With the new President's Commission on Combating Drug Addiction and the Opioid Crisis, we've updated this article which first appeared in August 2016 written by Marty Harding, Director of Training and Consultation, Hazelden Betty Ford Foundation

These are difficult times for many communities. Budgets are being cut; resources are dwindling. Law enforcement personnel, county officials, social services agencies, and healthcare providers are struggling to do more with less. At the same time, the opioid epidemic is devastating families and communities throughout America.

(Editor's Note) With 91 Americans dying each day from opioid overdoses, the Centers for Disease Control and Prevention have characterized it as an epidemic. 

For the past year, I’ve had the opportunity to work in six states to mobilize communities to address this epidemic: Massachusetts, Minnesota, Wisconsin, Kentucky, Florida, and Arkansas. In each state, people from every community sector have shared devastating stories of how they have been affected by opioid use. People who work in emergency rooms of their local hospitals are seeing a flood of overdose patients (from young teens to older adults), and first responders tell of the role they are now playing in saving lives by administering Narcan.

Law enforcement officers talk about their struggle to crack down on dealers and distribution networks. Employers are worried about lost productivity in the workplace due to opioid use. Faith leaders are overwhelmed by the number of deaths in their congregations. Community leaders are concerned about public safety. Educators ask if they’re doing enough to prevent opioid use among adolescents and how to intervene. And probably the most heartbreaking of all the stories are those told by parents who have lost a child to an opioid overdose.

As a local government administrator, you’ve seen and heard it all. Opioid use affects all of the departments you administer: public safety, facility management, transportation, fire and emergency services, and community and economic development. People turn to you for guidance about public policy.

Fortunately, communities are finding solutions to these concerns and working together across sectors to prevent opioid use, intervene, and provide resources for those who are affected by opioid use.  This is a critical time for cities and counties to mobilize and provide their communities with vital information and tools to combat heroin and prescription painkiller abuse with the goal of minimizing its social and economic impact.  

There is hope! Communities can successfully mobilize and take action.

On August 31, 2016, ICMA conducted a webinar on solutions that cities and counties are implementing to respond to the opioid epidemic. Lee Feldman, 2016-2017 ICMA president, and city manager, Fort Lauderdale, Florida, joined me for this webinar, and we explored these ideas that counties and cities have explored:

1. Creating community coalitions to work together across sectors. Managers have joined or started community coalitions that focus directly on the opioid crisis. They have recruited members from such diverse sectors of the community as employers, youth workers, faith community leaders, school administrators, teachers and counselors, public health and human services personnel, treatment professionals, law enforcement and county court services personnel, local pharmacists, and doctors, as well as other committed individuals, including people from the recovering community. These coalitions have joined forces and disseminated relevant information, conducted visioning sessions, developed and implemented action plans, and conducted educational sessions and informational campaigns throughout their communities.
2. Developing ordinances and places for safe drug disposal. Generally, these safe disposal sites are located in city halls under the supervision of law enforcement. Although drug take-back days are effective in increasing public awareness of the problem of unwanted prescriptions, a consistent, 24-7 lockbox for safe drug disposal dramatically increases the pounds of unwanted prescriptions that are collected, keeping them out of the hands of children and out of our water and landfills.
3. Establishing drug diversion task forces. Dedicated to sharing information and investigations to combat prescription fraud and illegal trafficking of prescription painkillers.
4. Providing training for first responders in the use of naloxone (Narcan) for reducing opioid overdoses. This strategy has been successfully implemented in many communities throughout the country, saving countless lives. New intranasal Narcan makes administration easier for both law enforcement and emergency personnel. Stigma about using Narcan still abounds, however, and city/county administrators must be armed with a strong rationale for counteracting negativity toward this approach.
5. Using drug courts to fight opioid addiction and trafficking. This approach reduces recidivism, encourages compliance with treatment, and supports families of drug court participants. It also reduces some of the burdens on jails by creating an effective diversion program.
6. Creating referral programs through law enforcement agencies. Some communities are trying innovative programs that allow people to voluntarily obtain help by going to the local sheriff’s office and requesting assistance. The community, county, or individual donors often cover the cost of treatment in these instances.
7. Disseminating information about state laws that encourage intervention. Good Samaritan laws protect citizens when they intervene to save a life due to an opioid overdose. Drug overdose amnesty laws allow people to call 911 when a friend or family member is overdosing without fear of being arrested themselves for opioid use or possession.
8. Building awareness about their state’s prescription drug monitoring program (PDMP). These efforts are critical to cutting down on “doctor shopping” and preventing opioid overdoses, but they are underused for a variety of reasons. Cities and counties are involving local doctors and pharmacies to build awareness of PDMPs and remove barriers to implementing them fully.
9. Hosting community mobilization events to put tools into the hands of every community sector. Community mobilization events, using Hazelden’s “Toolkit for Community Action,” have reached more than a 1,000 people in the past six months. We’ll share what we’ve learned from these events, and let you know how you can plan and launch an event in your community. 

Mobilizing your community doesn’t happen overnight, and it requires hard work. But the return on your investment of time, money, and effort is worth it. Imagine…. If hospital admissions for overdose death decrease. If law enforcement costs are reduced. If employers in your community see a rise in productivity. If violence, theft, and other crimes in your community decrease. If schools are a safer place for your children. If one life is saved. It’s worth it.

Related Resources:

• Podcast: Episode 5--The Opioid Epidemic
• Article: How One City Went "All-In" to Fight the Opioid Epidemic
• Article: Leading the Fight Against the Opioid Crisis
• Article: The Opioid Mission of Broome County, New York
• Blog Post: Virginia Launches New Tool to Combat Heroin, Prescription Opioid Abuse