This paper examines the implementation and perceived effectiveness of the Heroin Involved Death Investigation (HIDI) protocol, which is part of Cuyahoga County’s 2022-2026 strategic plan to combat drug trafficking and prevent overdose deaths.
In 2021, the United States recorded the highest number of deaths resulting from drug overdoses over a 12-month period. Synthetic opioids, including illicit fentanyl, were involved in 66 percent of these overdose deaths. Cuyahoga County’s (Ohio) Medical Examiner’s Office developed the Heroin Involved Death Investigation (HIDI) Protocol to support a safe, coordinated, and rapid response to active drug overdose death scenes. Per the protocol, alerts are sent to law enforcement investigators if the medical examiner suspects a death is related to opioid use or overdose. These alerts notify law enforcement of potential dangers and facilitate protection of the scene and collection of evidence. Researchers funded by the National Institute of Justice found the HIDI Protocol to be an innovative, collaborative system of data protection, collection, and flow that supports overdose investigations. In addition, the researchers identified several opportunities for improvement. The research team concluded that, with slight modifications, the HIDI Protocol could be implemented in other communities experiencing similar opioid overdose-related challenges. However, applications to other jurisdictions would need to consider potential risks and harms to individuals or groups and ethical considerations that may factor into use of the protocol. In addition, users should be aware of all relevant statutes, regulations, and/or governing judicial decisions related to the protocol’s use.