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Since the suicide and overdose fatality review (SOFR) team in Whitley County, Indiana, was formed in August 2022, it has learned so much. Within the rural community, the team was able to form quickly because everyone knew each other well because of their roles in the county. Within the team’s review process, the team has received significant and detailed information from the county’s prosecutor’s office, sheriff’s department, police department, Department of Child Services, and emergency department. All collaborative partners work very closely and well together and choose to find a resolve versus just engage discussion.

As information was brought to the table and discussed, the importance of developing a timeline of the decedent’s life was critical. The timeline helps the team identify gaps in services very quickly.

Recommendations that the SOFR team have identified so far are:

• Follow-up counseling for suicide attempts in the teenage years
• Gaps within mental health care in the county (three communities within the county do not have a community mental health office)
• Stigma around men receiving counseling through a divorce
• Recovery supports needed in the county

Implementing: Mission 25 is launching a Recovery Engagement Center (REC) to provide multiple pathways to recovery. This is a longtime needed service for Whitley County. The REC will open in late fall 2023.

Resources: Mission 25 and the health department are providing naloxone; the police department’s “Handle With Care” program was discussed for children who lost a parent or loved one by overdose or suicide; the Department of Child Services is providing family care.

This workshop will focus on jurisdictions who focused on the assembly of key, local stakeholders representing public health and public safety to address the problem of drug overdoses occurring in their communities. Through the use of information sharing tools such as the Overdose Detection Mapping Application Program (ODMAP), data dashboards, and overdose fatality review (OFR), these stakeholder groups have turned data into actionable responses to the opioid crisis. Panelists will discuss the evolution of their information sharing practices, including instances where the implementation of one process led to the use of an OFR. Panelists will also discuss their process for regular surveillance of data and how it informs the delivery of services in their communities.

In rural Sauk County, Wisconsin, if you are seen by emergency medical services (EMS) for anything substance use-related—stomach pains from drinking too much or an accidental or intentional overdose, for example—you receive a follow-up visit from response teams. A collaboration among Public Health Sauk County (PHSC), WisHope (a recovery community organization), and all six local EMS agencies, Sauk County Response Teams (SCRTs) are composed of EMS and a WisHope peer recovery coach. The teams make in-home or in-jail visit attempts to streamline a connection to needed services. The Sauk County Overdose Death Review Team recommended, planned, and helped implement SCRTs. The team reviewed multiple deaths in which the decedents had been previously seen by EMS for nonfatal incidents. The team also held a meeting to map area gaps in service delivery after a drug-related EMS incident and prioritized SCRTs as a solution to enhance linkages to care. PHSC applied and was awarded a grant, formed a planning committee, and hired an experienced consultant. SCRTs launched in May 2021. The teams receive about 10 referrals per month, and follow-up visits end in a successful connection with the client or a household member about half the time. Clients receive warm handoffs to services such as long-term peer support, treatment, harm reduction (Narcan, fentanyl test strips, education), and others (FoodShare, food pantries, health insurance, health and mental health care appointments, job training referrals, housing assistance, etc.). Monthly activity reports track referrals, rates of contact, clients’ ages and genders, and substances used.

Most decedents reviewed in Philadelphia, Pennsylvania’s overdose fatality review (OFR), OD Stat, had at least one interaction with emergency medical services (EMS) prior to their deaths. Philadelphia EMS has a naloxone leave-behind program, but the review team noted that many of the decedents would not have qualified for leave-behind naloxone and the accompanying education because they were not always using opioids. Much of the drug supply in Philadelphia is contaminated or adulterated with fentanyl, meaning that people who do not purposefully or knowingly use opioids could still be at risk for a future overdose. OD Stat pulled together a small subcommittee of public health and EMS staff members to review EMS’ current naloxone leave-behind policy. The policy at the time was to provide naloxone to people following a nonfatal opioid overdose. The Philadelphia OFR provided qualitative data from OD Stat showing that opioid overdose decedents often had EMS contacts prior to their overdoses for stimulant or hallucinogen-related calls. The OD Stat team recommended that the Philadelphia Fire Department/EMS update its policy to provide naloxone to any individual who uses drugs regardless of whether they knowingly use opioids or have experienced an overdose. By expanding its reach, EMS could provide education about widespread fentanyl contamination and increase its distribution of naloxone. EMS updated its internal policy and circulated an all-staff memorandum as of October 2020. Leave-behind naloxone was paid for through a grant funded by the Commonwealth of Pennsylvania. OD Stat tracks the number of leave-behind naloxone kits provided by EMS on an annual basis.

This presentation describes the methodical steps taken and lessons learned in developing the Broome County, New York, Accidental Injury and Death Review (AIDR) team. Opioid overdose prevention staff at the Broome County Health Department focused on the details and planning of the fatality review team to set it up for sustainability, right down to the name of the review team. Broome County intentionally expanded the name of the team to AIDR to include not only fatal overdoses but also individuals who were injured (survived an overdose) or died by suicide. Every step in the planning process was thought out for future needs as they relate to both substance use and mental health. A key strategy in the development of the team was meeting one-on-one with stakeholders to garner support as part of the process and get their buy-in and recommendations prior to the first meeting. By investing the time up front and fostering the relationships among partners at the table, the overdose prevention staff members developing the AIDR team gained valuable input from the multidisciplinary team and were able to engage them in participating without hesitation. Stakeholders were instrumental in formulating recommendations and suggestions and providing subject-matter expertise. In addition, the Broome County program staff researched successful overdose fatality review teams and were mentored by two fatality review teams, along with the coordinator of the child fatality review team in Broome County. Learn how public health professionals used a personal relationship approach by focusing on stakeholders’ strengths and proficiency to develop the AIDR team in Broome County.

The Michigan Public Health Institute (MPHI) began establishing overdose fatality review (OFR) teams in Michigan in 2021. Following case reviews, MPHI sought feedback, surveyed teams, and followed up on information gaps. This resulted in several community-based, often team member-led presentations that have provided unexpected learning opportunities. The review of the case of a veteran who died because of an overdose left team members with unanswered questions, especially regarding the services and resources available to this particular population. As a result, a review team member connected MPHI with a representative from the Michigan Veterans Affairs Agency, who presented to the team about these issues and ended up joining the team. Michigan’s Children’s Protective Services representatives presented information to teams regarding what happens when children experience the loss of their parents due to overdose. In addition, the largest harm reduction agency in the region provided training on Narcan access and administration, as well as the services that the agency provides. Finally, MPHI asked emergency medical services (EMS) to share its criteria for naloxone administration, post-overdose substance use disorder treatment resources provided by EMS and any changes MPHI should recommend where those resources do not exist, treatment for non-opioid overdoses, and whether the need for naloxone reversal is increasing from previous years. MPHI has invited additional groups to educate its teams regarding information from their respective disciplines in order to enhance team capacity and efficacy. Increasing teams’ awareness of the various resources available in their communities is crucial to ensuring a robust review process that produces better-informed recommendations to prevent overdoses in Michigan communities.

While establishing overdose fatality review (OFR) teams in Michigan, the Michigan Public Health Institute has naturally fallen into the model of working collaboratively with a review team and a separate community action group that drives forward the recommendations presented by the review team. These community action groups are existing groups that meet in each county, such as an opioid task force or a substance use coalition. Muskegon County’s OFR team works with the Muskegon Opiate Task Force acting as the community action group. Following each quarterly review, an infographic displaying the recommendations that resulted from each review is created. One case helped identify a municipality where there was a disproportionately high count of overdoses happening in that region’s hotels. Because of this finding, the team recommended the availability of Narcan at hotel front desks and common areas. The Muskegon Opiate Task Force, along with the implementation of this recommendation, placed “I Can Narcan” stickers on external windows of hotels and other establishments to indicate the presence of Narcan in that building. This allows external bystanders to take note of the presence of Narcan in a particular building, but especially for those who are using at the hotel. The review team has made several other recommendations around increasing access to naloxone, such as training all law enforcement officers to carry and administer naloxone. The task force continues to collaborate with law enforcement agencies to move this recommendation forward, and since the first review team meeting, the task force has helped change the policy and practice of one law enforcement agency in its jurisdiction.

The New York City, New York (NYC) RxStat initiative was established in 2012 and has included overdose fatality review (OFR) meetings since 2016. The past 2 years have brought many changes to RxStat. Today, RxStat has three meeting types, each with a clear goal and structure. These meeting types include:

• Drug trends meetings, which focus on high-level overdose trends and policies.
• OFR meetings, designed to unearth missed opportunities for overdose prevention and intervention.
• Action meetings, which create shared accountability and result in concrete recommendations and action items.

NYC has more than 2,000 fatal overdoses each year; the RxStat initiative cannot hope to review every case in its OFR meetings. Instead, it selects cases by theme to help focus the conversation in each OFR. Then, a subsequent action meeting focuses on how to take the gaps identified during the OFR and turn them into specific, achievable recommendations. In this presentation, the RxStat initiative will provide an overview of the goals and structure for all three meeting types and provide one to two case studies that provide an overview of:

• A theme the RxStat initiative chose for an OFR meeting.
• The process for selecting OFR cases that fit that theme.
• Gaps identified during the OFR meeting.
• Recommendations generated by the action meeting, including any workgroups created.
• Final actionable outcomes that resulted from the process.

This presentation showcases how RxStat moves from OFR case review to action and will provide examples of OFR themes that have resulted in fruitful discussion and action in NYC.

This workshop focuses on jurisdictions who focused on the assembly of key, local stakeholders representing public health and public safety to address the problem of drug overdoses occurring in their communities. Through the use of information sharing tools such as the Overdose Detection Mapping Application Program (ODMAP), data dashboards, and overdose fatality review (OFR), these stakeholder groups have turned data into actionable responses to the opioid crisis. Panelists discuss the evolution of their information sharing practices, including instances where the implementation of one process led to the use of an OFR. Panelists will also discuss their process for regular surveillance of data and how it informs the delivery of services in their communities.

This presentation provides a brief overview of ODMAP.

Overdose fatality review (OFR) teams represent multisector community stakeholders coming together to address substance use challenges in their communities. The heart of the work that these teams do is the development of recommendations—for the agencies, the community, the region, and the state. What if we conceptualize the work of the OFR as community systems development? What can happen when the team itself becomes the subject of recommendations (e.g., we recommend that this team help move our local system through the stages of the community readiness model)? If we start to track and show the outcomes of that—how individual agencies made process/policy changes or the new connections or collaborations made across team members’ agencies—those can be leveraged to set the foundation for continued, and more complex, efforts. This presentation discusses the case study of the LaPorte, Indiana, OFR team and how its work and collaboration contributed to the county being awarded a “community catalyst” grant to develop and implement a crisis intervention team (CIT). This effort will involve the participation of every law enforcement jurisdiction in the county and training for officers on utilizing the community system to provide appropriate responses and resources in crisis incidents such as overdose, suicide, or domestic violence. Patterns and recommendations identified by the OFR team can inform planning stage processes and training decisions. The OFR team will then have the unique ability to evaluate practical outcomes of CIT responses in future case reviews to provide a direct feedback loop for continuous improvement recommendations.

A suicide/overdose fatality review (S/OFR) can impact community change and policies. Having the right participants at the S/OFR is critical to positive community engagement. Bringing together cross-sectors of a rural community to create change can bring remarkable success and significant challenges! Protecting our children and future community leaders is a great reason to work toward a solution and put bias aside. In 2019, the Jay County, Indiana, community developed an S/OFR. In 2020, it reviewed its first decedent. Since that time, the county has been able to make strides toward the following:

• Adjustments to programs, processes, policies, and practices to meet changing priorities in the community’s needs
• Developing relationships with different sectors to implement substance use prevention strategies
• Engaging decision makers and community leaders to support substance use prevention policies, programs, and infrastructure

This presentation shares how, through the overdose fatality review (OFR) process, demographic trends in overdose deaths resulted in the development of an outreach plan and a marketing campaign using harm reduction interventions to target high-risk communities, including African-American, LGBTQ+, Latinx, and those experiencing homelessness. Columbus Public Health (CPH) is the lead agency for the Columbus and Franklin County Addiction Plan (C&FCAP) and a participating member in the Franklin County, Ohio, Overdose Fatality Review (OFR). In addition to the public health administrator from CPH’s Alcohol and Drug Services Division attending the OFR, a CPH epidemiologist attended in order to compile the demographic information, key findings, client histories, and other personal information of the individual cases. Based on the findings, an analysis of each decedent was performed, and a cross-examination brought forth emerging trends and areas to identify gaps in service including the African-American, LGBTQ+, Latinx, and homeless populations. Results also indicated that there was a slight increase in overdose deaths during the holiday season in specific neighborhoods, which resulted in geo-fencing messaging. With members of the C&FCAP, including the coroner; those with lived experience; grassroots organizations that focus on the homeless population and victims of human trafficking; and the quick response teams, a messaging campaign was developed and implemented.

Established in 2018, the Winnebago County, Wisconsin, overdose fatality review (OFR) team has pursued numerous recommendations that have positively affected the community over the past 4 years. This plenary session will highlight recommendations that came out of Winnebago County’s OFR team meeting and were implemented to connect people to resources, utilize peer-led programs, break stigmas, and begin changing the culture of an entire community.

After the OFR team discovered that few OFR cases had connections to the recovery community, the team recommended to support and expand a substance-free culture that engages many stakeholders in the community and focuses on the support of individuals and families that are on a path to recovery. The initial phase of implementation included adding people in recovery to the OFR table, starting a sounding board to understand the relevance of OFR recommendations, and hosting community conversations with people in recovery to better understand their journeys and how the community could be more supportive. Participants will learn how this recommendation grew to be the “We Heart You” campaign, which included the creation of the We Heart You resource and referral card, the implementation of a public service announcement (PSA) focused on how to use the card, and the hosting of a community event. Ripples in the community were created from this event, and since that time, Winnebago County has created the We Heart You App, a peer-led rapid response team, and a PSA that breaks down the stigma of people who have been impacted by substance use disorder and humanizes recovery. After this session, the PSA video will be made available to any community that needs an inspirational template on the thriving recovery community with inputted local resources. 

In partnership with community partners, the Lackawanna County, Pennsylvania, District Attorney’s Office established a local, multiagency overdose fatality review (OFR) team in 2020 to examine the contributing causes of overdose fatalities in Lackawanna County. This plenary session will focus on two separate recommendations involving community education and awareness, harm reduction strategies, and decriminalization of fentanyl test strips.

Through cases reviewed by Lackawanna County’s OFR team, it became clear that the risk of fentanyl overdose did not simply or predominantly lie with heroin use. The review of these cases led to the recommendation for a deeper analysis of fentanyl-related overdose deaths and to increase awareness of this local data and risk of fentanyl overdose. In order to do this, the Lackawanna County District Attorney and the Mayor of Scranton, Pennsylvania, held a press conference, where they presented data and stressed that fentanyl was being seen laced in all street drugs, not just heroin, and that there had been several local overdoses due to pure fentanyl being disguised as other drugs and pills. The press conference was covered by local media and disseminated both in the local newspaper and TV news coverage. A one-page fentanyl educational document was also developed and disseminated to the OFR team, the local recovery coalition, and other relevant community partners. This press conference led to extensive discussions with a wide variety of community partners regarding the decriminalization of fentanyl testing strips. In addition, both the Pennsylvania District Attorneys Association and the City of Scranton publicly advocated for a state bill to decriminalize fentanyl testing strips following these discussions, which passed in October 2022.

Another recommendation that Lackawanna County’s OFR team was able to identify, develop an action plan for, and implement involved ensuring that all Lackawanna County police departments have access to naloxone as well as training on naloxone administration and local resources. Through collaboration between the Lackawanna County District Attorney’s Office and Pennsylvania Ambulance, this recommendation was successfully implemented and then expanded to other sectors throughout the community. Because of a significant number of school nurses requesting naloxone through Lackawanna County’s naloxone-by-mail initiative, as well as increased overdoses due to fentanyl pills being disguised as medications such as Percocet and Vicodin—which are increasingly popular with high school students—the OFR team also generated a similar recommendation to ensure naloxone access and education in all Lackawanna County schools. The Lackawanna-Susquehanna Office of Drug and Alcohol Programs took the lead on this initiative and sent a letter to all the school superintendents, and the Lackawanna County District Attorney’s Office mailed letters to all police chiefs in Lackawanna County, with telephone follow-up completed for anyone who did not respond. All schools and police departments were provided with naloxone, resources, and training as needed and appropriate. One hundred percent of Lackawanna County schools and police departments now have naloxone and resources onsite and were provided training, if needed, as a result of the findings and recommendation from the OFR team.

This workshop focuses on jurisdictions who focused on the assembly of key, local stakeholders representing public health and public safety to address the problem of drug overdoses occurring in their communities. Through the use of information sharing tools such as the Overdose Detection Mapping Application Program (ODMAP), data dashboards, and overdose fatality review (OFR), these stakeholder groups have turned data into actionable responses to the opioid crisis. Panelists discuss the evolution of their information sharing practices, including instances where the implementation of one process led to the use of an OFR. Panelists will also discuss their process for regular surveillance of data and how it informs the delivery of services in their communities.

According to the Minnesota Department of Health’s (MDH) 2021 Overdose Data Report, Black Minnesotans are three times more likely to die of a drug overdose than white Minnesotans. As home to one of the largest Somali populations in the nation, Minnesota’s Somali community has been underrepresented in overdose data. When collecting data on race and ethnicity, Somalis are often classified solely as Black, with no mention of the relevant ethnic subgroup. In 2017, MDH identified that the state lacked specific data to address the needs of the Somali community. Voices from the community demonstrated anecdote stories of overdoses of Somali youth. To address this issue, MDH launched pilot overdose fatality reviews (OFRs) in 2019, which recommended applying the OFR model using a culturally specific lens in the Somali community. The following year, using funding from the Centers for Disease Control and Prevention Overdose Data to Action grant, MDH partnered with Alliance Wellness Center—a culturally specific provider specializing in treatment and recovery for Somalis. During OFR implementation training, the OFR team lead shared concerns about the deeply rooted stigma surrounding overdoses in the Somali community as a barrier to community participation and facilitation of OFRs. To address the cultural stigma and build organizational capacity, the OFR team conducted prevention interviews before implementing OFRs in the community. Through these deep conversations, the OFR team captured the Somali community’s collective voice and identified barriers preventing community discussion on overdose deaths.

To address the grave issue of substance misuse and the resulting fatalities in Marion County, the largest county in Indiana, the Marion County Public Health Department (MCPHD) formed a multidisciplinary overdose fatality review (OFR) team in November 2020 with the purpose of recommending data-driven changes based on the circumstances around overdose deaths in the county. From December 2020 to May 2022, a total of 33 overdose deaths were reviewed, and seven themes emerged, with the top three being mental health and stigma, health care access, and substance use awareness. After a year of case reviews, the team decided to form three action-oriented subcommittees based on the recommendations: (1) grief support, (2) advocacy, outreach, and information, and (3) access to care. Despite barriers, the subcommittees are continuing to perform exceptional work in terms of converting recommendations into action. The OFR team identified that families of decedents need easy access to grief support and mental health resources, especially at the coroner’s office, when their grief is still fresh. The grief support subcommittee acted by assembling grief support and mental health resources to share with the grieving families. It also advocated for the addition of a social worker among the coroner’s office staff who is trained to educate the family members regarding substance misuse and mental health needs. This has fostered empathetic surroundings for the families and encouraged them to seek help from the right sources. This initiative is a significant step toward reducing substance use stigma in the community.

The York County, Pennsylvania, Overdose Fatality Review (OFR) Team was established by a joint initiative among the City of York Bureau of Health, the York Opioid Collaborative, and the County of York Offices of the Coroner and District Attorney. The purpose of the OFR team is to identify drug overdose fatality trends; improve incidence data to accurately record the number of overdose deaths in a county; define effective strategies for coordinating overdose prevention strategies; recommend statutory, regulatory, and policy changes; promote coordination among agencies that investigate drug fatalities and provide services to families; and develop plans for enhancing efforts of partner organizations. Recommendations to date have focused on communication, information/resource sharing, training, referring to services, naloxone distribution, and education opportunities. The recommendations generated are presented to the OFR team’s governing committee, the Public Health and Safety Team (PHAST), that supports and provides resources for implementation. The “We Care, York” initiative was developed based on a recommendation identified during the OFR team’s first case review in June 2021. The recommendation was to create a referral-to-help card that partner agencies could share with at-risk individuals and their loved ones, based off Winnebago County, Wisconsin’s “We Heart You” initiative. “We Care, York” links individuals experiencing a mental health and/or substance use crisis to services and ensures that individuals are aware of resources in the community when they find themselves in need to minimize the stigma associated with seeking help.

Ending housing instability and homelessness is critical for improving public health and community wellbeing. Studies show much higher rates of physical health issues and mental health and/or substance use disorders among populations experiencing homelessness than among people who are stably housed. People experiencing homelessness often face a decline in their physical and mental health while sheltered or unsheltered; therefore, this is an important window for initiating mental health and/or substance use disorder treatments.

This publication provides strategies and implementation considerations for behavioral health providers and others practitioners to:

• Engage people currently experiencing homelessness
• Build strong relationships with these individuals
• Offer effective mental health and/or substance use disorder treatments
• Improve retention in recovery efforts

The guide includes four case studies to highlight strategies for providing treatment and recovery support services to people experiencing both unsheltered and sheltered homelessness. Additionally, it presents considerations for evaluation and quality improvement.

This document provides jail and prison administrators, program managers, medical staff in correctional settings, and reentry staff with a performance management framework to monitor MAT in correctional settings.

This article briefly describes opioid treatment programs (OTPs) and highlights the experiences of two OTPs during the COVID-19 pandemic. One of the OTPs, The Hope House, is a residential treatment program with two locations in Scottsdale, Arizona. The other, Western Wake Treatment Center, is a clinic-based OTP in Apex, North Carolina. The article's objective is to help Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) sites determine the best strategies to handle the impacts of the pandemic on their opioid use disorder programming/OTPs.

The United States remains in the midst of an unprecedented overdose epidemic, with more than 100,000 overdose deaths in the year ending April 2021. The vast majority of these overdose deaths are opioid-related and could have been averted had naloxone been administered by those present. Naloxone is one of the most powerful tools communities have in combating the overdose crisis; evidence shows that distribution can reduce overdose deaths. Jails have emerged as a critical overdose prevention touchpoint.

Strategies for preventing opioid misuse and SROs are offered, and the article covers universal suicide screening practices, integrated care, and family support services.

This brief also highlights the findings of original research on litigation related to deaths in jail custody and provides recommendations for reform.

There are a number of expert recommendations regarding how to identify, work with, and treat pregnant and postpartum individuals with substance use disorder (SUD) to ensure the best outcomes for both parent and child. There are also legal requirements regarding notification to state child welfare agencies of infants born affected by prenatal substance exposure or experiencing withdrawal and the creation of family care plans (also known as plans of safe care). This fact sheet provides readers with an overview of those recommendations and requirements.

The Overdose Fatality Review (OFR) Data System Version 2.0 was released in February 2022. The updated version is based on Version 1.0 pilot user feedback and was authored by Melissa Heinen and Lauren Savitskas with the Institute for Intergovernmental Research and Mallory O’Brien with the Bureau of Justice Assistance, Office of Justice Programs, U.S. Department of Justice and Consultant, IPA Overdose Fatality Reviews, U.S. Centers for Disease Control and Prevention.

The OFR Data System REDCap instrument was developed by Tom Chelius with the Medical College of Wisconsin.

This introduction to the Effective Integration Toolkit provides an overview of each of the five “Ps” for effective integration:

1. Promote recovery orientation
2. Prepare to integrate
3. Plan appropriate supports
4. Produce peer-supportive policies
5. Provide supervision and support

Throughout, there are checklists that will help inform what your program’s next steps are related to each of the five Ps.

This guide provides an overview of effective prevention policies that can be implemented at the local, state, tribal, and/or territorial levels. It lays out key considerations and strategies for these policies, including the most equitable ways to implement and enforce them. The guide illustrates how three United States communities have implemented these policies and concludes with guidance on conducting policy evaluations.

This article offers guidance for people assisting families and middle-aged and older adults who are in, or at risk of, this generational transmission of trauma. Intervening actions in the lives of adults who experienced ACEs can help prevent ACEs in their current or future children.

The first article in the series can be found at https://www.cossapresources.org/Content/Documents/Articles/RTI_Substance_Use_and_ACEs_Across_the_Lifespan_Part 1.pdf.

This U.S. Department of Justice/Drug Enforcement Administration drug fact sheet offers information about barbiturates: what they are, their origin, common street names, effects on the mind and body, overdose effects, etc.

Articles include:

• “That’s the Way Recovery Works: One Person in Recovery Helping Another”—Champions Share Journeys From Isolation to Connection and Far Beyond
• The Evolution of Boulder County, Colorado’s Project Readiness, Engagement, Navigation, Treatment, and Recovery (RENTR)
• The AMAAD Institute Shines as Peer Mentor Site in South Los Angeles
• More Than Naloxone: Emergency Medical Services (EMS) Combats Substance Use Disorder in South Carolina
• Podcast on Future of Prescription Drug Monitoring Programs, Best Practice Updates Lead PDMP Highlights

Information in the brief includes topics such as the Oneida County Opioid Task Force's Overdose Response Team, the Overdose Detection Mapping Application Program (ODMAP) and other real-time data collection and surveillance activities, data and information sharing tools, and the ways in which the Oneida County Opioid Task Force puts the data into action.

OFR facilitators, coordinators, and team members can implement various strategies to help address and reduce the effects of repeated exposure to stress and trauma and ultimately support the wellbeing of members and lead to a more constructive, proactive, and engaged review. This document offers some potential strategies to consider embedding throughout the OFR process.

It provides background information on each of the nine core abatement strategies described in the settlement agreements with opioid distributors and the opioid manufacturer Johnson & Johnson. These nine core abatement strategies are:

• Broaden access to naloxone
• Increase use of medications to treat opioid use disorder
• Provide treatment and supports during pregnancy and the postpartum period
• Expand services for neonatal opioid withdrawal syndrome
• Fund warm hand-off programs and recovery services
• Improve treatment in jails and prisons
• Enrich prevention strategies
• Expand harm reduction programs
• Support data collection and research

By investing in evidence-based programs and services that address areas of need, communities can save lives and address the toll of the opioid epidemic.

Articles include:

• COSSAP and Recovery Month 2022: Champions of Hope, Agents of Change
• Collaboration: Facilitating Alternatives, Facilitating Transitions
• A Message for Fire Departments on the Front Lines: The Evolving Opioid Epidemic Post-“Full-Blown” COVID-19 Pandemic
• Implementing Evidence-based Peer Programming
• Partnerships Initiative Final Consensus: Data Collaboration Delivers More Effective Responses for Communities Battling Substance Misuse
• Culturally Attuned Motivational Interviewing: Working With Ambivalence
• Debut of Missouri Program, New Evidence of Impacts Top PDMP Highlights
• Just Science Podcast Mini-season Highlights Law Enforcement-Community Relations

This summary report includes information pertaining to the District of Columbia and all U.S. territories and has been updated with recently enacted state laws on naloxone access as of July 2022.

These residences are commonly referred to by a number of names, including sober living houses, sober living environments, and recovery homes, and their primary purpose is to provide a home-like environment for individuals in recovery from substance use disorder to help sustain that recovery. This document includes information on the history of recovery residences, types of recovery residences, and the success of and issues faced by recovery residences.

The document is updated regularly with information on program and research resources supported by the Bureau of Justice Assistance, the Office of Juvenile Justice and Delinquency Prevention, and the National Institute of Justice, with hyperlinks to current training and technical assistance providers and relevant documents.

The RSAT Program supports state, territorial, local, and tribal governments to develop residential and aftercare services that emphasize partnerships between correctional staff and the treatment community to help adults with substance use disorders break the cycle of addiction. RSAT's authorizing legislation is the Violent Crime Control and Law Enforcement Act of 1994 (Public Law 103-322). The Bureau of Justice Assistance (BJA) is the administering agency, and the first year of appropriation was 1996.

Articles include:

• Active Outreach Pathway Effective Response to Substance Use in LGBTQ+ Community
• Highlighting the COSSAP Success of Peer Recovery Specialists in Local Jurisdictions
• OFR Team and Overdose Response Plan Start to Turn the Tide in Ocean County, New Jersey
• Culturally Attuned Motivational Interviewing: Responding to Resistance and Understanding Sustain Talk
• Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids Aims to Correct Misapplications From 2016
• Contingency Management, Substance Use Disorders, and Criminal Justice

These case studies illustrate the power of collaboration in helping to address opioid use disorder (OUD). Each case study shares the perspective of a different participant in a successful MAT partnership—a judge, a parole officer, and a social worker— and the factors that make their program successful, along with strategies for launching programs. Readers will walk away with tips on how stakeholder engagement, community education, and flexibility can help jails and courts work together to address the urgent issue of OUD.

These national standards are based on multiple state and local jurisdictions’ OFR and other fatality review practice-based experiences and can be implemented by OFR teams to achieve success. This document is a companion document to “Overdose Fatality Review: A Practitioner’s Guide to Implementation.”

This brief is one in a series highlighting projects that are part of the Rural Responses to the Opioid Epidemic project. Learn more about Rural Responses to the Opioid Epidemic at https://rural.cossapresources.org/.

This brief is one in a series highlighting projects that are part of the Rural Responses to the Opioid Epidemic project. Learn more about Rural Responses to the Opioid Epidemic at https://rural.cossapresources.org/.

This brief is one in a series highlighting projects that are part of the Rural Responses to the Opioid Epidemic project. Learn more about Rural Responses to the Opioid Epidemic at https://rural.cossapresources.org/.

This brief is one in a series highlighting projects that are part of the Rural Responses to the Opioid Epidemic project. Learn more about Rural Responses to the Opioid Epidemic at https://rural.cossapresources.org/.

This brief is one in a series highlighting projects that are part of the Rural Responses to the Opioid Epidemic project. Learn more about Rural Responses to the Opioid Epidemic at https://rural.cossapresources.org/ .

Through these efforts, the teams make contact with individuals and families who have experienced overdose to offer support and connections to services and treatment.

This brief is one in a series highlighting projects that are part of the Rural Responses to the Opioid Epidemic project. Learn more about Rural Responses to the Opioid Epidemic at https://rural.cossapresources.org/.

This brief is one in a series highlighting projects that are part of the Rural Responses to the Opioid Epidemic project. Learn more about Rural Responses to the Opioid Epidemic at https://rural.cossapresources.org/.

This brief is one in a series highlighting projects that are part of the Rural Responses to the Opioid Epidemic project. Learn more about Rural Responses to the Opioid Epidemic at https://rural.cossapresources.org/.

In this summary, readers will find information with respect to SSPs for each state, including citations to applicable statutes and/or regulations, whether the state allows SSPs by statute, whether there are any municipal or county ordinances or regulations in place within the state, program components, miscellaneous provisions, and information on any pending legislation.

Naloxone access laws promote widespread access to the prescription-only naloxone drug by offering civil, criminal, or disciplinary protection to medical providers, other professionals, and laypeople who prescribe, dispense, administer, or possess naloxone. Good Samaritan laws provide legal protection from arrest, criminal charges, or prosecution for people who possess illicit drugs or drug paraphernalia at the time that they seek medical assistance for a person who may be overdosing. Research on the impact of these laws has demonstrated that they can significantly reduce opioid overdose mortality.

Across the United States, jurisdictions are turning to first responder deflection (FRD) and pre-arrest diversion programming to combat the opioid crisis and to assist individuals suffering from substance use disorder (SUD). These programs help to connect individuals with SUDs to treatment and services and provide pivotal opportunities to redirect them away from placement in jails or emergency departments. These programs are known as law enforcement diversion, pre-arrest diversion, deflection, or pre-booking diversion, as well as other names. In this brief, they will be referred to as FRD programs.

This document defines peer support in correctional settings; describes the core competencies for peer support in correctional settings; highlights the use of peer support in short-term, medium-term, long-term, and community corrections settings to improve recovery and reentry outcomes; identifies emerging and best practices for integrating peer support into correctional settings; and provides recommendations for program design and implementation. Implementation tools, including a start-up checklist and sample job descriptions, are included.

Articles include:

• Model Deflection Law a Milestone in the Growth of a Winning Strategy Against Substance Use
• Jail-Based Medication-Assisted Treatment: Supporting Addiction Recovery
• Effective Transitional/Recovery Housing in Tribal Communities: Strategies and Considerations
• The Role of Peers in Opioid Overdose Prevention
• Increasing Access to Medications for Opioid Use Disorder in Jails and Prisons
• States With Multi-Copy PDMP Prescriptions Stymied OxyContin Sales, Study Finds; New Standard for Patient Matching Available
• Reentry and Recovery: Employment Matters

This article describes the efforts of New York State OICs to heighten their impact by incorporating peer recovery support services (PRSS) into their work. The authors present a framework for conceptualizing the adaptation and integration of PRSS into court settings, identifying essential elements of comprehensive programs, essential integration processes, key program design factors, and drivers of success. The framework suggests that while the core elements remain the same, effective integration of PRSS programs will vary from site to site.

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. Protecting individuals with OUD from discrimination is 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.

This article introduces administrative, clinical, and nonclinical jail staff to substance use disorder (SUD) screening instruments and their use in jail settings.

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?

A disproportionate number of people in jails have substance use disorders (SUDs). Incarceration provides a valuable opportunity for identifying SUD and addressing withdrawal. Within the first few hours and days of detainment, individuals who have suddenly stopped using alcohol, opioids, or other drugs may experience withdrawal symptoms, particularly when they have used the substances heavily or long-term. Without its identification and timely subsequent medical attention, withdrawal can lead to serious injury or death. Deaths from withdrawal are preventable, and jail administrators have a pressing responsibility to establish and implement withdrawal policy and protocols that will save lives and ensure legal compliance.

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).

This Advisory provides guidance on identifying and addressing suicidal thoughts and behaviors among individuals with SUD. It is based on SAMHSA’s Treatment Improvement Protocol (TIP) 50, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment. It summarizes key messages, promotes use of the Zero Suicide framework, part of the Surgeon General’s national strategy for suicide prevention, and provides additional resources for substance use clinicians and program administrators regarding the treatment of clients with suicidal thoughts and behaviors in SUD treatment settings.

This publication is intended to add to some of the information (e.g., pharmacological approaches) currently found in the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Improvement Protocol (TIP) 51, Substance Abuse Treatment: Addressing the Specific Needs of Women. It offers guidance to providers and administrators about the particular needs of women during substance use disorder treatment. It summarizes key messages, recommendations for screening and assessment, gender-focused approaches to treatment and support, and considerations for women in specific racial/ethnic populations.

MAT has been shown to be a safe and effective method for treating opioid use disorders, whether involving heroin, fentanyl, or pain relievers.

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.

Correctional facilities can play an important role in preventing overdose deaths. Research has shown that opioid overdose education and naloxone distribution programs in prisons and jails reduce mortality. This report provides an overview of the National Commission on Correctional Health Care's stance on using naloxone in the correctional system.

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 article provides recommendations from the American College of Obstetricians and Gynecologists on facilitating quality care of incarcerated patients to improve the health care of incarcerated pregnant, postpartum, and nonpregnant individuals at the local, state, and national levels. 

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.

Emergency departments (EDs) sporadically use a high-dose buprenorphine induction strategy for the treatment of opioid use disorder (OUD) in response to the increasing potency of the illicit opioid drug supply and commonly encountered delays in access to follow-up care. The objective of this case series is to examine the safety and tolerability of high-dose (>12 mg) buprenorphine induction for patients with OUD presenting to an ED.

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 TIP reviews three Food and Drug Administration-approved medications for opioid use disorder treatment—methadone, naltrexone, and buprenorphine—and the other strategies and services needed to support people in recovery.

As people return to their communities after incarceration, seamless continuity of health care is essential for better health outcomes. To help ensure this continuity and to prevent duplication of services, the National Commission on Correctional Health Care recommends correctional facilities provide outgoing patients with portable health records that patients may share with their selected or designated community health resource.

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.

An important way to support recovery from heroin or prescription opioid use disorder is to maintain abstinence from those drugs. Someone in recovery can also use medications that reduce the negative effects of withdrawal and cravings without producing the euphoria that the original drug of abuse caused. This report provides descriptions of medications that help to reduce the symptoms of withdrawal from opioids by acting as agonists and partial agonists to opioid receptors in the brain.

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 TIP reviews what is known about treating the medical, psychiatric, and substance use disorder-related problems associated with the use of cocaine and methamphetamine and the misuse of prescription stimulants. 

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.

This TIP describes the unique ways in which the signs and symptoms of substance use disorder (SUD) manifest in older adults; drug and alcohol use disorder screening tools, assessments, and treatments specifically tailored for older clients' needs; the interaction between SUDs and cognitive impairment; and strategies to help providers improve their older clients' social functioning and overall wellness.

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.

The purpose of this publication is to help readers develop or expand existing telehealth programs. 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.

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).

Most individuals imprisoned in federal and state prisons and a large proportion of people in jails lack health insurance, yielding worse health care access postrelease, disruptions in continuity of care for serious conditions, and chances of relapse for many health issues. Lack of insurance coverage postrelease, particularly for mental health and substance abuse services, increases the risk of rearrest, poor health outcomes, and often homelessness. This brief discusses the National Commission on Correctional Health Care's stance on insurance coverage for detainees and the postrelease population. 

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.

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.

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 American Society of Addiction Medicine (ASAM) resource is intended to address current practice concerns and provide clear guidance that will lead to more consistent  treatment practices in the field.

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.

This U.S. Drug Enforcement Administration fact sheet offers an overview of benzodiazepines, a class of drugs that produce central nervous system depression and are most commonly used to treat insomnia and anxiety.

This guide provides an overview of policies and evidence-based practices that reduce the risk of overdose and relapse.

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.

This guideline is an update and replacement of 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.

The National Commission on Correctional Health Care and the American Foundation for Suicide Prevention have created this authoritative resource on preventing suicide in correctional facilities. Drawing from both organizations’ expertise, with input from national experts in the field of correctional mental health and suicide prevention, this guide provides a road map, tools, and resources for navigating the complexities of suicide prevention within correctional facilities—a serious problem in the United States.

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.

This publication outlines program development, logistics, and evaluation of jail-based naloxone distribution programs as well as lessons learned from two case studies.

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.

This publication examines a wide range of evidence-based practices for screening and assessment of people in the justice system who have co-occurring mental and substance use disorders (CODs). The use of evidence-based approaches for screening and assessment is likely to result in more accurate matching of offenders to treatment services and more effective treatment and supervision outcomes. Key systemic and clinical challenges are discussed, as well as approaches for conducting screening and assessment.

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.

The American Psychological Association developed this clinical practice guideline to provide recommendations for the treatment of depressive disorders (including major depression, subsyndromal depression, and persistent depressive disorder). It addresses three developmental cohorts: children and adolescents; general adults; and older adults (ages 60 and over). Ten systematic reviews and meta-analyses, along with other literature and observations from practitioners and patients, served as the basis for the guideline. The guideline development panel consisted of health professionals from psychology, psychiatry, and primary care as well as community members who self-identified as having had depression.

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.

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 publication provides an overview of the effects of opioid use disorder on pregnancy and the outcomes of pregnancy as well as recommendations on screening tools, practices, and treatment options throughout the pregnancy and beyond for the individual and the infant.

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.

It also highlights the prevalence of mental and substance use disorders in correctional settings.

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.

It reviews gender-specific research and best practices, such as common patterns of initial use and specific treatment issues and strategies.

This manual offers guidelines for working with suicidal adults living with substance use disorders. It covers risk factors and warning signs for suicide, core competencies, and clinical vignettes.

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.

This resource provides clinicians with updated information and expands on the issues commonly encountered in the delivery of detoxification services. It was created by a panel of experts with diverse experience in detoxification services—physicians, psychologists, counselors, nurses, and social workers, all with particular expertise to share. 

This Substance Abuse and Mental Health Services Administration (SAMHSA) manual provides guidance on the use of medication-assisted treatment for alcohol use misuse. It summarizes approved medications, screening and assessment, treatment planning, and patient monitoring.

This pocket guide offers:

• A Checklist for Prescribing Medication
• Approved Medications for Use in Treatment of Alcohol Use Disorder
• Standard Drink Sizes/Amounts and Recommended Limits

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.

Drug enforcement policies that deter women from seeking prenatal care are contrary to the welfare of the mother and fetus. Incarceration and the threat of incarceration have proved to be ineffective in reducing the incidence of alcohol or drug misuse. Obstetrician–gynecologists should be aware of the reporting requirements related to alcohol and drug misuse within their states. They are encouraged to work with state legislators to retract legislation that punishes women for substance misuse during pregnancy.

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.

The Clinical Opiate Withdrawal Scale (COWS) is an 11-item scale designed to be administered by a clinician. This tool can be used in both inpatient and outpatient settings to reproducibly rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time. The summed score for the complete scale can be used to help clinicians determine the stage or severity of opiate withdrawal and assess the level of physical dependence on opioids. Practitioners sometimes express concern about the objectivity of the items in the COWS; however, the symptoms of opioid withdrawal have been likened to a severe influenza infection (e.g., nausea, vomiting, sweating, joint aches, agitation, tremor), and patients should not exceed the lowest score in most categories without exhibiting some observable sign or symptom of withdrawal.

Many quantification instruments have been developed for monitoring alcohol withdrawal. No single instrument is significantly superior to the others. What is clear is that there are significant clinical advantages to quantifying the alcohol withdrawal syndrome. Quantification is key to preventing excess morbidity and mortality in a group of patients who are at risk for alcohol withdrawal. Such instruments help clinical personnel recognize the process of withdrawal before it progresses to more advanced stages, such as delirium tremens. By intervening with appropriate pharmacotherapy in those patients who require it, while sparing the majority of patients whose syndromes do not progress to that point, the clinician can prevent over- and undertreatment of the alcohol withdrawal syndrome. Finally, by quantifying and monitoring the withdrawal process, the treatment regimen can be modified as needed.