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End Mass Overdose Inc.

 1326 Columbia Road #4
 Boston, MA 02127
[P] (617) 645-8305
[F] --
http://www.endmassoverdose.org
[email protected]
Allison Burns
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INCORPORATED: 2015
 Printable Profile (Summary / Full)
EIN 47-3870286

LAST UPDATED: 10/03/2016
Organization DBA --
Former Names --
Organization received a competitive grant from the Boston Foundation in the past five years No

Summary

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Mission StatementMORE »

To reduce the number of opioid overdoses and substance misuse-related health complications and costs to society. To empower the public with knowledge and build a forward-looking network that engages patients, community, healthcare, legal, and government stakeholders. 

Mission Statement

To reduce the number of opioid overdoses and substance misuse-related health complications and costs to society. To empower the public with knowledge and build a forward-looking network that engages patients, community, healthcare, legal, and government stakeholders. 


FinancialsMORE »

Fiscal Year July 01, 2016 to June 30, 2017
Projected Income $2,500.00
Projected Expense $35,000.00

ProgramsMORE »

  • Community Overdose Education and Naloxone (Narcan) Training
  • Opioid Education and Naloxone Training Course for Healthcare Workers and Other Professionals
  • Pharmacist Toolkit: Pharmacist and Pharmacy Intern Opioid Antagonist and Overdose Certification

Revenue vs. Expense ($000s)

Expense Breakdown (%)

No data available

Expense Breakdown (%)

No data available

Expense Breakdown (%)

No data available

For more details regarding the organization's financial information, select the financial tab and review available comments.


Overview

Mission Statement

To reduce the number of opioid overdoses and substance misuse-related health complications and costs to society. To empower the public with knowledge and build a forward-looking network that engages patients, community, healthcare, legal, and government stakeholders. 


Background Statement

End Mass Overdose, Inc. is a Boston-based 501(c)(3) nonprofit organization that targets the Opioid Epidemic and implements strategies, solutions, and crisis interventions to improve public health outcomes by educating healthcare professionals, training community members, and providing patient advocacy to underserved populations.  
 
End Mass Overdose was founded by Dr. Allison Burns, PharmD in May 2015.  Allison, a graduate of the United States Naval Academy, served as a pilot in the United States Navy until she was injured on active duty.  Dr. Burns was prescribed a significant amount of narcotic painkillers to treat her hip and foot injuries, which sparked her interest in proper opioid prescribing and dispensing practices. Following surgery, she turned her in flight suit for a white coat and transitioned to civilian healthcare with a continued interest in pain management. She witnessed the devastating toll the opioid epidemic took on the community, including barriers to naloxone (Narcan) access, stigma, and lack of patient advocacy and resources.  The epidemic became personal when her younger brother came forward as a heroin addict.  Shortly thereafter, Dr. Burns formed End Mass Overdose and developed a Board of Directors, Opioid Task Force, and team of forward-looking individuals dedicated to serving and empowering the public during this health crisis.

Impact Statement

FY16 Milestones
  • Collaborated with state representatives on the landmark Opioid Bill Developed resource guides featured by MA Pharmacists Association (MPhA)
  • Partnered with Bureau of Substance Abuse Services (BSAS)
  • Selected to be an Amazon Smile Foundation Charity
  • Formed a 25-member Task Force
  • Joined Advisory Board of Maximizing Opioid Safety with Naloxone (MOON) Study at Boston Medical Center
  • Trained 350 housing workers at statewide Mass Housing Conference
  • Trained 375 Doctor of Pharmacy students at MCPHS University
FY17 Goals
  • Train 3,000 community members in opioid overdose and harm reduction strategies
  • Launch a destigmatization campaign
  • Offer medical continuing education courses to healthcare professionals in order to encourage better prescribing and dispensing practices and improve patient outcomes 

Needs Statement

1. Funding: $45,000 to support our community opioid education workshops, overdose prevention training, and daily operations
2. Trainers: licensed healthcare professionals to help instruct/facilitate our opioid education and naloxone (Narcan) trainings
3. Venues: currently a mobile organization that brings services to the customer, goal is to establish physical locations where trainings and workshops can be held    
4. Administrative assistants: to assist with office management 
5.  Grant writers: to help in the grant application process
 

CEO Statement

As a pharmacist, I have never refused treatment to the lung cancer patient or a diabetic having a heart attack at the door.  I have never said you shouldn't have smoked those cigarettes.  You shouldn't have eaten that last cheeseburger.  Yet, the medical profession continually turns away addicts who relapse.  Society constantly belittles those with substance use disorder, making them feel like they do not deserve treatment because they caused their own problems.  This misconception is dangerously inaccurate and has only exacerbated the current public health crisis.  Furthermore, I am horrified by the lack of accountability that the medical profession has taken in the current public health crisis.  There are two key players in the opioid epidemic: prescribers and dispensers.  As professionals, we need to utilize better assessments and treatment modalities to improve patient outcomes. 

Board Chair Statement

End Mass Overdose, Inc. has already begun to impact the community within five short months of operation by increasing access to intranasal naloxone (an opioid overdose reversal agent) and providing overdose response training and destigmatization education.  With an increasing amount of requests and referrals from the Department of Public Health for opioid education and naloxone distribution coming in, our biggest challenge is sustaining the work we have started with proper funding.  Currently, End Mass Overdose, Inc. is applying for state and federal grants, but the process is painstakingly slow.  Luckily, we have many community and student volunteers, as well as recovering addicts, who volunteer to help us continue to deliver our services.  The outpouring support and thanks we have received has made this an incredibly rewarding experience for everyone involved. 

Geographic Area Served

GREATER BOSTON REGION, MA
End Mass Overdose, Inc. primary serves the Greater Boston area, as well as the South Shore, the Cape, and the Islands.  We have also served areas in the Worcester county.  

Organization Categories

  1. Public & Societal Benefit - Public & Societal Benefit NEC
  2. Mental Health & Crisis Intervention - Addictive Disorders NEC
  3. Education - Adult Education

Independent research has been conducted on this organization's theory of change or on the effectiveness of this organization's program(s)

No

Programs

Community Overdose Education and Naloxone (Narcan) Training

Learn about opioid overdose and response:
  • Understand what opioids are, including lesser known opioids like tramadol and codeine, how these substances work, and how they cause an overdose

  • Risk factors for overdose

  • Identify difference between opioid intoxication (being "very high"), overdose, and withdrawal

  • Compare and contrast different formulations of naloxone (Narcan), including both intranasal products

  • Learn how to assemble and administer naloxone (Narcan)

  • Troubleshooting during an overdose, including broken Narcan device

  • Understand the roles of the community member and substance user in the opioid epidemic ​

 
Budget  $30,000.00
Category  Mental Health, Substance Abuse Programs, General/other Substance Abuse Crisis Intervention
Population Served Alcohol, Drug, Substance Abusers General/Unspecified Families
Program Short-Term Success  Short-term success will be increased number of community members trained in overdose prevention/response, increased access to naloxone, increase in number of standing orders, and increased community awareness.   
Program Long-Term Success  Longterm success will be a reduction in the number of fatal overdoses. More specifically, a reduction in overdoses that correlates with increased access to naloxone per zip code. 
Program Success Monitored By 
Immediate program success is monitored through an evaluation process which is utilized for all activities to assess whether, as a result of the participant attending the activity, there is a change in learner knowledge, competence, or skills from baseline. Either a paper or electronic evaluation will be utilized.
 
Longterm success is measured through an evaluation of overdose statistics and public health data provided by the Department of Public Health, CDC, and other governing bodies.  Previous evidence has shown that overdose rates decrease in communities with access to overdose training and naloxone (Narcan).    
Examples of Program Success  Examples of program success include a reduction in number of overdoses, decrease in number of hospital admittances for overdose-related events, and increase in number of naloxone rescue kits distributed. 

Opioid Education and Naloxone Training Course for Healthcare Workers and Other Professionals

Instructional and training program that teaches healthcare workers, police officers, firefighters, social workers, teachers, coaches, counselors, and other professionals working with at-risk populations about overdose prevention and opioid therapy risk management.  Program includes naloxone (intranasal and intramuscular) administrator training, opioid overdose recognition and response, including initial assessment of the victim and special precautions, overview of treatment agreements, Prescription Drug Monitoring (PMP) review, legal and liability considerations, and resources for treatment/recovery. Course includes Certificate of Completion
Budget  $20,000.00
Category  Mental Health, Substance Abuse Programs, General/other Substance Abuse Crisis Intervention
Population Served College Aged (18-26 years) Adults General/Unspecified
Program Short-Term Success  Short-term success will be effective delivery of training to Doctor of Pharmacy students in the 2016 spring semester at Massachusetts College of Pharmacy and Health Sciences (MCPHS).  Inclusion of the program as a graduation requirement for students in all healthcare-related fields within MCPHS and eventual expansion of program to other campuses, colleges, universities, and training sites.  
Program Long-Term Success  Long-term success will be establishing overdose education and opioid therapy risk management as a requirement for both graduation and renewal of licensure in all healthcare fields.  
Program Success Monitored By  Program success will be monitored by student, preceptor, and patient surveys and testimonials.  Survey questions will include, but are not limited to, is this training worthwhile for your career, how will this training improve patient care, what was the best and worst parts of training, and how can this training be improved.  Student surveys will be administered after the initial training and again after assigned clinical rotations to determine if student used knowledge in practice. Preceptor surveys and patient testimonials will be used to determine if student was knowledgable and communicated this knowledge effectively.  
Examples of Program Success  Program success will be measured by its sustainability, i.e. the inclusion and expansion of the program to other schools, hospitals, and training sites.  Success will ultimately translate to better patient care.  

Pharmacist Toolkit: Pharmacist and Pharmacy Intern Opioid Antagonist and Overdose Certification

To dispense naloxone without a prescription under the MA Standing Order, all pharmacists must be trained through a Department of Public Health and Massachusetts Board of Registration in Pharmacy approved training program. End Mass Overdose, Inc.'s program is one of three approved options in the Massachusetts. Learning objectives include the following:

  • Examine the epidemiology of overdose and the opioid epidemic

  • Define an opioid and understand the pharmacology of an opioid overdose

  • Recognize opioid overdose risk factors in your patients

  • Understand the rationale for and scope of overdose risk reduction and prevention

  • Incorporate patient education of overdose risk reduction and prevention

  • Set up a standing order for naloxone

  • Hands-on naloxone training

  • Identify the differences between opioid withdrawal, intoxication, and overdose

  • Identify the signs of opioid overdose and how to respond•Learn how to administer IM and IN naloxone

  • Define the legal issues for pharmacists

Budget  $15,000.00
Category  Mental Health, Substance Abuse Programs, General/other Substance Abuse Crisis Intervention
Population Served General/Unspecified Adults
Program Short-Term Success  Short term success will be increasing the number of pharmacies with a Standing Order for Naloxone, particularly in remote or rural areas with limited access to resources. 
Program Long-Term Success  Long term success will be establishing a Standing Order for Naloxone (SON) in at least one community pharmacy in every town in Massachusetts.  
Program Success Monitored By  Program success will be monitored by surveys and feedback from pharmacy staff and community members about the effectiveness and impact of having a standing order.  Surveys will be distributed every 6 months. 
Examples of Program Success  Reduction in overdoses that correlates to areas with established community pharmacy-based naloxone programs.  

CEO/Executive Director/Board Comments

The opportunities to provide prescription drug and overdose prevention, training, and treatment services are greatly needed during the current opioid epidemic.  The greatest challenge is bringing our comprehensive services and programs to as many communities as possible in the shortest amount of time in order to provide effective public health crisis intervention. 

Management


CEO/Executive Director Dr. Allison Burns
CEO Term Start May 2015
CEO Email [email protected]
CEO Experience

Allison Burns is the founder and CEO of End Mass Overdose, Inc. and a resident (PGY1 Pharmacy Practice) at Beth Israel Deaconess Medical Center.  Allison holds a Bachelor’s of Science degree from the United States Naval Academy and a Doctor of Pharmacy from Massachusetts College of Pharmacy and Health Sciences. After being commissioned a pilot in the United States Navy, Allison was injured, but continued to dedicate her life to public service when she traded in her flight suit for a white coat. Her current practice sites are Massachusetts General Hospital and the Department of Veterans Affairs Boston Healthcare System- Jamaica Plain Campus. She is also sits on the Advisory Board for Maximizing Opioid Safety with Naloxone at Boston Medical Center. In her outpatient and inpatient pharmacy roles, Allison comes into daily contact with active substance users, individuals in recovery, social workers, and healthcare practionitioners. She also has a sibling in long-term heroin recovery. Allison is focused on improving substance use disorder treatment outcomes, recovery management, the implementation of evidence-based practice, the effects of continuing care, and reducing the stigmas associated with addiction.

Allison has wide variety of experience in diverse clinical settings, including Brigham and Women’s Hospital Chronic Pain Clinic, the Massachusetts Board of Pharmacy, Kindred Hospital Longterm Care, VA Hosptial, St. Elizabeth’s Hospital- Infectious Disease Unit, Massachusetts General Hospital, and CVS Pharmacy.

Allison is currently a member of the following professional organizations: American Society of Health-System Pharmacists (ASHP), American Pharmacists Association (APhA), Massachusetts Pharmacists Association, Industry Pharmacists Organization, and acting President of Student Veterans of America- MCPHS Chapter.

Co-CEO --
Co-CEO Term Start --
Co-CEO Email --
Co-CEO Experience --

Former CEOs and Terms

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Senior Staff

Name Title Experience/Biography
Sergeant Brendan Douglas Clerk Sgt. Douglas is a founding member of End Mass Overdose, Inc. He has previous nonprofit experience as a Director of Little Hugs Foundation, Inc. He also has extensive grant experience, writing 6-figure grants for the Milton Police Department for the past 5 years.  

Awards

Award Awarding Organization Year
11th Annual Advanced Practice Management Business Competition- First Place Massachusetts College of Pharmacy and Health Sciences 2015

Affiliations

Affiliation Year
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Member of state association of nonprofits? No
Name of state association --

External Assessments and Accreditations

External Assessment or Accreditation Year
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Collaborations

End Mass Overdose, Inc. has collaborated with several schools and community groups across Massachusetts, including Massachusetts College of Pharmacy, The Uxbridge and Northbridge Coalition, Blackstone Valley Heroin Awareness Group, The Opioid Coalition of Falmouth, and the Maximizing Opioid Safety with Naloxone Study at Boston Medical Center.  

CEO/Executive Director/Board Comments

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Foundation Comments

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Staff Information

Number of Full Time Staff 1
Number of Part Time Staff 6
Number of Volunteers 25
Number of Contract Staff 0
Staff Retention Rate % 100%

Staff Demographics

Ethnicity African American/Black: 1
Asian American/Pacific Islander: 20
Caucasian: 8
Hispanic/Latino: 0
Native American/American Indian: 0
Other: 4
Other (if specified): Middle Eastern
Gender Female: 17
Male: 15
Not Specified 0

Plans & Policies

Organization has Fundraising Plan? Under Development
Organization has Strategic Plan? Under Development
Years Strategic Plan Considers 1
Management Succession Plan Under Development
Business Continuity of Operations Plan No
Organization Policies And Procedures Under Development
Nondiscrimination Policy Yes
Whistle Blower Policy Yes
Document Destruction Policy No
Directors and Officers Insurance Policy No
State Charitable Solicitations Permit Yes
State Registration Yes

Risk Management Provisions

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Reporting and Evaluations

Management Reports to Board? N/A
CEO Formal Evaluation and Frequency Yes Annually
Senior Management Formal Evaluation and Frequency Yes Annually
Non Management Formal Evaluation and Frequency Yes Annually

Governance


Board Chair Dr. Allison Burns
Board Chair Company Affiliation President
Board Chair Term May 2016 - May 2018
Board Co-Chair Sgt Brendan Douglas
Board Co-Chair Company Affiliation Clerk
Board Co-Chair Term May 2016 - May 2018

Board Members

Name Company Affiliations Status
Caitlyn Burke MBA Fellow at End Mass Overdose, Heller School of Business, Brandeis University NonVoting
Dr. Allison Burns President, CEO Voting
Sergeant Brendan Douglas Director of Law Enforcement Engagement, Clerk Voting
Dr. Cameron Dumas Director of Finance, Treasurer Voting
Dr. Joseph Ferullo Director of Business Development Voting
Mr. Michael Gervais Director of Community Relations and Outreach Voting
Amit Hirani Chairman of the Task Force NonVoting
Raymond Melika Deputy Chairman of the Task Force NonVoting

Constituent Board Members

Name Company Affiliations Status
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Youth Board Members

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Advisory Board Members

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Board Demographics

Ethnicity African American/Black: 0
Asian American/Pacific Islander: 1
Caucasian: 5
Hispanic/Latino: 0
Native American/American Indian: 0
Other: 1
Other (if specified): Middle Eastern
Gender Female: 2
Male: 5
Not Specified 0

Board Information

Board Term Lengths 2
Board Term Limits 0
Board Meeting Attendance % 100%
Written Board Selection Criteria Yes
Written Conflict Of Interest Policy Yes
Percentage of Monetary Contributions 25%
Percentage of In-Kind Contributions 100%
Constituency Includes Client Representation No

Standing Committees

  • --
  • Advisory Board / Advisory Council

CEO/Executive Director/Board Comments

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Foundation Comments

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Financials


Revenue vs. Expense ($000s)

Expense Breakdown (%)

No data available

Expense Breakdown (%)

No data available

Expense Breakdown (%)

No data available

Fiscal Year July 01, 2016 to June 30, 2017
Projected Income $2,500.00
Projected Expense $35,000.00
Form 990s

2015 990-N

Audit Documents --
IRS Letter of Exemption

IRS Letter of Determination

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Financial Planning

Endowment Value --
Spending Policy Income Only
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Credit Line No
Reserve Fund No
How many months does reserve cover? --

Capital Campaign

Are you currently in a Capital Campaign? No
Capital Campaign Purpose --
Campaign Goal $30,000.00
Capital Campaign Dates July 2016 - July 2017
Capital Campaign Raised-to-Date Amount $600.00
Capital Campaign Anticipated in Next 5 Years? Yes

Short Term Solvency

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Long Term Solvency

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CEO/Executive Director/Board Comments

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Foundation Comments

This organization is newer and received its nonprofit status from the IRS in July 2015, per the above posted IRS Letter of Determination. As such, a full year of financial data will be posted in the charts and graphs above when it becomes available. Please note, the nonprofit's FY16 budget file can be found on the Documents tab.

Impact

The Impact tab is a section on the Giving Common added in October 2013; as such the majority of nonprofits have not yet had the chance to complete this voluntary section. The purpose of the Impact section is to ask five deceptively simple questions that require reflection and promote communication about what really matters – results. The goal is to encourage strategic thinking about how a nonprofit will achieve its goals. The following Impact questions are being completed by nonprofits slowly, thoughtfully and at the right time for their respective organizations to ensure the most accurate information possible.


1. What is your organization aiming to accomplish?

The goal of End Mass Overdose, Inc. (EMO) is to provide opioid epidemic response and strategy.  EMO recommends intervention strategies and implements programs to reduce barriers to naloxone access, maximize opioid safety awareness and education, and connect and strengthen existing systems, such as the Prescription Drug Monitoring Programs.  EMO will become the leader on substance abuse prevention, education, and treatment in the Commonwealth of Massachusetts. With success, we hope to serve as a framework for other overdose education and naloxone distribution programs throughout the country.  

2. What are your strategies for making this happen?

End Mass Overdose, Inc. provides opioid epidemic response and strategy through a variety of comprehensive services that reduce the number of overdoses and drug-related costs.  The short term harm reduction and overdose prevention strategy is to increase access to naloxone (opioid overdose reversal agent), provide opioid training and certification courses, and raise awareness/reduce the stigma of addiction through de-stigmatization campaign.  The long term strategy is to distribute naloxone at every overdose training sessions,  offer combined CPR and naloxone training certifications, and make opioid therapy risk management mandatory mandatory for both renewal of healthcare professional licensure and for graduation from a healthcare-related professional program.  
 
Currently, CEO and President Allison Burns sits on the Advisory Board for Maximizing Opioid Safety with Naloxone at Boston Medical Center and collaborates on an interstate level to advise stakeholders in state government, academia, and the community on overdose prevention and reduction strategies in Massachusetts and Rhode Island.  This interstate collaboration has been helpful in analyzing strategies that work and reform programs that do not and has served as a springboard for her to promote and implement successful strategies used End Mass Overdose, Inc.  

3. What are your organization’s capabilities for doing this?

End Mass Overdose, Inc. (EMO) is one of two state-approved opioid antagonist training programs by the Massachusetts Department of Public Health and the Board of Registration in Pharmacy.  EMO has partnered with several other community organizations and coalitions to increase access to our services.  Our DPH endorsement and referrals has allowed us to serve communities throughout the Commonwealth.  Our partnership with MCPHS University has allowed us to pioneer and launch an opioid therapy and harm reduction course, which is mandatory for all Doctor of Pharmacy students in the 2016 spring semester.  We hope to show the value of this training and make it a graduation requirement for all healthcare professionals in order to promote better prescribing practices and broader public health goals.  Our diverse Board of Directors has allowed us to reach a broad target audience and establish a presence in academia, police departments, pharmacies, and several hospitals, including the VA Boston Healthcare System, Brigham & Women's Hospital, Massachusetts General Hospital, and Kindred Hospital.  EMO's core internal strength is our staff's expertise and patient-centered skills (3 staff members hold Doctorate-level healthcare degrees).   Our core external strength is our partnerships and endorsements.  These combined strengths allow EMO to offer a variety of substance abuse services, advocacy, and crisis intervention to reach all those impacted by this public health crisis, from struggling addicts and concerned families to medical personnel, counselors, teachers, firemen, and police officers.  

4. How will your organization know if you are making progress?

Outcomes Assessment

An evaluation process is utilized for all activities to assess whether, as a result of the participant attending the activity, there is a change in learner knowledge, competence, or skills from baseline. Either a paper or electronic evaluation will be utilized. The link to the electronic survey and evaluation form is sent via email to the participants within 24-48 hours of activity completion. Attendance is tracked via mandatory sign in sheet, where participants are asked to list their email addresses. For participants who do not have computer access or prefer to not provide an email address, a paper survey and evaluation form is provided on-site at the activity to evaluate changes in learner knowledge, competence, and skills from baseline. Both the electronic and paper evaluations also include a section to provide feedback about the course/training event and the instructors.

Outcome Levels to be Achieved

· Level 1: participation

o Source of data: attendance records

· Level 2: satisfaction

o Source of data: questionnaire/survey completed by attendees after the educational activity

· Level 3: learning and procedural knowledge

o Source of data: pre and post-tests of knowledge, self-report of knowledge gained in post-activity survey

· Level 4: Competence

o Source of data: observation in educational setting; will observe attendees assemble naloxone rescue kits

 
 
Progress and success is measured by public health and overdose data provided by the DPH, CDC, and other governing bodies.  EMO also analyzes data from focus groups, pharmacies, and hospitals to evaluate the impact and effectiveness of our recommended initiatives. An example of our business metrics includes the following: a reduction in the number of overdoses is a sign of progress.  A reduction in fatal overdoses that correlates with increased naloxone access per zip code is a measure of success.  Increased use of the Prescription Drug Monitoring Program (PMP) is a measure of progress.  A reduction in the number of prescriptions written and dispensed for painkillers per pharmacy location is a measure of success.  Key milestones include establishing a Standing Order for Naloxone (SON) in every town in Massachusetts, increasing naloxone distribution, and establishing substance abuse training as a mandatory graduation and renewal requirement in pharmacy and other healthcare professions.  
 
EMO recognizes it must continuously redefine its market based on drug trends. Over the years, heroin use has evolved as users began to take it simultaneously with prescription drugs, namely Percocet, and as suppliers began to cut their product with the painkiller Fentanyl to increase profits and potency. EMO recognizes the significance of these social trends, both as a contributing factor to the lethality of drug use and as a driving force in our dynamic marketplace. To best serve our client base and achieve our mission of addiction harm reduction, EMO’s R&D Department pledges to stay current on emerging drug patterns per area. Existing programs have failed to update with current drug fads and thus, their services have become less effective over time.  EMO utilizes reports from its expert staff of pharmacists, police officers, and veterans, as well as anonymous feedback from community members, recovering addicts, and current users to stay up-to-date and adjust its services to best serve the public. 

5. What have and haven’t you accomplished so far?

Current accomplishments include connecting community members and groups with the resources needed to reduce overdose-related events, such as setting up Standing Orders for Naloxone (SON), hosting awareness events, and providing overdose education and naloxone certification for professionals, families, and substance users.  A potential obstacle is a lack of understanding and knowledge of the barriers to naloxone access.  One major barrier is although Massachusetts has passed legislation that allows for a standing order, that does not guarantee that every pharmacy has taken the steps to establish the order.  Setting up an order takes time, resources, knowledge, and supervisor approval. Consequently, many community pharmacies do not stock or dispense naloxone without a prescription.  End Mass Overdose, Inc. removes these burdens, sets up the standing order on behalf of the pharmacy, trains the staff on counseling and billing procedures, offers certification courses for bystanders, and publicizes that naloxone is available to the community.  Another barrier to naloxone access is the skyrocketing price of the drug.  EMO is working to establish a relationship with the pharmaceutical companies to purchase and provide discounted and/or free supply to the community.  Overall, EMO's greatest obstacle to providing any and all of our services is funding to sustain our operations.