being misunderstood or used to identify individuals, she said. 

“We just want to … make sure we’re providing as much detailed information as we can without identifying an individual on a map,” she said.  

Casey Patterson, who works for both the Rocky Mountain HIDTA and the Wyoming Division of Criminal Investigation, echoes Burrell’s concerns. He believes stigma plays a role, too.

“If this was publicly releasable, then there’s parts of the state that are afraid — and this is nationwide, this is not just Wyoming — there’s communities nationwide that may not want a stigma attached to them that’s based on incorrect data or incomplete data,” he said.

ODMAP is a quick-turn dataset that may have errors, like the inclusion of deaths that may later be determined non-overdoses, he said. 

“This is surveillance data, this isn’t information that you would want to hang your hat on,” Patterson said. 

Patterson is one of just a few individuals in Wyoming aggregating and importing data into ODMAP. Burrell said he could technically release information to the public, but DCI denied WyoFile’s request for the data that Patterson puts into the mapping system. 

“Those records contain medical data on individuals and therefore cannot be released under W.S. 16-4-203(d)(i) of the Public Records Act,” ​​Assistant Attorney General Megan Pope stated in an email. 

DCI also denied a follow-up request for redacted records. 

Wyoming Department of Health Director Stefan Johansson also has access to ODMAP, but shares the concerns of Patterson and Burrell about making it public.

“I think [ODMAP] is just like everything in my world, which is: it can be frustrating [because of] the information you do and don’t have,” he said. “There’s a litany of caveats with even the ODMAP data. There’s issues that always need to be worked out with duplications when you have multiple entities contributing data to a database.”

Meanwhile, Denver-based Rocky Mountain HIDTA Executive Director Keith Weis said his program prioritizes working with law enforcement, public health and harm-reduction groups. 

“Quite frankly, the opioid crisis is a crisis and it’s just been really great to see everyone coming to the table working together for the common cause, which is obviously to help save lives out there,” he said. 

As far as making sure everyone knows about and has access to resources, Weis said there is still work to do, but things are improving. Technology like ODMAP is only a few years old, he noted. 

“We’re making progress every day,” he said. “Is it perfect right now? It could be better. Everything could always be better. And we’re going to strive to make it better every day.”

He cautioned that actual trends take time to analyze, but said the Rocky Mountain HIDTA is working to publish the region’s predictions and threat assessments faster. HIDTAs also have to spend time finding the fastest, best data sources in rural states like Wyoming before spreading the word about them, he said. 

“Once we start that,” he said, “it’s a matter of just getting out throughout the state to provide information and kind of educate these other agencies on their capabilities that are possible out there.”

Partners in data

There are ways for people to learn about ODMAP trends without having direct access.

“If it’s not something that you are eligible to use, there are so many other resources,” Burrell said. “Maybe it’s connecting with an agency you see in your area that is able to use ODMAP and kind of building off of that, because it is one tool in a system.”

People ask where to place mobile crisis units or do naloxone outreach, she said. Those are examples of questions those who have ODMAP and other resources might help figure out.

“Because ideally, those numbers — through these conversations — go down and those are direct lives saved,” she said. 

While ODMAP encourages partnering, and HIDTAs are charged with spreading the word about the resource, many Wyoming stakeholders were in the dark. 

That includes leaders like Campbell County Commissioner Colleen Faber. Only after receiving questions from WyoFile did county officials find out there were other ways to obtain local overdose data, she said. 

A public health prevention specialist there recently obtained access to ODMAP, Faber said, “so she’ll be collecting that and sharing that more with commissioners so we know what that looks like for Campbell County.” 

That previously unavailable information could aid counties and towns as they decide what to do with 65% of the state’s millions of dollars in opioid settlement funds. Accessing overdose information could help them direct those funds. 

Ariel Bernath with Wyoming Harm Reduction Collective was also unaware this was something her group could access through a partnership. 

Local trend data can help with grants, Bernath said, but it can also prompt her group to spread the word about potentially dangerous batches of drugs to those who use them. Tenets of harm reduction include meeting people “where they’re at” and helping in ways local communities need most, whether that be safe use or supportive abstinence. 

Harm reduction organizations currently text or call each other to give heads up about a dangerous batch of fentanyl or drugs like xylazine, Bernath said. 

“In a way, it’s like people are protecting themselves,” she said.

In the near future, social media could also play a role in disseminating ODMAP data in Wyoming.

Spike alerts

A “spike alert” is a customizable feature within ODMAP that can alert an agency when a spike in overdoses of a certain number occurs across an area. The agency could then use those alerts to let the public know what’s going on via social media or other channels.

Before working with ODMAP, Burrell was a public health analyst in Virginia. She recalls an instance when her agency took a spike alert and worked with local law enforcement and others to put together a social media post.

“We ended up deciding to say ‘this is a lethal batch that’s coming through’ so they could see the severity of the bad batch that was going on,” she said. “As a complementary component, say, [we wrote] ‘here’s where to go get Narcan, and here’s how to learn about Narcan and get trained.’”

That one post had a big effect.

“Our local health department ran out of Narcan that weekend,” she said. “That Facebook post that they did saw 400 times more traffic than their coalition page had at any other post.”

These kinds of posts could include information about harm reduction initiatives and good samaritan laws, too, she said. Good samaritan laws shield those trying to help someone who is overdosing from prosecution, even if they, too, used illicit drugs. Wyoming is one of the few states without such protections.

The posts aren’t about scaring people, Burrell said, but rather letting them know officials are thinking things through “and we want to make sure you have help if you need it. Here’s where to get help. Here’s how to talk to somebody if you need.”

It’s something that Wyoming officials could eventually do, too, by using the ODMAP social media toolkit, Patterson said.  

Speaking with WyoFile early this year, Patterson said he was hoping to launch such social media alerts here in 2023 or 2024.

Social media blasts are one of the many solutions to limited overdose data WyoFile accrued while reporting. Check out the fourth and final story in this series to explore solutions and suggestions for how the state could spend its millions in opioid settlement funds for maximum effect. 

If you or someone you know is having suicidal thoughts, you can call or text the Suicide Prevention Lifeline at 988.

WyoFile is an independent nonprofit news organization focused on Wyoming people, places and policy.