In partnership with community partners, the Lackawanna County, Pennsylvania, District Attorney’s Office established a local, multiagency overdose fatality review (OFR) team in 2020 to examine the contributing causes of overdose fatalities in Lackawanna County. This plenary session will focus on two separate recommendations involving community education and awareness, harm reduction strategies, and decriminalization of fentanyl test strips.

Through cases reviewed by Lackawanna County’s OFR team, it became clear that the risk of fentanyl overdose did not simply or predominantly lie with heroin use. The review of these cases led to the recommendation for a deeper analysis of fentanyl-related overdose deaths and to increase awareness of this local data and risk of fentanyl overdose. In order to do this, the Lackawanna County District Attorney and the Mayor of Scranton, Pennsylvania, held a press conference, where they presented data and stressed that fentanyl was being seen laced in all street drugs, not just heroin, and that there had been several local overdoses due to pure fentanyl being disguised as other drugs and pills. The press conference was covered by local media and disseminated both in the local newspaper and TV news coverage. A one-page fentanyl educational document was also developed and disseminated to the OFR team, the local recovery coalition, and other relevant community partners. This press conference led to extensive discussions with a wide variety of community partners regarding the decriminalization of fentanyl testing strips. In addition, both the Pennsylvania District Attorneys Association and the City of Scranton publicly advocated for a state bill to decriminalize fentanyl testing strips following these discussions, which passed in October 2022.

Another recommendation that Lackawanna County’s OFR team was able to identify, develop an action plan for, and implement involved ensuring that all Lackawanna County police departments have access to naloxone as well as training on naloxone administration and local resources. Through collaboration between the Lackawanna County District Attorney’s Office and Pennsylvania Ambulance, this recommendation was successfully implemented and then expanded to other sectors throughout the community. Because of a significant number of school nurses requesting naloxone through Lackawanna County’s naloxone-by-mail initiative, as well as increased overdoses due to fentanyl pills being disguised as medications such as Percocet and Vicodin—which are increasingly popular with high school students—the OFR team also generated a similar recommendation to ensure naloxone access and education in all Lackawanna County schools. The Lackawanna-Susquehanna Office of Drug and Alcohol Programs took the lead on this initiative and sent a letter to all the school superintendents, and the Lackawanna County District Attorney’s Office mailed letters to all police chiefs in Lackawanna County, with telephone follow-up completed for anyone who did not respond. All schools and police departments were provided with naloxone, resources, and training as needed and appropriate. One hundred percent of Lackawanna County schools and police departments now have naloxone and resources onsite and were provided training, if needed, as a result of the findings and recommendation from the OFR team.