Publications and Digital Media

Discusses how the Americans with Disabilities Act can help protect people in recovery from opioid use disorder (OUD) who are not engaging in illegal drug use, including those who are taking legally prescribed medication to treat their OUD, from discrimination.

This includes enforcing the Americans with Disabilities Act (ADA), which prohibits discrimination against people in recovery from opioid use disorder (OUD) who are not engaging in illegal drug use, including those who are taking legally prescribed medication to treat their OUD. This guidance document provides information about how the ADA can protect individuals with OUD from discrimination—an important part of combating the opioid epidemic across American communities. While this document focuses on individuals with OUD, the legal principles discussed also apply to individuals with other types of substance use disorders.

Learn more about OFRs and facilitation at https://www.cossapresources.org/Tools/OFR.

This document focuses on proposed investments in the 18 National Drug Control Program agencies, but making progress requires collaboration among federal, state, local, and tribal communities across the country.  Although financial resources cannot solve this crisis entirely, it is hoped that this increased level of support enables the dedicated prevention, treatment, recovery, and harm reduction workforce to reach more Americans impacted by this epidemic and strengthens efforts to stop the flow of illicit drugs into American communities.

The goal of the workshop, hosted by BJA and supported by RTI International and the Police Executive Research Forum, was to highlight innovative partnerships among diverse stakeholders in order to prevent and respond to increased stimulant use. Participants included representatives from state, local, and federal law enforcement agencies; researchers and public health officials; and social service providers. The workshop was held via Zoom and consisted of four 90-minute panel presentations, each followed by a moderated question-and-answer session. Panel topics included the scope and science of stimulant addiction, police-led initiatives, and partnerships to address stimulants, broader policy efforts, and community relations.

This article discusses naloxone distribution as a public health approach to overdose prevention and will offer COSSAP grantees steps for implementing naloxone programming.

This article is the first of a two-part series and includes topics such as:

• Mental and Behavioral Health in the Criminal Justice System
• Jail Diversion Models
  • Pre-Arrest
  • Pre-Charges
  • Post-Charges
• Suggested Resources
  • Pre-Trial
  • Pre-Charges
  • Specialty Court Programs
• Next Steps

The Methamphetamine Response Act:

• Declares methamphetamine an emerging drug threat, as defined in section 702 of the Office of National Drug Control Policy (ONDCP) Reauthorization Act of 1998.
• Requires ONDCP to develop, implement and make public, within 90 days of enactment, a national emerging threats response plan that is specific to methamphetamine, in accordance with section 709(d) of the Office of National Drug Control Policy Reauthorization Act of 1998.

The ONDCP's "Plan to Address Methamphetamine Supply, Use, and Consequences" (subsequently released on May 7, 2022) can be viewed at https://www.whitehouse.gov/wp-content/uploads/2022/05/ONDCP-Plan-to-Address-Methamphetamine-Supply-Use-and-Consequences.pdf. 

Selecting a facilitator that maintains trust of the team and can navigate difficult conversations is a key element in the success of an OFR team. This document offers ten tips for successful meeting facilitation.

This Office of Justice Programs’ National Institute of Justice (NIJ) article covers the topic of NIJ-funded research that examines ways to disrupt opioid distribution networks through data-driven network analysis and the use of citizen intelligence.  The work described in this article was supported by NIJ funding awarded to the Pennsylvania State University.

Articles include:

• Applying Lessons Learned to the "New" Methamphetamine Crisis
• Family Accountability and Recovery Court in North Carolina Reunites Women in Recovery With Their Families
• Neurobiology of Trauma and the Impact on Addiction Among Tribal Populations Part 2: Working With Addiction Using a Trauma-Informed Lens
• Veterans Justice Programs as Deflection Entry Point to U.S. Department of Veterans Affairs Treatment and Services
• NaloxBox: Exploring Free, Publicly Available, Lifesaving Naloxone
• Updated Overdose Statistics Visualization Tool, Childhood Maltreatment Study Highlight PDMP TTAC News
• Overdose Response Strategy (ORS) Webinar: Building Intensive Partnerships Between Public Health and Public Safety

The fact sheet offers information about fentanyl, including street names for the drug, signs of an overdose, and what to do if you think someone is overdosing.

In addition, it provides an overview of key legislation and significant court cases related to substance withdrawal and outlines steps for creating a comprehensive response for individuals with substance use disorders.  Advocates for Human Potential, Inc. (AHP), one of COSSAP’s TTA providers, developed it in partnership with BJA and the National Institute of Corrections (NIC), along with the support of the Georgetown University Law Center.

BJA, in partnership with NIC and in conjunction with the National Commission on Correctional Health Care (NCCHC), the American Society of Addiction Medicine (ASAM), and AHP, are developing guidelines to help jail administrators in the detection and proper management of acute withdrawal from alcohol, sedative-hypnotic drugs, opioids, and stimulants among individuals in custody.  Collectively, they are working with an expert advisory committee of clinical and non-clinical representatives (i.e., experts in addiction medicine, correctional health care, and jail administration) to guide the development of the guidelines, which will be informed by best and evidence-based medical practice while accounting for the practical realities of medically managed withdrawal in jails.  It is anticipated that the guidelines will be published in Summer 2022, after a draft is reviewed by field stakeholders.

Topics include:

• Why Screen for Substance Use Disorders in Jails?
• When Should a Person Be Screened for SUDs?
• What Are the Challenges to Screening in Jails?
• What Is a Screening Tool?
• What Makes a Good Screening Tool?
• What Screening Tools Are Commonly Used in Jails?
• Where Can I Find More Information?

Addresses withdrawal in jails—describing the scope of the challenge, providing an overview of key legislation and significant court cases related to substance withdrawal, and outlining steps for creating a comprehensive response for individuals with substance use disorders.

Within the data sharing agreement there are important areas to consider for inclusion. At a minimum the agreement should specify the following: parties involved; the purpose or need for the data sharing agreement; nature of the data to be collected; access and confidentiality of data; how the data is to be used; how and in what situations the agreement can be severed by either party; and relevant legal authorities (tribal, state, local, federal).

The questions and corresponding answers are offered in this document, categorized by session.

Naloxone is a life-saving medication that can reverse an overdose from opioids, including heroin, fentanyl, and prescription opioid medications.1 Often given as a nasal spray, naloxone is safe and easy to use.

Articles include:

• "Thank you for making our communities safer, healthier, and stronger": 2021 Virtual COSSAP National Forum a Success
• Myths and Facts About Medication-Assisted Treatment
• Neurobiology of Trauma and the Impact on Addiction Among Tribal Populations Part 1: Trauma and the Brain
• The Impact of Law Enforcement Drug Interdiction Strategies and Public Health Partnerships on Addressing Stimulant Use and Overdose Deaths
• Changes Spurred by OFR Team Transform Battle Against Substance Use in Winnebago County
• Take Back Day: A Collective Success for COSSAP Drug Disposal Program Grantees
• New PDMP TTAC Web Page Lists Funding Opportunities
• Rural Health Information Hub: Invaluable Resource for First Responder Deflection Programs
• The Impact of the COVID-19 Pandemic on Alcohol Use

Learn about the systemic changes—including recognizing the correlation between addiction and related mental health and childhood trauma challenges, among others, and leveraging networks of providers to identify and treat problems proactively so that future crises can be averted—that were among the reforms enacted in Winnebago County directly as a result of recommendations by the OFR team.

The study showed that buprenorphine use increased substantially in correctional settings during the past five years, although use is still rare among all incarcerated individuals with opioid use disorder.  The study’s authors concluded that despite the increase in buprenorphine use, access in jails and prisons is still inadequate.

Understanding trauma is an important part of responding to calls in a trauma-informed approach. Taking steps to develop deflection programs that help connect children with treatment and services through prevention and intervention efforts can help interrupt the impacts of trauma and produce positive outcomes for children. Deflection offers first responders a way to implement such programs through partnerships among law enforcement, fire and emergency medical service agencies, treatment and service providers, and schools.

Since states are permitted to resubmit AFCARS data, the estimates may change over time. This report reflects all AFCARS data received as of October 4, 2021, related to AFCARS reporting periods through September 30, 2020.

It also provides information on the Forensic Technology Center for Excellence, which is also a program of the NIJ.  Resources to address the opioid crisis are also provided.

As the national training and technical assistance (TTA) provider for the Office for Victims of Crime’s (OVC) Enhancing Community Responses to the Opioid and America’s Addiction Crisis grant programs, JBS International (JBS) has provided and developed TTA resources to support grantees. 

This resource is a supporting document for the "Building a New Foundation: Incorporating Equity, Diversity, and Inclusion in Residential Substance Abuse Treatment Programs" presentation of the 2021 Virtual COSSAP National Forum.

This article also highlights programs that exemplify deflection initiatives that enable fire and EMS personnel to go beyond naloxone administration and reliance on emergency departments and to actively link individuals to treatment and services. Deflection programs offer a promising alternative to traditional justice system responses and demonstrate that a  collaborative approach involving community-based organizations can create pathways to treatment and recovery.

The TIP offers recommendations on treatment approaches and maximizing treatment engagement and retention, and strategies for initiating and maintaining abstinence.

Articles include:

• As Overdose Fatality Review (OFR) Circle Widens, Ripple Effects Intersect in Pennsylvania County
• Considerations for Deflection and First Responder Diversion Programs: Taking a Trauma-Informed Approach
• Peer Recovery Support Services (PRSS) in Tribal Communities: Lessons Learned From the Field
• Institutionalizing Support for Drug Endangered Children (DEC) in Tribal Communities
• National Association of Counties (NACo) Annual Conference Workshop Highlights County Innovations in Diversion
• Gender-Responsive Programming for Women in the Criminal Justice System
• New Analysis Compares Prescription Drug Monitoring Program (PDMP) Efforts Across States
• COSSAP Launches Facebook and Twitter Pages

By prompting the county’s district attorney and the mayor of its largest city to call for the decriminalization of test strips to counter skyrocketing use of fentanyl, the OFR team showed itself to be the go-to vehicle for real-time, data-driven action in response to drug use trends in Lackawanna County. In so doing, the OFR team’s recommendations not only stood to save lives, but also presented a template for community responses everywhere.

This document seeks to provide prosecutors with a set of guiding principles and strategies for advancing drug policy grounded in principles of harm reduction, public health, and racial justice. These recommendations convey ideas informed by best practices, empirical evidence, and the collective wisdom of a working group of prosecutors, defense attorneys, advocates, people who have personally experienced incarceration for drug-related crimes, and public health experts from diverse jurisdictions.

It also provides recommendations for reform. Black Americans are incarcerated in state prisons across the country at nearly five times the rate of whites, and Latinx people are 1.3 times as likely to be incarcerated than non-Latinx whites.

The Longmont Public Safety Department’s Crisis Outreach Response and Engagement (CORE) team is one of many co-response teams that is made up of mental health professionals who work with local law enforcement agencies to address behavioral health-related calls. Learn more about CORE and co-response programs—including joint efforts in Boulder County, Weld County, and Louisville—in this article.

This handout packet is for the "Examining the Intersection Between Historical Trauma and Addiction" presentation of the 2021 Virtual COSSAP National Forum.

Topics include identification of co-occurring disorders; types of screening, assessment, and diagnostic instruments; approaches for treating co-occurring disorders; and recommendations for further investigation.

This article offers an overview of alternative family structures impacted by substance use disorders (SUD); working with schools, social services, and public and behavioral health departments to support children and caregivers impacted by SUD; and partnership and sustainability.

This publication describes PDPHE’s activities to create a robust, near real-time data collection and information sharing infrastructure for public safety, public health, and behavioral health partners.

This Overdose Data to Action (OD2A) evaluation profile can be tailored to the evaluation needs of programs and initiatives to ensure they are implemented effectively for desired outcomes. The profile contains guidance on the types of evaluation questions, indicators, data sources, and data collection methods that can be used to evaluate the specified topic and activities. State and local health departments, community-based organizations, medical and healthcare professionals, and program managers can use the profile to determine how well programs and initiatives are being implemented and the effectiveness on desired outcomes.

Articles include:

• Virtual Convening Connects Rural Communities With Array of Resources to Fight Substance Use
• Prearrest Diversion: Addressing the SUD-Mental Illness Link
• Improving Public Perception of PRSS: Combating Resistance, Bias, and Fear
• Implementing Programs to Support Drug Endangered Children in Tribal Communities: Getting Buy-In From Law Enforcement
• MAT Retention: Barriers and Best Practices
• Snapshot: Overdose Fatality Review Activities in Florida
• Snapshot: Webinar on State-Level Data Integration in Tennessee

The first program is the Eastern Shore Mobile Care Collaborative (ESMCC) at Caroline County Health Department in Maryland. The second is the Mobile Health Services program implemented by the Colorado Department of Human Services, Office of Behavioral Health (OBH).

The Ross County Health District (RCHD) is one of the six local communities funded by the Bureau of Justice Assistance's Partnership to Support Data-Driven Responses Demonstration Project. RCHD conducted analysis and collected input from community service agencies, peer recovery supporters, law enforcement, and health care providers to develop data-driven strategies to prevent and reduce overdose deaths.

This rule change, which took effect on July 28, 2021, will have a significant impact on the nation’s 1,700 DEA-registered and future methadone service providers. DEA will no longer require providers to obtain a separate registration in order to operate a mobile component and distribute controlled substances. Removing the dual-registration requirement will make it easier to supply treatment services to rural and underserved areas.  Additional information is provided in this article.

This report is motivated by a desire to improve access to medication for opioid use disorder (MOUD), specialty care, community support services, and peer advocates through opioid courts and other drug treatment courts. It shares lessons from opioid court practitioners and their partners about what quality MOUD care, treatment, and use look like; how to promptly identify potential court participants and provide access to MOUD and specialty care; and how to identify and engage MOUD providers. It also includes descriptions of recent innovations developed during the COVID-19 pandemic that could make it easier to connect patients to MOUD in the future. The goal is to assist practitioners in treatment courts and other settings as they seek to improve access to MOUD and specialty treatment services as part of the criminal legal process.

Main goals of this document are to shift focus from a deficit approach to a more strengths-based comprehension of how Native communities can implement and integrate Western-based methods while maintaining their culturally informed practices that have been developed over centuries.

This document is a supporting document for the "Navigating Confidentiality in First Responder Deflection" session of the 2021 Virtual COSSAP National Forum.

Adverse childhood experiences, referred to as ACEs, are defined by the Centers for Disease Control and Prevention (CDC) as “potentially traumatic events that occur in childhood (0–17 years).” One common example of an ACE witnessed by Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) grantees is growing up in a household with substance use; other examples include parental separation or experiencing abuse or neglect.

The success of an OFR is directly related to its leadership. While champions of the process are needed, it is the role of facilitator that will make or break the team. This guidance document covers real-life examples facilitators can use to motivate the team to move recommendations forward and address the overall purpose of OFRs: to prevent overdose deaths.

This program brief includes information about campaign messages, campaign activities, direct-mail prevention education, educational materials in local businesses, wellness bags with educational materials, community Narcan trainings, New Haven Innovative Community Engagement, evaluation plans, and tips for other communities.

This rule helps to expand access to methadone and other related services by relaxing certain requirements for NTP mobile treatment units, including allowing mobile NTPs to operate at locations away from, but in the same state as, the registered NTP location. The rule explicitly clarifies that such locations can include a correctional facility.

This document is intended to provide guidance on funding opportunities within the American Rescue Plan Act of 2021 for communities such as the Bureau of Justice Assistance’s Comprehensive Opioid, Stimulant, and Substance Abuse Program grantees.

Articles include:

• National Commission on COVID-19 and Criminal Justice Recommendations to Reshape Criminal Justice
• Peer Recovery Support Service Programs Consider Hybrid Approach
• Medication-Assisted Treatment: A Promising Resource for Addressing Opiate Use in Tribal Communities
• Implementing MAT in Jails—Focus on Naltrexone
• Ross County Health District Partnership Project
• "Families are Instrumental in Recovery": Experts extol Value of Family-Focused Care
• New Guide Explains Changes in Patient Privacy Regulations for PDMPs

This policy brief highlights the common challenges and opportunities for governors and state officials to inform state and local policy development and improve outcomes for individuals with SUD who are under community supervision.

This document is a sample new OFR member packet developed by the Union County Overdose Prevention & Fatality Review Coalition.

It is the most comprehensive overview of the field and its role in responding to the opioid crisis—as well as how first responder deflection offers alternatives to law enforcement and first responders in their work. The report provides an introduction to and history of the field and discusses how significantly diversion and first responder deflection are as responses to the opioid crisis. The "Key Findings and Takeaways" section highlights major conclusions of the data gathered and analyzed, with embedded links to the relevant data addressed by each key finding. A "Conclusions" section projects how the critical findings of this report may apply to a range of policies and important issues in the justice system and related areas, including public health, public safety, and other sectors.

An effective facilitator is a neutral convener who is a good listener, develops trust with partners, encourages group participation and engagement, leads but does not direct discussion, and guides the group towards collective problem solving to craft recommendations.

It includes the following sections: Purpose; Primary Functions; Knowledge-Skills-Abilities; Organizational Structure; and Specifications.

Co-authored by Leo Belgarde, Sr., it provides a first person account of his experiences as a tribal officer, Bureau of Indian Affairs officer, city officer, and county police officer. It describes events that precipitated him seeking treatment for PTSD and the consequences he faced due to accessing treatment. Healing Our Protectors is a resource that has been developed to provide strength-based, positive, culturally responsive strategies for Indigenous law enforcement officers. If the officer does not connect with this aspect of their culture, this resource still supports a cultural representation of where they are policing and can be modified to meet their needs.

Learn about the origins of the self-referral pathway, how the pathway works, and the ten critical elements of self-referral initiatives. Also included are case studies of five sites: Anne Arundel County, Maryland: Safe Stations; Dixon, Illinois: Safe Passage; Hudson Valley, New York: Hope Not Handcuffs; Manchester, New Hampshire: Manchester Safe Station Program; and Walker County, Alabama: Mercy Project.

Articles include:

• “Change Happens at the Speed of Trust”: OFR Forum Raises Profile of Winning Strategy in Battle Against Substance Abuse
• New COSSAP Drug Disposal Program Tackles Hidden Driver of Substance Abuse
• Establishing Programs to Support Drug Endangered Children (DEC): Is My Community Ready?
• Treatment Courts’ Peer Recovery Specialists Help Program Participants During COVID-19 Pandemic
• Implementing MAT in Jails: Focus on Methadone
• Four Pillars of Innovation: How EMS in Contra Costa County Connected Resources to Improve Opioid Epidemic Response
• Words Matter: The Importance of Using Compassionate and Person-First Language
• The National Substance Use Warmline: A Resource for Prescribers, Drug Court Health Care Professionals, and PDMP Administrators

The 2021 Virtual National Forum on OFR, cohosted by COSSAP and the Centers for Disease Control and Prevention (CDC), turned out to be COSSAP’s largest—and by every measure most successful—online event to date. The event successfully demonstrated the value of OFRs to a larger audience of stakeholders capable of incorporating OFRs into local strategies to combat substance abuse.

President Biden has made clear that addressing the overdose and addiction epidemic is an urgent priority for his administration. These drug policy priorities take a bold approach to reducing overdoses and saving lives.  The priorities provide guideposts to ensure that the federal government promotes evidence-based public health and public safety interventions.  The priorities also emphasize several cross-cutting facets of the epidemic, namely by focusing on ensuring racial equity in drug policy and promoting harm-reduction efforts.

The 2020 National Drug Threat Assessment (NDTA) is a comprehensive assessment of the threat posed to the United States by the trafficking and abuse of illicit drugs, the diversion and abuse of licit drugs, and the laundering of proceeds generated through illicit drug sales. It also addresses the role domestic groups, including organized violent gangs, serve in domestic drug trafficking.

Find key information about PDMP history, importance of PDMP data access, considerations for increasing access to and utilization of PDMP data, implications for PDMPs located within and outside of the state health department, and examples of PDMP use in overdose prevention and response work.

The WSYR-TC News Channel 9 report includes a link to the Oneida County Overdose Response Team Dashboard.

This brief explains how jail physicians can use the DEA “72-Hour Emergency Rule” to continue these essential medications without interruption while the jail establishes a longer term plan for continuation. This is essential to maintain sobriety and prevent relapse, overdose, and death.

In this uniquely collaborative model, defendants with addiction to substances participate in a substance misbuse treatment regimen that involves a drug court team and community providers.

It relies on a coordinated and collaborative approach8 and reinforces the need for probation officers to have the appropriate resources to connect people to individualized treatments and supports.

The brief serves as an update to the 2009 publication from The Council of State Governments (CSG) Justice Center titled Improving Responses to People with Mental Illnesses: The Essential Elements of Specialized Probation Initiatives . 9 Since the release of that publication, the use of collaborative comprehensive case management and the incorporation of a team approach among probation and behavioral health professionals are now key components for reducing recidivism.

Articles include:

• Peer Support in First Responder-led Diversion and Deflection Programs: Necessary Tools in the Fight Against COVID-19
• Preventing Underage Substance Use in Tribal Communities
• Implementing MAT in Jails: Focus on Buprenorphine
• Firefighters and Diversion: Spotlight on Arlington County (Virginia)
• Trends in Prosecutorial Response to the Opioid Epidemic
• Developing and Implementing a Telehealth Training Program
• PDMP Online Tools

The Office of National Drug Control Policy (ONDCP) announced through this press release the largest-ever award of baseline funding to its High Intensity Drug Trafficking Areas (HIDTA) Program. The announced funding includes a historic expansion of the innovative Overdose Response Strategy (ORS), which brings together drug intelligence officers and public health analysts at the local and regional level to share information and develop intervention and support services that reduce overdoses. The ORS will now extend to all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.

More than $273 million will be disbursed to 33 regional HIDTAs nationwide. Funding includes more than $5 million to expand and maintain the ORS.

States and localities across the United States have implemented overdose fatality review teams to address the impact of the opioid crisis on their communities. Literature on overdose fatality review teams reviewed in this article includes writings on goals, recommendations, and information sharing protocols, as well as considerations from other fatality review teams.

Overdose fatality review (OFR) is a powerful tool that can be used to identify and respond to community-specific patterns related to drug overdose deaths. LAPPA’s Model Overdose Fatality Review Teams Act was written in consultation with a host of subject matter experts. While overdose deaths occur nationally, OFRs established at the local level allow for the identification of challenges unique to a local area. This Model Act addresses the duties, responsibilities, and composition of OFR teams in order for them to properly examine and understand the circumstances leading up to a fatal overdose.

Without legislation, the OFR team—and the individuals and entities from whom it requests information—are bound to their own interpretations of the confidentiality provisions of the Health Insurance Portability and Accountability Act (HIPAA), 42 U.S.C. § 290dd-2, 42 C.F.R. Part 2, and state or local confidentiality laws. This may result in an unwillingness to provide the requested information due to unduly restrictive interpretations and/or confusion caused by varying conclusions among jurisdictions. Second, OFR legislation helps to enhance the legitimacy of OFR teams, especially in areas where some community members may be reluctant to establish a team on their own. Finally, legislation promotes uniformity and consistency among the local teams within the state.

This resource was developed by the Legislative Analysis and Public Policy Association (LAPPA) through funding from the Office of National Drug Control Policy, Executive Office of the President. 

This report describes how programs leverage cross-system collaborations, discusses adverse childhood experiences (ACEs) and their connection to substance misuse, and details initial considerations and helpful resources for communities interested in replicating successful programs.

Multiple hospital organizations have implemented alternatives to opioids (ALTO) programs. These programs emphasize the use of nonopioid therapies as a preferred first-line treatment for pain.

This document provides an overview of FQHCs and spotlights FQHC partnerships with the King County Treatment Corrections Project in Washington State and the Hudson County Department of Corrections.

Also included are considerations in developing the API and lessons learned from the Data Integration Project by Columbus Public Health.

The goal of this series is to inform jurisdictions considering whether a mobile treatment program would work in their communities and to determine what type of model would fit best.  The two mobile models featured in this article are an induction-only program that prescribes Suboxone (buprenorphine/naloxone) and a methadone delivery program that was created because of the COVID-19 public health emergency.

This document was developed by a local OFR team and summarizes the five steps that should be done to effectively recruit partners to participate in an OFR.

The tool was developed by a public health analyst to assist local OFR teams in scheduling necessary steps to begin an OFR initiative. The steps and information are based on the Overdose Fatality Review: A Practitioner's Guide to Implementation.

This document walks the reader through how to modify and use the OFR Project Management Template Gantt chart.

This document is a compilation of several local OFR teams' timeline displays used in virtual case reviews.

This special issue of the Journal for Advancing Justice addresses programs and interventions designed to assist individuals with mental health and substance use disorders who come to the attention of law enforcement and community corrections programs. It also analyzes community supervision practices in an effort to contribute to the research on effective strategies for probation, parole, and pretrial supervision programs.

The resource was developed and made available by the Indiana State Department of Health.

Suicide and Overdose Fatality Review is a network of locally-led stakeholder teams that review suicide and overdose fatalities in their communities. The goal is to develop data-informed prevention initiatives to prevent future deaths. By working together and learning from these sentinel events, Indiana teams are seeing results.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (HHS) that leads public health efforts to advance the behavioral health of the nation and to improve the lives of individuals living with mental and substance use disorders, and their families. The vision of SAMHSA is to provide leadership and resources – programs, policies, information and data, funding, and personnel advance mental and substance use disorder prevention, treatment, and recovery services to improve individual, community, and public health. The mission is to reduce the impact of substance misuse and mental illness on America's communities.

Contact information is provided for each Regional Administrator and Assistant Regional Administrator.

Topics include first steps when collecting data, county information, census data, overdose death data, student substance use data, and crime and victimization data.

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP). It includes a link to the Center for Victim Research's online searchable directory of researchers interested in victimization and victim services.

Included are questions to ask to center the focus of the data collection effort and to identify potential data sources. 

Stress is a major concern among American Indian/Alaska Native (AI/AN) populations because of the toll it takes on mental and physical health, as well as the strong relationship between stress and relapse into addictive behaviors. Indeed, chronic stress places AI/AN populations at higher risk for chronic disease, mental health disorders, and substance abuse than the general population. Further, susceptibility to chronic stress is exacerbated by issues such as adverse childhood experiences as well as those specific to tribal populations, such as historical trauma, political turmoil, and systemic injustice.

For Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) grantees—and anyone else— working to address substance abuse in tribal areas, this article offers support to identify stress and anxiety and how they affect behavioral health outcomes in Native American populations while also offering ways to mitigate, handle, and even embrace stress.

In April 2020, the FXB Center for Health and Human Rights at Harvard University, Doris Duke Charitable Foundation, First Focus on Children, and Open Society Foundations convened a group of experts in public health, harm reduction, drug policy, and child welfare. The experts shared ideas on how to direct the opioid litigation settlement funds toward structural and policy reform that advances public health and health equity. The recommendations found in this position paper reflect the views of those participants.

Articles include:

• New COSSAP Virtual Site Visit Shows the Transformative Power of Peer Support
• Stress, Addiction, and Native Americans: A Pathway to Healthier Living
• Technological Innovations in the Justice System: Promoting Safety, Facilitating Recovery
• Critical Elements of Successful First Responder Diversion Programs
• Using Telehealth for Medication-Assisted Treatment in the Criminal Justice System
• Stimulant Use Disorder: Resources for Recovery Workers and Their Clients
• New User-Friendly Online Tool Tracks PDMP Legislation and Regulations

Some states have legislation to support OFR. Knowing what states have state statute supporting OFR and what it entails is useful to OFR teams within these states. It can also be useful to states without OFR statute to reference in the development of their own statute(s).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

Public health data and other resources can be used to improve attorneys' ability to work on multi-disciplinary teams and their understanding of substance use by youth and families involved in the juvenile and family court systems.

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

Articles include:

• The Opioid Crisis: The Critical Role of Law Enforcement
• BJA Launches Online Tools to Equip Communities to Implement Overdose Fatality Reviews—and Save Lives
• Adverse Childhood Experiences and Their Impact on Tribal Communities
• MAT: Making a Difference in Upstate New York
• Facilitating Successful Reentry Through Peer Recovery Support Services
• How to Select Telehealth Services
• Evidence-Based Interventions for Treating Stimulant Use Disorders
• PMIX National Architecture Brings Consistency and Cost Efficiency to PDMP Data Sharing
• New Funding Opportunity: The Comprehensive Secure and Responsible Drug Disposal Program

This report gives specific suggestions to local governments on how best to apply settlement funds to address the opioid epidemic. It also provides evidence-based abatement options, describes the infrastructure and context required to successfully implement such efforts, and gives existing evidence about the potential impact of each option.

The overall goal of the 2019 Cornerstone Project is to advance the scale-up of evidence-based services that reduce overdose risk during and upon release from incarceration in jail. The Project examines four evidence-based overdose prevention services in jails serving counties most affected by the opioid overdose crisis. These four services include screening for substance use disorder, overdose education and naloxone distribution, linkage to care upon release, and maintenance medication-assisted treatment (maintenance MAT). The report provides a sections regarding jails and staff, why overdose prevention services are needed in jails, training opportunities, lessons learned, and references.

Beginning with an exploration of ACEs and their impacts on the general population, this article then examines research on ACEs specific to the American Indian/Alaskan Native population and ends by describing strategies to strengthen protective factors that buffer against the impact of ACEs and reduce their deleterious long-term impacts on tribal communities, including substance abuse.

In December 2019, BJA and OVC convened more than 250 multidisciplinary experts from all levels of government and across communities—including criminal justice, public health, and victims’ services—to share innovations and best practices, leverage strategies and resources, and pursue solutions through presentations and peer discussion.

For additional information, please visit https://www.samhsa.gov/practitioner-training.

The Department of Justice’s Office of Justice Programs (OJP) awarded grants totaling more than $340 million to help fight the addiction crisis looming over the United States, dramatically impacting crime victims, children, families, first responders, and communities at large. Four components within OJP – the Bureau of Justice Assistance (BJA), the Office of Juvenile Justice and Delinquency Prevention (OJJDP), the Office for Victims of Crime (OVC), and the National Institute of Justice (NIJ) – provided funds to address the opioid and stimulant crisis. The grants are detailed in this document.

The opioid crisis, particularly its effect on children, presents a profound and ongoing challenge. Through the spectrum of the five pathways that provide access to deflection, police officers can use their position to make a difference in the lives of these children in three important ways: 1) turning every encounter into an opportunity; 2) harnessing deflection as a means for early identification and intervention in the lives of drug-endangered children; and 3) realizing that addiction is not just about an individual, but also about the family. This publication includes helpful resources in the endnotes and is a result of a partnership effort between the Police, Treatment, and Community Collaborative (PTACC; more at https://ptaccollaborative.org/) and National Alliance for Drug Endangered Children (National DEC; more at https://www.nationaldec.org/). PTACC and National DEC are members of the National Stakeholder Partnership (NSP), collaboratively supported by the Bureau of Justice Assistance and the Office for Victims of Crime. The overarching goals of the NSP are to advance awareness and knowledge to help mitigate the traumatization of children and youth and to advance dissemination of innovative practices throughout the field. NSP resources and guidance will be posted on the COSSAP Resource Center as the various products become available.

This document is a supporting document for the "Navigating Confidentiality in First Responder Deflection" session of the 2021 Virtual COSSAP National Forum.

The document provides the history and background of ODMAP, describes the platform features, provides examples of ODMAP utilization for rapid responses, and provides resources to get started with ODMAP.

By strengthening comprehensive, collaborative initiatives undertaken by the Bernalillo County Department of Behavioral Health Services (DBHS), COSSAP funding is supporting efforts to reduce drug use and overdose deaths in Bernalillo County, as well as to mitigate impacts on crime victims. DBHS is expanding its harm reduction services to address addiction and the adverse effects of injection drug use, including overdose, HIV and hepatitis C infections, incarceration, and drug-related crime. These initiatives address service accessibility gaps throughout Bernalillo County for people who have been disproportionately impacted by drug misuse, including people experiencing homelessness and urban Native Americans.

The Opioid Task Force (OTF) was formed, which has since grown to 46 members and meets regularly to share information and discuss policy interventions to reduce overdose deaths. Simultaneously, Kenosha Human Development Services (KHDS) launched a boots-on-the-ground support team, which is composed entirely of people with lived experience, to bring resources and information to individuals after they experience an overdose. The OTF supports specific partnerships necessary for referrals to the peer support team, including the provision of overdose patient information from the local hospitals and emergency medical services (EMS). In turn, the support team helps to reduce the stigma of addiction and improve morale among OTF members. As part of the program, both initiatives are evaluated on an ongoing basis to inform adjustments and improvements to the program as the county learns what is working. The primary goal of these projects is to reduce overdose deaths. Promisingly, Kenosha County has experienced a significant decline in overdose deaths since their launch.

At its core, the Marion County syringe service program provides sterile injection equipment to people who use drugs, which is proven to reduce the spread of infectious disease. Regular engagement of individuals in a syringe service program has also been associated with reduction in overdose risk and injection drug use and facilitates more successful connections with substance use disorder treatment. The program is staffed by peer recovery coaches, all of whom are individuals with the lived experience of substance use. They offer unique support to program participants, and their experience has improved the effectiveness of the program’s responses. Staff members are trained in motivational interviewing and de-escalation techniques, as well as how to connect people to recovery resources, build recovery capital, and reduce barriers to care.

The ORS was created to help local communities reduce drug overdoses and save lives by sharing timely data, pertinent intelligence, and innovative strategies. The mission of the ORS is to help communities reduce fatal and non-fatal drug overdoses by connecting public health and public safety agencies, sharing information, and supporting evidence-based interventions.

This article explains ways to engage these partnerships and highlights how improving collaboration among community organizations such as law enforcement agencies, mental health providers, child welfare agencies, and schools will play a critical role in this approach. Each community partner’s expertise will help tailor interventions to the needs and issues affecting children and families affected by SUDs.

The article highlights efforts that collect near-real-time data, identify types of abused substances, and rapidly disseminate critical data to where they are needed. These initiatives include three examples of data integration efforts: a locally driven initiative in Columbus, Ohio; a state-level project in Tennessee; and a national data collection system involving the nation’s forensic crime laboratories.

It describes how the SPPD use ODMAP data, including supporting its Recovery Access Program (RAP) that connects overdose survivors with community services and supports.

It includes details of the types of telehealth services available, lists key steps for telehealth readiness, and offers examples of how telehealth is being used in practice.

Overdose Fatality Review (OFR) is a nationally recognized model used by a growing number of communities to strengthen their community-based responses to the opioid overdose epidemic. The goal of this OFR guide is to provide the reader with the needed information to build a successful OFR process with a strong foundation in coalition, data collection, and prevention. The OFR guide content draws on other fatality reviews and the authors’ practice-based knowledge. It is organized into five modules: Recruit Your OFR Team, Plan Your OFR Team, Facilitate Your OFR Team, Collect Your OFR Data, Build a Recommendation Plan.

Articles include:

• Peer Recovery Support Services (PRSS): Supporting Recovery in Times of Crisis
• PRSS: Building Recovery Capital
• Stimulants: Recent Trends and Prevention Resources
• Reentering the Community from Incarceration: Housing Matters
• Building an Organizational Culture That Values Law Enforcement Diversion
• New BJA Collaborative Program Will Build Tribal Capacity to Reduce Overdoses
• New Visualization Tools on PDMP TTAC Website Ease Searches

As the gatekeepers of the justice system, police play an important role in connecting vulnerable individuals, including those with mental health and substance use disorders, to services and resources. Linkage to these services and resources can address the underlying issues that, without intervention, can lead to patterns of repeat engagement with the justice system. The Officer Intervention pathway is centered on connecting eligible individuals to treatment and services to address the underlying reason for their alleged offense while still holding them accountable for it.

The guide includes basic definitions, as well as in-depth information about substance use disorders, treatment options, communication strategies, and self-care tips. This guide was released in the summer of 2020. It was created by the Addiction Policy Forum staff in conjunction with an Expert Review Panel composed of prominent researchers and physicians in the addiction field. The guide was also crafted with support from the Family Support Advisory Committee made up of family members with lived experience.

Corresponding online resources are available at https://www.addictionpolicy.org/navigating-addiction.

In the early 1970's, as part of its efforts to increase treatment for substance use disorder and reduce the stigma surrounding such treatment, the federal government enacted the Drug Abuse Office and Treatment Act of 1972.1. That Act included a statutory provision for the confidentiality of patient records, now codified at 42 U.S.C. § 290dd-2. This article addresses the two most recent sets of amendments concerning treatment record privacy laws created by: (1) the passage of the Coronavirus Aid, Relief, and Economic Security (CARES) Act on March 27, 2020; and (2) the adoption of revisions to 42 C.F.R. Part 2, effective August 14, 2020, by the Substance Abuse and Mental Health Services Administration (SAMHSA).

As a nationally recognized model, overdose fatality review (OFR) is being used by a growing number of communities to strengthen their community-based responses to the opioid overdose epidemic. The purpose of an OFR is to effectively identify system gaps and innovative community-specific overdose prevention and intervention strategies. In practice, OFRs involve a series of confidential individual death reviews by a multidisciplinary team. A death review examines a decedent’s life to facilitate a deeper understanding of the missed opportunities for prevention and intervention that may have prevented an overdose. By conducting a series of OFRs, jurisdictions begin to see patterns of need and opportunity, not only within specific agencies but across systems.

This presentation highlights one state’s OFRs experience partnering with their PDMP program. Participants will learn more about OFRs, benefits of OFR and PDMP partnerships, challenges of participating and sharing data and how they may be overcome, and how PDMP programs may build a relationship with their local OFRs.

States have implemented many different strategies to address opioid use disorder/substance use disorders (OUD/SUD) and promote safe prescribing practices. One of these strategies is maintaining prescription drug monitoring programs (PDMPs) to inform clinical decisions and help support referrals to OUD/SUD treatment. PDMPs serve as information tools for many providers and public health and safety professionals who use the data to address OUD/SUD through improved clinical decision making, enhanced public health interventions, and faster detection of prescription fraud and diversion.

The National Governors Association developed a toolkit to highlight state practices in PDMP policy and identify opportunities to improve access and ease of use by health care providers. The toolkit includes a series of 10 considerations, highlighting different approaches states have taken to implement those strategies. In producing this toolkit, the National Governors Association Center for Best Practices (NGA Center) consulted with national and state experts, including through a virtual roundtable on March 31, 2020, that was largely comprised of state officials, to discuss how states have used their PDMPs as part of broader strategies to address OUD/SUD.

Because PDMPs are already widely adopted and utilized among states and providers, the considerations in this toolkit reflect opportunities for state leaders to share best practices and make enhancements to advance functionality and improve utilization as part of a broader data-driven approach to promote the health and wellbeing of state residents. It also serves as a primer for individuals interested in learning about how PDMPs can advance initiatives to address OUD/SUD.

The COSSAP TTA Program supports jurisdictions in need—including BJA and partner grantees, states, tribes, and local communities—in building and sustaining multidisciplinary public safety and public health responses to the abuse of illicit substances. TTA is provided in a variety of formats, including expert consultations, virtual and in-person training events, workshop and meeting presentations, and online resources. Learn more about the COSSAP TTA Program in this briefing sheet.

ORCP emerged from a desire to equip inmates with vocational, educational, and other skills that could lead to gainful employment, thereby reducing the likelihood of recidivism. Judge Laurie A. White and Judge Arthur Hunter of the Orleans Parish,Louisiana, Criminal District Court worked with the Louisiana Department of Public Safety & Corrections (DPS&C) to develop the program in 2010; by 2011, Louisiana passed legislation establishing reentry courts.

List of effective facilitation qualities.

Template for OFR meeting minutes.

List of data each type of agency will want to bring and share at an OFR.

Sample outline of how to present a case to OFR members.

Sample OFR confidentiality agreement.

Example of a sign-in sheet for an OFR that also is a confidentiality agreement.

Example of an outline of information to share with a governing committee.

Example of an interagency data sharing agreement for member's agencies to sign before sharing data.

Sample list of OFR meeting ground rules.

Sample list of questions to help guide members in summarizing and sharing case information.

Sample OFR meeting agenda.

Sample email to inform OFR members about cases that will be reviewed at next OFR meeting.

Sample letter text that may be used to recruit new OFR members.

Sample letter text that can be used to remind OFR members of upcoming meeting and cases to review.

Sample table to develop a work plan for recommendations.

Lists data to include in a summary data report.

Lists questions to guide an OFR data sharing protocol.

A growing number of law enforcement officers and first responders across the country are administering naloxone to individuals to reverse the effects of opioid overdoses. If these individuals are not subsequently and quickly connected to treatment, recovery support, and other needed resources, they are at high risk of experiencing another potentially fatal overdose. The Naloxone Plus pathway is centered on the connection of individuals to treatment and follow-up services after an opioid overdose. The emphasis in this pathway is on the Plus—administering naloxone or responding after an overdose plus the connection to treatment. Naloxone Plus is a national standard for law enforcement response in communities that have high rates of overdose.

List of activities that need to be accomplish before launching and convening an OFR.

List of OFR coordinator's activities before each meeting.

This compilation of training resources includes videos, online learning, and print documents that were screened specifically for corrections officers and other corrections personnel seeking to promote the well-being and reentry of inmates with opioid use disorder or substance use disorders. Unless otherwise indicated, all resources listed are available free of charge electronically.

Articles include:

• First-Responder Trauma and the Opioid Crisis
• The Effectiveness of Peer-to-Peer Learning
• Social-Emotional Development as a Key to Combatting Substance Abuse in Tribal Communities
• Opportunities for Peer-to-Peer Connections: Commonalities Among FY 2019 Statewide COAP Grantees
• Increasing Access to Medications for Opioid Use Disorder Through Peer Recovery Support Services
• RxCheck Hub Connection Status Summary
• Maintaining OFR Momentum During COVID-19

Access to near real-time fatal and nonfatal overdose data can help public safety and public health agencies mobilize prevention and intervention responses. ODMAP is a tool that can enable communities to develop tailored interventions targeting specific geographic areas or high-risk individuals.

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This article includes the following topics:

• What is social-emotional development?
• What is the relevance of social-emotional skill development for a tribal population?
• What are the specific skills?
• How do we support development of social-emotional skills?

In addition, this resource will assist in understanding the many pathways associated with developing an opioid use disorder (OUD) and identifying complexities associated with parental OUD and affects on children, youth, and families.

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This document is a supporting document for the "Navigating Confidentiality in First Responder Deflection" session of the 2021 Virtual COSSAP National Forum.

The "Catching Up With COSSAP" Newsletter collects articles (many original to this publication), resources, and training announcements with the express goal of supporting and informing those dedicated to turning the tide of America's substance abuse crisis. We also appreciate the chance to tell the stories of colleagues and communities across the nation. If you are willing to share your experiences in combating the epidemic, we invite you to make a difference by adding your voice at cossap@iir.com. You are also encouraged to pass along this resource to build our COSSAP community.

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

Developed in partnership with OFR practitioners, this document is offered to provide guidance to OFR teams on if and how to do OFR virtual meetings.

Released by the U.S. Drug Enforcement Administration (DEA) on a periodic basis, Drugs of Abuse provides important science-based information about the harms and consequences of drug use, describing a drug’s effects on the body and mind, overdose potential, origin, legal status, and other key factors. In addition, the guide outlines U.S. drug regulation, including drug scheduling and chemical controls. The 2020 digital edition updates the 2017 Drugs of Abuse publication with the most current information on new and emerging trends in drug misuse and abuse, including fentanyl, marijuana and marijuana concentrates, vaping, and stimulant drugs.

Because education plays a critical role in preventing substance abuse, this comprehensive guide is intended as a tool not just for medical practitioners and law enforcement officials, but also for educators, families, and communities. Drugs of Abuse also offers a list of additional drug education and prevention resources, including the DEA websites: www.DEA.gov, www.getsmartaboutdrugs.com for parents, www.justthinktwice.com for teens, www.campusdrugprevention.gov for colleges and universities, and www.operationprevention.com for school and work curriculum.

The Legislative Analysis and Public Policy Association (LAPPA) has developed a guidance document that discusses the application of Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health and Human Services (HHS) Privacy Rule to ODMAP. 

The Public Health and Safety Team (PHAST) Toolkit is a resource developed to help local jurisdictions reduce opioid overdose deaths by increasing collaboration and coordination among all sectors, with a particular focus on public health and public safety agencies. The toolkit begins with an introduction, which describes the need for effective partnership among public health and public safety agencies and provides an overview of PHAST and the SOS Process. The toolkit contains two distinct modules for two different audiences. Module 1 is designed for PHAST leadership. Module 2 is intended for use by multi-sector partners.

In early 2019, the National Association of Counties (NACo) and National Sheriffs’ Association (NSA) convened the task force to meet and to hold countless discussions with local criminal justice system stakeholders and county officials to facilitate the development of this report and subsequent recommendations. This report is aimed at criminal justice system stakeholders at all levels of government. It is divided into four sections: recommendations for government entities, an overview of pretrial detainees and jail health care, best practices in jail health care and strengthening the care continuum, and legal implications and recommendations. This report outlines methodologies to improve health outcomes for justice-involved individuals and ultimately break the cycle of recidivism that has burdened local jails and the county systems that support this population.

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

This is one resource within a suite of related resources made possible through participation in the Office for Victims of Crime (OVC) and Bureau of Justice Assistance (BJA) National Stakeholder Partnership (NSP).

It also provides the strategic direction necessary for the federal government to prevent initiates to drug use through education and evidence-based prevention, provide treatment for those suffering from the disease of addiction so they can reach long-term recovery, and reduce the availability of these dangerous drugs in every American community.

The purpose of the guide is to arm rural leaders with information they can put into immediate action to create change. It provides background information, recommended action steps, and promising practices to help manage the impact of substance use disorder on local communities and help persons with the disease of addiction. The topics are based on lessons learned from Department of Agriculture rural roundtable discussions held in over a dozen states, as well as the experiences of several rural stakeholder partners.

This supplement offers a listing of promising practices that a community can replicate or use to inspire its own action to find a solution to substance use disorder.

This report uses the most recent final mortality data from the National Vital Statistics System (NVSS) to update trends in drug overdose deaths, describe demographic and geographic patterns, and identify shifts in the types of drugs involved.

Provides information on evidence-based strategies and standards of care for alcohol withdrawal management in ambulatory and inpatient settings.

Correctional administrators and health care providers are on the frontlines of the opioid epidemic as justice-involved individuals are disproportionately at risk of having opioid use disorder (OUD) and dying from opioid overdose. Despite the high rates of OUD among incarcerated individuals, evidence-based treatment does exist and can be successfully implemented within jails and prisons. The most effective treatment for OUD is the use of U.S. Food and Drug Administration (FDA)-approved medications (methadone, buprenorphine and naltrexone), a treatment modality commonly known as medication-assisted treatment (MAT) or medication for opioid use disorder (MOUD). Across the nation, a growing number of jails and prisons offer MAT for OUD resulting in positive outcomes for patients, staff and jurisdictions. Download this valuable planning and implementation toolkit.

Defining and identifying high-utilizer calls for consensus among the justice, health, and human services systems and a formal agreement to share data. Each jurisdiction will determine a definition of high utilizers that works for that jurisdiction. Collaborators on data-driven justice strategies should bring together the appropriate legal, policy, and technology leaders to begin the conversation on identifying high utilizers.

Cross-sector data sharing is lauded as an integral part of complex care. Sharing data among multiple sectors—such as behavioral health, medicine, criminal justice, housing, and education—seems like a straightforward way to understand people’s complex health and social needs and provide whole-person care. In practice, however, sharing data is not always so simple. These sample data sharing agreements were used as part of Camden ARISE, which linked data from criminal justice, health care, and housing in Camden, New Jersey. The agreements can be adapted for use by other cross-sector groups seeking to share data.

Presents an update on evidence-based treatment of opioid use disorder and replaces the 2015 ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use.

The breakout session was part of the larger national event, “The Opioid Crisis and the Nation’s Youth—Strategies and Solutions to Serve our Youngest Victims,” held December 4-5, 2019, in Alexandria, Virginia. The convening was collaboratively supported by the Bureau of Justice Assistance (BJA) and Office for Victims of Crime (OVC) and brought together grantees from BJA’s Comprehensive Opioid Abuse Program and OVC’s Enhancing Community Responses to America's Drug Crisis: Serving Our Youngest Crime Victim initiative as well as federal leaders, subject matter experts, and stakeholders and partners.

Supported by the Bureau of Justice Assistance (BJA), the COAP Newsletter collects articles (many original to COAP), resources, and training announcements with the express goal of supporting and informing those dedicated to turning the tide of America’s opioid crisis.

It covers the latest data available on rates of opioid prescribing, substance use disorder, nonfatal hospitalizations and emergency department visits, and overdose deaths. National information, and some state information, is presented to serve as a resource to help address the ongoing national problem of drug abuse, addiction, and overdose.

This report provides recommendations for actions that state and local leaders can take immediately to increase evidence-based practices, decrease arbitrary determinations, and prevent overdose deaths.

This online resource offers a collection of tools and resources for providers, staff, and patients who offer or use medication-assisted treatment (MAT) services.

Federal statutes, regulations, and guidelines govern medication-assisted treatment (MAT) for opioid addiction. The Substance Abuse and Mental Health Services Administration's (SAMHSA) Division of Pharmacologic Therapies (DPT), part of the SAMHSA Center for Substance Abuse Treatment (CSAT), oversees accreditation standards and certification processes for opioid treatment programs (OTPs). DPT also works with the Drug Enforcement Administration (DEA) and the states to regulate certain medications used in MAT. This online resource provides additional information on these regulations and criteria.

The workshop's mission was to investigate the connection between incarceration and health inequities to better understand the distributive impact of incarceration on low-income families and communities of color. Topics of discussion focused on the experience of incarceration and reentry, mass incarceration as a public health issue, women’s health in jails and prisons, the effects of reentry on the individual and the community, and promising practices and models for reentry. The programs and models that are described in this publication are all Philadelphia-based because Philadelphia has one of the highest rates of incarceration of any major American city. This publication summarizes the presentations and discussions of the workshop.

The goal is to provide decisionmakers, researchers, media outlets, and the public with insights intended to improve their understanding of the synthetic opioid problem and how to respond to it.

By including the criminal justice system as a path to treatment, states may see an increase in access to and retention in treatment, as well as lower rates of overdoses, re-offending, and re-incarcerations. In this brief, states are provided an overview of the issue, the challenges to incorporating MAT, key considerations for establishing MAT in criminal justice settings, and existing standards/guidelines.

Medication-assisted treatment (MAT) is the use of FDA-approved medications with behavioral therapies to treat alcohol and opioid use disorders.  When provided as part of the rehabilitation and reentry process for people incarcerated in correctional facilities, MAT addresses substance use as a criminogenic risk factor and may contribute to long-term recovery and reduced recidivism. As with any medication or treatment, there is risk of diversion; but, with the appropriate program elements in place, sheriffs, wardens, and jail administrators can provide this effective and evidence-based treatment to individuals during incarceration.  This action brief addresses strategies and techniques to decrease the diversion of drugs used in MAT.

Medication-assisted treatment (MAT) uses FDA-approved medicines such as buprenorphine (Suboxone), methadone, and naltrexone (Vivitrol), often supplemented by behavioral treatment and social supports. Harm-reduction services are employed to keep patients safe until they are ready to seek treatment—services such as dispensing naloxone, an opioid antidote that prevents death from overdose, and providing clean syringes to prevent HIV and hepatitis C. A medication-first approach allows patients to be stabilized first on medication and then be brought to the appropriate level of care to fit their needs—thereby decreasing the risk of overdose and relapse. Despite data showing the success of MAT in treating drug addiction, objections are still common. Following are some frequent objections and evidence-based responses.

Across the country, court-based strategies to prevent overdose deaths continue to expand and evolve. While the models and practices included in this document vary, they all aim to save the lives of justice-involved individuals at risk of overdose. These programs are working to connect at-risk individuals with more immediate treatment and supportive services and use evidence-based practices to enhance the justice system’s response to the opioid epidemic.

This document offers examples of how state prescription drug monitoring programs (PDMPs) are involved in the overall efforts to address and prevent drug overdoses.

This resource offers planners a tool for building effective programs that incorporate the best research currently available. These essential elements can help courts achieve the goal of preventing overdose deaths while offering individuals and families impacted by opioid use disorders the support they need to start down the long road to recovery. Practitioners everywhere are urged to put these essential elements into action.

This report contains data from an environmental scan survey that the National Association of County and City Health Officials distributed in January 2019 to 388 local health departments (LHD) identified from the 2018 Forces of Change survey as respondents who reported conducting activities to address "opioid use and abuse" in 2017. The goal of the scan was to create a foundational understanding of LHD opioid overdose prevention and response efforts to inform priorities at the local, state, and national levels.This sample is not intended to be nationally representative.

Information is included on dosing, complicating factors, diagnosing opioid withdrawal, and more.

For individuals with behavioral health issues, reentry to the community following incarceration is a period of potential vulnerability if appropriate services are not in place. This publication offers 10 guidelines to promote the necessary partnerships between behavioral health and criminal justice professionals to ensure an individual’s successful transition from jail or prison to the community. Recommendations from the guidelines include universal screening, individualized treatment plans, continuity of care, and data sharing across agencies. This publication updates the work first conducted in 2013 by SAMHSA’s GAINS Center in collaboration with the Council of State Governments Justice Center. The guidelines brought together principles from the Adults with Behavioral Health Needs Under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery; the Assess, Plan, Identify, and Coordinate (APIC) model; and evidence-based practices. The guidelines set out in this document help stakeholders incorporate evidence-based practices into their reentry processes. The guidelines are designed to support partnerships between criminal justice and behavioral health stakeholders. Through these collaborative partnerships providers are able to successfully identify individuals who need services, understand what services are needed, and determine how to meet these needs upon transition to community-based treatment and supervision. This publication is a valuable tool for professionals in behavioral health, corrections, and community agencies.

The Bureau of Justice Assistance (BJA) Comprehensive Opioid Abuse Program (COAP) is pleased to offer this briefing sheet that details BJA COAP's Peer Recovery Support Services Mentoring Initiative.

This bulletin, released by the National Governors Association, addresses the reemergence of stimulants and the challenges it presents in efforts to combat the opioid epidemic.

Supported by the Bureau of Justice Assistance (BJA), the COAP Newsletter collects articles (many original to COAP), resources, and training announcements with the express goal of supporting and informing those dedicated to turning the tide of America’s opioid crisis.

The Bureau of Justice Assistance (BJA) Comprehensive Opioid Abuse Program (COAP) is pleased to offer this briefing sheet that details BJA COAP's support to local governments.

The Bureau of Justice Assistance (BJA) Comprehensive Opioid Abuse Program (COAP) is pleased to offer this briefing sheet that details BJA COAP's support to states and territories.

The Bureau of Justice Assistance (BJA) Comprehensive Opioid Abuse Program (COAP) is pleased to offer this briefing sheet that details BJA COAP's support to tribal communities.

The Bureau of Justice Assistance (BJA) Comprehensive Opioid Abuse Program (COAP) is pleased to offer this briefing sheet that details BJA COAP's Training and Technical Assistance Program.

The Bureau of Justice Assistance (BJA) Comprehensive Opioid Abuse Program (COAP) is pleased to offer this briefing sheet that details COAP.

The Bureau of Justice Assistance (BJA) Comprehensive Opioid Abuse Program (COAP) is pleased to offer this briefing sheet that details BJA COAP's support of law enforcement/first responder diversion programs.

Supported by the Bureau of Justice Assistance (BJA), the COAP Newsletter collects articles (many original to COAP), resources, and training announcements with the express goal of supporting and informing those dedicated to turning the tide of America’s opioid crisis.

This publication suggests activities to create or strengthen collaboration between policymakers, low-income housing providers, advocates, and other stakeholders.

The Bureau of Justice Assistance (BJA) Comprehensive Opioid Abuse Program (COAP) has selected four organizations to serve as the first mentors in a new initiative to foster promising approaches, best practices, and evidence-supported peer program programming to address the opioid epidemic. These programs work with first responders, law enforcement, courts, jails, prisons, and community corrections to help persons with opioid use disorders achieve and maintain recovery from addiction.

Research findings in the following seven areas are reviewed: location of buprenorphine induction, combining buprenorphine with a benzodiazepine, relapse during buprenorphine treatment, requirements for counseling, uses of drug testing, use of other substances during buprenorphine treatment, and duration of buprenorphine treatment. For each area, evidence for needed updates and modifications in practice is provided. These modifications will facilitate more successful, evidence-based treatment and care for patients with OUD.

The Council of State Governments' (CSG) National Reentry Resource Center (NRRC) has released a fact sheet on Best Practices for Successful Reentry for People Who Have Opioid Addictions. The fact sheet describes the best practices that correctional, community-based behavioral health, and probation and parole agencies can implement within their systems to ensure that reentry for people who have opioid addictions is safe and successful. The document provides an overview of ten ways in which the professionals in these agencies can help ensure success, which fall under the following categories: planning and coordination, behavioral health treatment and cognitive behavioral interventions, probation and parole supervision, and recovery support services.

This article and corresponding radio segment feature the new quick response team (QRT) in Huntington, West Virginia—a collaborative project involving law enforcement, the county’s medical first responders, and several drug treatment providers. The goal of the QRT is to locate people who have recently survived drug overdoses, visit them, and let them know how to get help.

The Inter Tribal Council of Arizona, Inc. (ITCA) Tribal Epidemiology Center (TEC) compiled background data to describe the epidemic in Indian Country using a variety of Arizona state data sources. This White Paper highlights important areas of concern related to the opioid epidemic, including policy and litigation that may impact Tribes in Arizona.

The views and opinions expressed in this resource are those of the authors and do not necessarily reflect the official policy or position of the National Criminal Justice Training Center (NCJTC) at Fox Valley Technical College. Further, NCJTC does not support or promote an official position on the litigation referenced in this document.

This resource, developed to support jail administrators in providing effective treatment for opioid misuse and helping to halt the opioid epidemic in the United States, introduces what has been learned from sheriffs’ and jail administrators’ innovative use of medication-assisted treatment, a cornerstone of best practice for recovery from substance misuse; describes the essential components of these programs; and discusses the latest research on how the programs are best implemented, as well as the medications approved for opioid use disorders.

The Addiction Policy Forum, the Addiction Policy Leadership Action Network, and the National Association for Children of Addiction offer this toolkit as a resource to help guide counselors, teachers, psychologists, and social workers through the challenges of helping children impacted by addiction.

The U.S. Department of Health and Human Services (HHS) has developed this case scenario to provide clinicians with an example of a clinical practice engagement consistent with the U.S. Drug Enforcement Administration (DEA) statement and applicable HHS-administered authorities.

This resource is provided to assist community leaders, local and regional organizers, non-profit groups, law enforcement, public health, and members of the public in understanding and navigating effective strategies to prevent opioid overdose in their communities.

Supported by the Bureau of Justice Assistance (BJA), the COAP Newsletter collects articles (many original to COAP), resources, and training announcements with the express goal of supporting and informing those dedicated to turning the tide of America’s opioid crisis.

This pocket guide is designed to help counselors and therapists working with drug court participants refer and link participants to opioid treatment services in outpatient offices, clinics, and Opioid Treatment Programs (OTPs).

This pocket guide is intended for non-clinical drug court team members (e.g., court coordinators, judges, defense attorneys, prosecutors, parole officers, case managers, peer mentors, recovery coaches). It will describe how the team member can support both the provider and those participants prescribed or considering medication-assisted treatment (MAT).

It summarizes the requirements of the federal SUD confidentiality rules set forth under 42 Code of Federal Regulations (CFR) Part 2, discusses the steps that primary care practices currently take to effectively coordinate SUD care without violating the rules, suggests additional compliance strategies that might enhance data sharing, and offers for consideration modest revisions to the rules that could promote the integration of care without undermining patient privacy.

This Substance Abuse and Mental Health Services Administration toolkit includes opioid use disorder facts, five essential steps for first responders, information for prescribers, safety advice for patients and family members, and information on recovering from an opioid overdose.

The Congressional Research Service (CRS), a component of the Library of Congress, issued a report that gives an overview of prescription drug monitoring programs (PDMPs), including operations, interstate data sharing, compliance and enforcement mechanisms, costs, and funding. The report also addresses policy issues, federal grant programs, and the effectiveness of PDMPs for law enforcement and health care.

As Congress considered a bill to reauthorize the Office of National Drug Control Policy (ONDCP), the U.S. Government Accountability Office was asked to discuss in testimony before the Committee on Oversight and Government Reform, House of Representatives, federal agencies' specific opioid-related strategies and the extent to which each agency is measuring its performance, as well as federal agencies' efforts to enhance collaboration and information sharing to limit the availability of illicit opioids, ongoing challenges to doing so, and ONDCP's role in enhancing such collaboration.

This toolkit, developed by the U.S. Department of Health and Human Services Center for Faith-Based and Neighborhood Partnerships, contains practical steps that an organization can take to bring hope and healing to people suffering from the consequences of opioid abuse disorder.

The Pain Management Best Practices Inter-Agency Task Force was established to propose updates to best practices and issue recommendations that address gaps or inconsistencies for managing chronic and acute pain. The Task Force, which was called for by the Comprehensive Addiction and Recovery Act of 2016, is assigned the following responsibilities:

• Determining whether there are gaps or inconsistencies in pain management best practices among federal agencies
• Proposing recommendations on addressing gaps or inconsistencies
• Providing the public with an opportunity to comment on any proposed recommendations
• Developing a strategy for disseminating information about best practices

The National Institute on Drug Abuse maintains this online resource.

The pre-trial population of defendants—particularly in rural areas of the country—has significantly increased, and jails in smaller jurisdictions are responsible for an outsized share of jail population growth. From 1970 to 2014, jail populations grew by almost sevenfold in small counties but only threefold in large counties. This document explores why this growth may have occurred and makes numerous recommendations to reduce pre-trial populations, particularly in rural America.

This fact sheet provides:

• three necessary steps to complete prior to utilizing a treatment center
• the five signs of a quality treatment center, which include:
  • a review of the accreditation
  • medication
  • evidence-based practices
  • position on the role of families
  • support networks

Supported by the Bureau of Justice Assistance (BJA), the COAP Newsletter collects articles (many original to COAP), resources, and training announcements with the express goal of supporting and informing those dedicated to turning the tide of America’s opioid crisis.

The Recovery Housing Toolkit was released by the National Council for Behavioral Health and the National Alliance for Recovery Residences.

This report features key statistics and infographics from the latest data on increasing emergency department visits for suspected opioid overdoses. It includes actionable ideas and training for improving outcomes.

A small but growing group of corrections professionals across the country has started to implement jail or prison-based overdose education and naloxone distribution programs to serve people who are returning to the community following incarceration who face a dramatically increased risk of death from overdose.

This resource presents an estimation of the per-capita state-level and county-level nonmortality and total economic burdens of the opioid crisis in 2015.

The opioid crisis cost $504 billion, which is 2.8 percent of the Gross Domestic Product, in 2015. Learn more statistics about this public health emergency in this infographic.

This resource describes three post-overdose interventions that have shown promise in reducing the risk of subsequent overdoses and improving other health outcomes among people who have experienced a nonfatal overdose, highlighting the role of prevention practitioners in supporting these efforts.

Naloxone access laws make naloxone easier to obtain by expanding how the medication can be distributed beyond traditional prescriptions. This document describes the aims of naloxone access laws and the various forms they can take.

The clinical guide helps health-care professionals and patients determine the most clinically appropriate action for a particular situation and informs individualized treatment decisions.

Features recommendations for continuous quality improvement, clinical performance enhancement, patient safety, initial health assessment, pharmaceutical operations, and women’s health.

It covers quantitative statistical outcomes spanning 9 years of the Montana Department of Corrections (DOC) contracted program for the treatment of male methamphetamine and other drug offenders: The Nexus program in Lewistown, MT operated by Community Counseling and Correctional Services (CCCS). All data from report prepared by Timothy B. Conley, Ph.D. and Sierra Lake, Research Assistant Clinical and Research Consulting, LLC Missoula, Montana, December 12, 2017.

The Council of Economic Advisers (CEA) estimates the economic cost of fatalities resulting from overdoses using conventional economic estimates for valuing life routinely used by U.S. Federal agencies. It also adjusts for underreporting of opioids in overdose deaths, includes heroin-related fatalities, and incorporates nonfatal costs of opioid misuse. CEA estimates that in 2015, the economic cost of the opioid crisis was $504.0 billion, or 2.8 percent of GDP that year. This is over six times larger than the most recently estimated economic cost of the epidemic.

This blueprint, written to inform the efforts of researchers and analysts in local government agencies and in research settings, combines lessons learned from a wide-ranging literature review with the direct experience of Urban Institute (Urban) researchers, who collected, integrated, mapped, and analyzed interagency and cross-jurisdictional data from the Washington, DC, metropolitan area, a project referred to throughout this blueprint as Metropolitan Crime Mapping. The goal of this blueprint is to encourage similar projects by identifying the opportunities that cross-sectional analysis offers, suggesting strategies to overcome barriers that researchers may encounter, and providing an overview of what the future holds for cross-sector data sharing and analysis.

The Federal Office of Rural Health Policy (FORHP) piloted a program in 2015 called the Rural Opioid Overdose Reversal (ROOR) Program that funded 18 awardees to develop community partnerships in an effort to combat the opioid crisis at the local level. The goal of the program was to reduce the incidences of morbidity and mortality related to opioid overdoses in rural communities through the purchase and placement of naloxone, in addition to the training of licensed healthcare professionals,emergency responders, and other community members to recognize the signs and symptoms of overdose and administer naloxone. This report provides a summary of lessons learned from ROOR grant recipients on how to engage, educate and connect stakeholders to resources available to help combat the opioid overdose epidemic. This report provides a summary of lessons learned from ROOR grant recipients on how to engage, educate, and connect stakeholders to resources available to help combat the opioid overdose epidemic.

This paper examines the varying approaches states have taken to connect eligible people who are released from prison and jail to the mental health care and substance use treatment they need by ensuring health care coverage through some combination of Medicaid, SSI/SSDI, and veterans’ benefits.

The Health Insurance Portability and Accountability Act (HIPAA) is frequently characterized as a barrier to implementing a smarter, more data-driven approach to diverting the high-utilizer population and providing treatment and services. This document addresses what HIPAA restricts and—more importantly—how HIPAA can be used as a tool to better serve high-utilizers and other populations in your community.

As the incidence of opioid and heroin addiction grows, American law enforcement has developed new approaches to combating it. Based on collaborative partnerships with public health and other professionals, these new strategies stress prevention and treatment as well as enforcement. To identify the most effective of these approaches, the COPS Office hosted the Law Enforcement and Public Health: Successful Partnerships in Addressing Opioid Use Forum in partnership with the Office of National Drug Control Policy and the Police Executive Research Forum. Participants—who included representatives from public health agencies, law enforcement executives, and other stakeholders—discussed the establishment of treatment and prevention partnerships, the use of naloxone deployment programs, and best practices to mitigate drug use. They also discussed methods for sharing access to data and intelligence. This report not only documents the discussions but also describes innovative programs based on collaboration between the public health and public safety sectors.

The Familiar Faces initiative is systems mapping, design, and improvement work centered on creating a system of integrated care for complex health populations that can eventually benefit any user of publicly funded health services. Familiar Faces is a sentinel population defined as individuals who are frequent utilizers of the King County Jail (defined as having been booked four or more times in a 12-month period) and who also have mental health and/or substance use conditions.

This policy is a supporting document for the "Getting Started: Best Practices and Common Challenges for New Peer Recovery Support Services Programming" presentation of the 2021 Virtual COSSAP National Forum.

The Centers for Disease Control and Prevention (CDC) developed guidelines to improve prescribing opioids for chronic pain. Recommendations focus on the use of opioids in treating pain lasting longer than three months or past the time of normal tissue healing, outside of active cancer treatment, palliative care, and end-of-life care.

These numbers, statistics, and stories represent the largest ever collection of information from LGBTQ prisoners. This collection of information is possible because of the time taken by 1,118 prisoners across the United States to handwrite responses to our 133-question survey, which was itself designed/drafted with prisoners themselves. Black & Pink’s free world leadership extends the utmost thanks to prisoner members who took the time to help design and respond to the National LGBTQ Prisoner Survey and for sharing their deeply personal and valuable stories of harm and resilience. LGBTQ people, particularly people of color and poor people, experience high levels of policing and criminalization, leading to arrest and incarceration. Once inside prison, LGBTQ people are subject to constant violence by both prison staff and prisoners. This report seeks to offer a tool for organizers, both inside and outside of prisons, to strengthen the national campaigns and grassroots efforts to alleviate the immediate suffering of prisoners and bring an end to the prison industrial complex while centering the needs of LGBTQ prisoners.

This policy is a supporting document for the "Getting Started:  Best Practices and Common Challenges for New Peer Recovery Support Services Programming" presentation of the 2021 Virtual COSSAP National Forum.

Provides clinicians with updated information and expands on the issues commonly encountered in the delivery of withdrawal management services.

This toolkit summarizes important information that elected officials, agency leaders, and city staff need to know about the federal laws and regulations related to individual privacy rights that govern data-sharing.  The purpose is to support local leaders in using integrated data to improve services while respecting the privacy of residents.

To explore how Medicaid could best advance models for this high-need group of patients, the Center for Health Care Strategies (CHCS), in partnership with the National Governors Association, hosted a Super-Utilizer Summit on February 11 and 12, 2013. The summit brought together leaders from super-utilizer programs across the country, states, the Centers for Medicare & Medicaid Services, the Robert Wood Johnson Foundation (RWJF) Aligning Forces for Quality (AF4Q) alliances, health plans, and other key stakeholders to share strategies for changing how our health care system interacts with these high-need, high-cost patients. The meeting was made possible through the generous support of RWJF and the Atlantic Philanthropies. The appendices include materials related to existing complex care management programs that can be educational resources for states and policymakers considering ways to implement, spread, and sustain such programs.

It found that incarceration reduces former inmates' earnings by 40 percent and limits their future economic mobility. It also found that one in every 28 children in the U.S. has a parent behind bars, up from one in 125 just 25 years ago.