In response to America’s widespread opioid addiction, counties and other local governments are concentrating their efforts on three broad approaches: prevention, treatment and enforcement.
Prevention
On the prevention front, cities and counties are working to raise public awareness about the dangers of prescription and illicit opioids. This includes school programming but also direct public appeals. In Erie County, PA, “open-bedroom” displays located in shopping malls teach parents to better recognize signs of addiction in their homes.
Elsewhere, in Ocean County, NJ, “funeral cards” are passed out by local officials to funeral directors. These cards list information about safe drug disposal to decrease the chances that prescription drugs left behind by the deceased are later misused by others.
Treatment
In terms of treatment, cities and counties have largely focused on increasing the availability of medication-assisted-treatments (MATs) and the overdose antagonist naloxone. MATs typically involve a long-term medication, such as methadone, buprenorphine or naltrexone replacing heroin, combined with counseling, peer-to-peer support and close monitoring.
MAT is considered the evidence-based model to address addiction and co-occurring mental health problems. Naloxone, meanwhile, has already saved countless lives from opioid overdose, and many cities and counties have made the drug more widely available to both first responders and the public.
Enforcement
Lastly, cities and counties have taken significant steps to assess law enforcement response. Reduction of illicit opioids remains a priority, and cooperation at the regional, state and federal level has proved critical. Simultaneously, cities and counties are rethinking approaches to low-level criminal behavior due to struggles with addiction.
There is a gathering consensus that we cannot arrest our way out of this epidemic and that the criminalization of addiction is costly and often counterproductive. Seattle and King County have launched a city-county collaborative effort titled LEAD (Law Enforcement Assisted Diversion) that gives local law enforcement officers the discretion to forego arresting individuals for low-level drug crimes, prioritizing treatment efforts instead.
These local efforts, of course, need (and receive) support from our state and federal partners. But only by pursuing these three avenues on the front lines of addiction will we begin to curtail this crisis.
Hadi Sedigh, Associate Legislative Director, National Association of Counties, [email protected]