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Overdose Surveillance

The Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) is a statewide syndromic surveillance system used by the Indiana Department of Health (IDOH) to analyze emergency department data in near real time. ESSENCE has traditionally been used to identify communicable disease outbreaks such as meningitis clusters, hepatitis A, hepatitis B, mumps, Zika and COVID-19.

The Office of Data and Analytics (ODA) monitors ESSENCE daily to identify emerging overdose trends. IDOH utilizes a set of standard overdose queries developed by the Centers for Disease and Prevention that are routinely updated to improve sensitivity and specificity of all overdose data collected from hospital facilities. When the case definition for an overdose outbreak or cluster has been met within ESSENCE, IDOH alerts the corresponding local health department of potential increased drug overdose activity in their area. LHDs play a leading role in responding to overdose outbreaks and spikes through leveraging community partners, mobilizing outreach initiatives and establishing linkage to care.

Note: Overdose cases in ESSENCE are always considered suspected overdoses as opposed to confirmed because false positives may be collected or a case may not be a true overdose. In addition, Emergency department visits rely only on the patient exhibiting or reporting clinical signs/symptoms of poisoning/overdose, but have not been validated with laboratory testing.

To learn more about ESSENCE visit If you are a member of a reporting hospital facility or a local health department staff member, sign up for an ESSENCE account by emailing Shelby Nierman, overdose surveillance systems epidemiologist, at