Opioid Solutions Center

Pretrial services typically consist of assessments and decisions concerning bail, release and community supervision in anticipation of future court appearances. These processes provide important opportunities to engage local health care and social services providers and link defendants and their families to the care that they need.

Coordination of care upon release is the deliberate organization and sharing of information between correctional and community-based service providers to ensure the most effective care for each person returning to the community. 

Pre-arrest diversion strategies enable law enforcement officers to refer community members with unmet needs to trauma-informed case management and support services in lieu of arrest, prosecution and incarceration.

Comprehensive services integrate multiple forms of substance use, mental health and case management services and may include: evidence-based treatments for SUD, integrated mental health treatment services, housing support, transportation support, employment and educational services, income support, social support, legal services and child care. 

As the owners and operators of systems of service that regularly interface with people affected by substance use such as hospitals, jails, courts and community colleges, counties are well positioned to link community members with evidence-based options for care, especially medications for opioid use disorder (MOUD). 

A warm hand-off is a form of referral to treatment or other services. A typical referral gives someone information about how to reach the services they need but may leave them to contact those services on their own. In contrast, a warm hand-off is a transfer of care between service providers through face-to-face, phone or video interaction in the presence of the person being helped.

Youth-focused programs, including school-based programs, may help support young people and their families, strengthen community connections and mitigate the long-term negative impacts of adverse childhood experiences. 

The Food and Drug Administration (FDA) has approved three medications that safely and effectively treat opioid use disorder (OUD) to improve the health and wellbeing of people living with OUD. MAT is defined by on-going, long-term treatment with one of these three medications. 

Syringe services programs (SSPs) provide low-barrier access to sterile supplies for safer substance use, naloxone and overdose prevention tools like fentanyl test strips and drug checking services. SSPs also provide a range of other services, such as options for safe syringe disposal, overdose recognition and response training and help accessing services for HIV, substance use disorders and more. 

Medication-assisted treatment (MAT) is considered the “gold standard” of care for opioid use disorder (OUD). Because incarceration is a known driver of opioid overdose, failure to provide this gold standard of care to incarcerated individuals may exacerbate health risks in your community.

Effective treatment for pregnant and parenting people means expanding access to MOUD and adopting a family-centered approach that prioritizes keeping families together.

Naloxone is a “rescue” drug that quickly and safely reverses opioid overdose. It is available as an injectable solution and as a nasal spray. Naloxone works by blocking the effects of opioids in the body. Virtually all opioid overdose deaths are preventable if naloxone is administered in time. 

Post-overdose response teams (also called quick response teams or post-overdose outreach programs) conduct outreach and offer services to people who have experienced an overdose within about 72 hours of the overdose event.

Neonatal Abstinence Syndrome or NAS (also called Neonatal Opioid Withdrawal Syndrome or NOWS) is a condition that sometimes affects newborns of parents who have taken opioids during pregnancy. Because NAS does not cause long-term health consequences, treatment with MOUD – as opposed to withdrawal and abstinence – is safer for both parents and their infants.

Our health care system’s capacity to provide medications for opioid use disorder (MOUD) falls far below the current demand for care. Only 1 in 4 people who need MOUD are able to access them. A multi-pronged approach is needed to build up the treatment workforce, create effective pathways to care and save lives. 

Between 2022 and 2040, states, counties and cities expect to receive over $50 billion in payments from the national opioid settlements. As settlement payments are disbursed in the coming years, continued state-local coordination is key to ensuring that these resources are effectively invested.

For America’s counties, harm reduction complements prevention, treatment and recovery services to create a more holistic and effective system of care.

To support counties with utilizing opioid settlement funds to advance health equity, NACo developed case studies on five counties that are integrating opioid settlement funds into ongoing health equity initiatives. This resource details steps taken by these counties during the first year of opioid settlement payments and considerations for counties in other jurisdictions.

A hospital program in Fulton County, Ga. that educates patients on opioids, and is working to prevent misuse and dependency at the source, is expanding to four rural counties in Georgia.

Counties are receiving a sizable amount of money from the national opioids settlement, but the needs generated by the crisis continue to grow.

Milwaukee County, Wis. is taking steps to make sure those resources are as close to the people who need them as possible, including strategic placing of harm-reduction vending machines in historically underinvested neighborhoods.

At NACo’s 2023 Legislative Conference, county officials discussed harm reduction as a path forward through the opioid epidemic. Three participants in NACo’s Opioid Solutions Leadership Network served as panelists at the workshop. 

30 counties selected to represent county excellence in opioid settlement implementation