Opioid Epidemic


Addressing the opioid epidemic is vital for city leaders, and municipalities are instrumental in breaking the cycle of addiction and destruction. Cities are taking action by taking a public health approach in lieu of criminalizing users. In response to this crisis, the National League of Cities and National Association of Counties issued a comprehensive report. Best practices include:

  • Education: Cities should publicly talk about the crisis, focusing on prevention and treatment options, not on punishment. Education is key to prevention.
  • Prevention: Needle exchange programs and dump sites have proven to be effective. Prescription drug monitoring programs can assess potential abuse and help with prevention. Cities can also expand insurance coverage of government employees to include addiction treatment.
  • First responders: Give first responders tools to properly respond. Naloxone is used to treat overdoses, and expanding access will reduce overdose deaths.
  • Data & technology: Federal data can be years behind. By collecting your own local data, municipalities can better track and respond. Telemedicine solutions can be especially valuable for rural municipalities, as it provides long distance addiction treatment.
  • Treatment: Cities should also work to expand accessibility of treatment with community partners. Additionally, building out drug courts is an important step in moving away from criminalizing addiction. Adopting “Good Samaritan” laws has become a best practice. These laws protect users who report overdoses and encourage treatment over criminalization.
  • Engage community leaders: Community leaders play a key role in directing people to treatment, helping prevent addiction, and creating a unified response. 

Technical Assistance for Members

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What Cities Can Do

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Multi-faceted Approach

The Mayors Innovation Project member city of Burlington, VT has led the way in the opioid crisis. Their Mayor set out guiding principles and their Police Department, informed by data, works across agencies, and recently was a part of a coalition to unveil 10 Standards of Care, all to attack this ongoing health crisis. These 10 Standards of Care are closely aligned with strategies Mayor Weinberger and the City have determined to be most meaningful in turning the tide of the opioid crisis. Their work has also been highlighted in the Vera Institute of Justice.

Wilmington, NC, is looking to become an innovation hub for battling the crisis. They put together a multi-field taskforce to take their response beyond naloxone, creating a “rapid response” team to help deal with the crisis and get people into treatment.

Worcester, MA saw a string of nine overdoses over a period of six days in 2014 and decided to act. They launched several efforts to confront the epidemic, including building partnerships between departments and service providers, educating the community, installing medication drop-off boxes, and more.


Ithaca, NY has developed a “Public Health and Safety Approach to Drugs and Drug Policy” in moving away from criminalization of those with addictions.

Open Sites & Treatment

Boston, MA created what’s been dubbed the “Methadone Mile,” where they’ve clustered treatment around one of their hardest hit areas. Putting everything people need within a reachable distance.

Binghamton, NY Mayor Richard C. David announced an “Intensive Care Navigator Program”, which helps people leaving addiction centers find safe housing, provide transportation to medical and counseling appointments, and to ensure placement in a long-term care facility. This initiative has helped cover gaps and provide long-term treatment for those that need it.


Indianapolis, IN has expanded opioid treatment and used data to help build a response to the opioid epidemic by creating Mobile Crisis Assistance Teams to respond to crisis calls.


Baltimore, MD has used what they call a “blanket prescription” for Naloxone to save lives, training over 10,000 people to use naloxone. They are building to “ensure access to on-demand treatment” for those suffering from addiction.


Everett, WA is currently suing Purdue Pharma, the maker of OxyContin. They also have social workers embedded within law enforcement to help guide those suffering from addiction to treatment programs and resources around the city.