According to the U.S. Department of Health and Human Services, 116 people die each day from opioid-related drug overdoses. The misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and Prevention estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.
Cuyahoga County Heroin Crime Initiative
October 2018 - December 2020
The Begun Center serves as a research and evaluation partner to the Cuyahoga County, Ohio Heroin and Crime Initiative, to evaluate the Heroin-Involved Death Investigations (HIDI) protocol for Cuyahoga County. This work is supported by the National Institute of Justice.
The Cuyahoga County Opiate Task Force was created to increase awareness of the dangers associated with the misuse of opiates/opioids as well as to implement strategies and policies that will have a positive impact on this epidemic. In addition to the Begun Center, the Cuyahoga County, Ohio Heroin and Crime Initiative (HCI) also includes the United States Attorney’s Office for the Northern District of Ohio, the Cuyahoga County Prosecutor’s Office, the Cuyahoga County Medical Examiner’s Office and the City of Cleveland Division of Police.
The Begun Center and collaborators are working to support improved investigations and increasing the number of indictments of major heroin and opioid-related drug traffickers. More specifically the Begun Center is exploring the perceived effectiveness of Cuyahoga County’s Heroin-Involved Death Investigations protocol (the “HIDI protocol”) to strengthen the protocol’s role in the investigative process. The Begun Center also is analyzing local and federal prosecution data to add insight into the key elements supporting successful prosecutions of major traffickers at the local and federal levels.
The Begun Center’s evaluation of CCMEO’s death data also is providing insight into the changes occurring in drug overdose deaths. This is process-oriented research working to get key stakeholders to the table to closely examine fatal drug overdose incidents. Doing so highlights the importance of non-fatal overdose incidents and engaging people into treatment. The Begun Center will be interviewing key stakeholders (i.e., detectives, ME investigators, prosecutors and data analysts) to identify areas of need, gaps, opportunities to decrease fatal and non-fatal drug overdoses, etc.
Funder: National Institute of Justice
Comprehensive Opioid Abuse Site-Based Program (COAP)
October 2018 - present
The Begun Center is contracted through the Cuyahoga County ADAMHS Board on this Bureau of Justice Assistance-funded grant project. The program aims to reduce inappropriate opioid use overdose facilities. As evaluation partner, the Begun Center will use Ohio Automated Rx Reporting System data (prescription monitoring), identify key partners in addressing the opioid crisis, and bring people together to improve access to and sharing of data.
Information from law enforcement, public/private health, behavioral health, and social welfare organizations are often maintained in different agencies and are not integrated to support broader community policies and practices. This funding supports the Data Subcommittee of the
USANDO Heroin and Opioid Task Force (HOTF) in working to improve access to and sharing of data vital to stakeholders in the Northern District of Ohio by developing the Action Plan for creating a blueprint for an integrated IT data-sharing platform. This project leverages the existing partnerships of the HOTF, including the ADAMHS Board, Drug Enforcement Administration, FBI, the Ohio High Intensity Drug Trafficking Areas (HIDTA) program, Ohio Department of Job and Family Services, CCPO, CDP, CCMEO, Cuyahoga County Drug Court, the Begun Center, BioEnterprise, Accenture, and members of the treatment and user communities.
Cuyahoga County Overdose 2 Action (OD2A) Initiative
September 2019 - present
The Cuyahoga County Board of Health (CCBH) was awarded $13.2 million over a three‐year period from the CDC to prevent opioid‐related overdoses and deaths. The Cuyahoga County OD2A Initiative (CCOD2A Initiative) will enhance surveillance and prevention activities to facilitate a comprehensive integration and analysis of Cuyahoga County’s local opioid-related morbidity and mortality and assessing the ability to use these data to inform prevention. The CCOD2A Initiative also will focus on a variety of prevention efforts, including (1) establishing linkages to care; (2) expanding partnerships with public safety and first responders; (3)increasing provider and health system support; (4) expanding state and local integration, (5) promoting innovative prevention approaches and (6) optimizing prescription drug monitoring programs. The Begun Center is contracted to receive $679,830 per year for 3 years to evaluate the initiative.
Additional partners: ADAMHS Board of Cuyahoga County, Cuyahoga County Medical Examiner’s Office, MetroHealth, St. Vincent Charity Hospital, Center for Health Affairs, Cleveland Division of Police, Thrive, Woodrow, Beech Brook, Cleveland State University, Circle Health Services, PAXIS, Northeast Ohio Educational Service Center, and NARCAD.
Research Team: Daniel J. Flannery (Principal Investigator), Michelle L. Riske-Morris (Principal Investigator), Mark S. Fleisher, Karen Coen Flynn, Sarah Fulton, Ed Dabkowski, Vaishali Deo, Junghyae Lee, Ryan McMaster, Emily Szymanski, Rodney Thomas
Treatment Perspectives of Those Who have Experienced an Opioid Overdose and their Caregivers
November 2019 - present
Funded by the Woodruff Foundation, the purpose of this mixed-methods research is to learn the drug use and drug treatment perspectives of adults who have experienced an opioid overdose in the last five years, and lay and professional caregivers who have provided care to an adult who has experienced an opioid overdose in the last five years. The Begun Center seeks to collect data to inform treatment providers’ understanding of ways to connect and engage with adults who have experienced an opioid overdose, as well as data on adults’ opioid-overdose experiences to inform treatment providers’ efforts to quickly and effectively engage them with treatment.
Research Team: Karen Coen Flynn (Principal Investigator)
- Deo, V., Gilson, T., Kaspar, C., and Singer, M.E. (2021, January). The fentanyl phase of the opioid epidemic in Cuyahoga County. Journal of Forensic Sciences.
- Flannery, D.J., Gilson, T., Bhullar, M., and Noriega, I. (2020, August). Research in Brief: Carfentanil—A Fourth Wave of Fatal Overdoses. Police Chief Magazine.
- Flannery, D.J, and Singer, M. (2018, July). Thought Leaders' Corner: What role can population health play in dealing with the Opioid Crisis? Population Health News.
- Singer, M. (2017, August). An epidemic about moral failure or a public health emergency? Akron Beacon Journa.
- Singer, M. (2018, April). Ways to address the opioid crisis. New York Times.
In the Media
- Case Western Reserve and Cleveland Municipal Court receive Justice Department grants to fight opioid epidemic. Cleveland Plain Dealer, October 2017.
- Case Western Reserve University part of a multi-million-dollar grant to combat opioid epidemic. Case Western Reserve University, October 2019.
- Going After Opioid Dealers: Researchers Help Improve Tools for Investigators and Prosecutors. CWRU Think Magazine, May 2018.
- Understanding an Epidemic: Researchers Delve into the Expanding Opioid Crisis—and Work to Combat It. CWRU Think Magazine, October 2017.
- Fatal opioid traffickers targeted by nearly $1 million federal grant. Case Western Reserve University, October 2017.