America's Opioid Crisis: Counties as Frontline Forces in the Fight

Key Takeaways

From Our Partners

This post is sponsored by our partners at Netsmart

The opioid crisis and addiction remain twin crises faced by the American healthcare industry today. Despite passionate advocacy and innovative, focused programs by public and private supporters, the opioid crisis continues to devastate communities across the United States. In 2023, an estimated 107,543 drug overdose deaths occurred in the U.S.—a decrease of 3% from the previous year, according to CDC data. 

While national headlines often focus on federal policies and funding to combat the crisis, a critical battlefield in the fight is occurring at the county level where providers and families combat the opioid crisis up close. Counties serve as the first line of defense, providing essential services in public health, mental health, law enforcement and social services—supporting communities in crisis and driving lasting recovery.

Counties at the Vanguard: An Evolving Frontline Role

Counties have always been key players in managing public health emergencies, particularly for vulnerable populations. Their responsibilities now extend to innovative opioid crisis management strategies, responding to the complexities of addiction and recovery. The National Association of Counties (NACo) has developed comprehensive strategies to aid counties in this effort, underscoring three vital pillars: coordinated care, continuum of care delivery and expanding Medication-Assisted Treatment (MAT) programs. 

These strategies are not mere abstract ideas; they’re practical, on-the-ground initiatives. For instance, numerous counties are pioneering jail diversion programs, connecting individuals to treatment services as an alternative to incarceration. This approach prevents repeated cycling through the justice system, prioritizing treatment and rehabilitation over punishment. Simultaneously, counties continue to utilize "warm handoffs" to ensure individuals move smoothly from one treatment level to the next, reducing the risk of relapse during transitions. 

MAT programs, which combine medications with counseling and behavioral therapies, are particularly effective in opioid recovery. In counties where MAT is prioritized, overdose death rates have decreased by 59% according to a recent JAMA study. By establishing and expanding MAT programs, counties are building supportive, recovery-oriented communities that address addiction from multiple angles.

Netsmart: Supporting NACo's Vision and Empowering Counties

The success of county-led strategies depends on strong partnerships with organizations committed to empowering local governments and supporting communities. Netsmart aligns with NACo’s vision, offering cutting-edge technology that raises the bar for care standards. Our sophisticated tools are empowering counties and their frontline care providers to set the gold standard in opioid response, deploying evidence-based treatments and coordinating efforts across health, social services and law enforcement.

Technology partnerships with private, public and governmental entities are crucial for expanding treatment and prevention initiatives. Counties partnering with Netsmart gain access to resources that strengthen these efforts, making measurable progress possible even in areas with limited resources. Through these partnerships, counties are positioned as national leaders, showcasing what is possible when technology and community-focused care work in tandem.

Technology as the Backbone of County Opioid Crisis Strategies

Innovative technology enables counties to coordinate, track and optimize care delivery effectively. Empowering county providers to do more with less to increase access to care is a major win in combatting this national healthcare crisis. Supporting that care with an integrated electronic health record (EHR) further enhances the positive outcomes of those seeking treatment by promoting seamless care transitions, gentler intake processes, simplified provider workflows and applying more personalized attention when it’s needed most. 

Netsmart solutions are tailor-made to support NACo’s strategic framework, meeting county-specific needs across various treatment settings. For instance, our EHRs adapt to the specific requirements of Office-Based Opioid Treatment (OBOT), Opioid Treatment Programs (OTP) and inpatient detoxification services. This coordination allows counties to deliver consistent, reliable care when and where it’s needed most.

Another essential tool in this framework is CareManager, a population health management solution that streamlines care coordination and interoperability. CareManager allows different entities involved in addiction treatment to communicate seamlessly, ensuring that every individual receives appropriate, continuous care regardless of where they enter the system. In Rappahannock County for example, CareManager has been instrumental in a robust jail diversion program, supporting individuals from incarceration into treatment. Success stories like Rappahannock demonstrate the potential for Netsmart tools to bolster county-level initiatives.

Counties Continue to Lead Change

Empowered counties are capable of driving meaningful change in the opioid crisis, armed with the right strategies, key partnerships and coordinated technology. As they continue to champion innovative solutions and leverage technology to expand access to care, counties solidify their role as the frontline forces in this ongoing and winnable fight. 

Meet the Authors

Julie Ingram, MSW, is Vice President of Public Sector, Counties at Netsmart, where she leads innovative strategies to transform healthcare delivery for public sector clients. With a background as a social worker, Julie brings a deep understanding of the challenges and opportunities within human services and healthcare systems. Over her 12 years with Netsmart, she has held leadership roles driving client success and technology adoption across diverse regions. Prior to joining Netsmart, Julie held roles working with healthcare agencies on technology to support their providers. Julie has worked in a variety of treatment settings, including direct service and supervisory roles, in communities such as substance abuse, IDD, child and family services, and mental health. Her passion for public sector healthcare innovation continues to shape impactful solutions that improve lives nationwide

Neal Tilghman, Executive Advisor of Addictions & Mental Health at Netsmart, combines a keen awareness of the current state of behavioral health, addictions treatment and physical health, with a forward-looking approach as to where our clients need to be and how we get them there with the appropriate technology. As an advocate of integrated care and its inclusion of addictions, Neal promotes whole-person care as the best means to achieve better patient outcomes and reduce costs. Neal completed his graduated studies at East Carolina University and has 30 years of experience in behavioral health.