Home > Health > Opioid Epidemic

Opioid Epidemic

Over a 14 year period, opioid overdoses increased from 6,242 in 2000, to nearly 30,000 in 2014. Addressing the opioid epidemic is vital for city leaders, and municipalities are instrumental in breaking the cycle of addiction and life destruction our communities are facing.

Across the nation cities are taking action by taking a public health approach instead of criminalizing users and addicts.  In response to this crisis, the National League of Cities and National Association of Counties issued a comprehensive report in 2016. Some of these initiatives and best practices from around the country include:

  • Education: Cities should publicly talk about the crisis, focusing more on prevention and treatment options and focusing less on punishment. A harsh tone can prevent people from coming forward to seek treatment, and conversely talking about addiction as a health crisis leads more people to seek treatment. Education is key to prevention, and prevention saves lives, families, and city funds.
  • Prevention: Needle exchange programs and dump sites at pharmacies and public facilities 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: Educate first responders about the crisis and giving them tools to properly respond, in particular Naloxone. Naloxone is used to treat overdoses, and expanding access to first responders and to caregivers will reduce overdose deaths.
  • Data collection & technology: Federal data can be years behind. By collecting your own local data, municipalities can better track and respond to the epidemic. Telemedicine solutions can be especially valuable for rural municipalities, as it provides long distance addiction treatment that first responders, treatment providers, and service care providers can give to those in need.
  • 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 and moving to a public health model. Adopting “Good Samaritan” laws has become best practices for cities, these laws protect users reporting an overdose from criminal prosecution and encourage treatment over criminalization.
  • Engage community leaders: Make sure that community leaders are educated on the crisis. They play a key role in directing people to treatment, helping prevent addiction in the first place, and creating a unified response alongside government officials, prosecutors, law enforcement, and more. A team with faith leaders, involved parents, local medical professionals, and education leaders can create an engaged community to rally resources around the crisis. 

Ten Standards of Care: Policing and The Opioid Crisis, Police Executive Research Forum, June 4th, 2018. Read more.

Wilmington’s Solution to the Opioid Crisis, J. Brian Charles, Governing, September 1st, 2017. Read more.

Tapping Local Data to Fight Drug Overdoses: Part II, Dispatch Your Own Data, Jonathan Jay, Data-Smart City Solutions, August 28th, 2017. Read more.

Tapping Local Data to Fight Drug Overdoses: Part I, Know Your Epidemic, Jonathan Jay, Data-Smart City Solutions, August 14th, 2017. Read more.

What Does the National Opioid Emergency Mean for States and Cities, Mattie Quinn, Governing, August 14th, 2017. Read more.

How Indianapolis Naloxone is Driving Policy, Building a Social Service Response, Adam Stone, Government Technology, July 13th, 2017. Read more.

Three Million in Grants for DART and QRT Teams to be Available to Address Opioid Epidemic, Ohio Attorney General, July 11th, 2017. Read more.

A Prescription for Action: Local Leadership in Ending the Opioid Crisis, National League of Cities and National Association of Counties, October 15th, 2016. Read more.

The Ithaca Plan: A Public Health and Safety Approach to Drugs and Drug Policy, City of Ithaca, NY, February 1st, 2016. More information on this article can be found here.

Physicians and PDMPS: Improving the Use of Prescription Drug Monitoring Programs, The Network for Excellence in Health Innovation, November 1st, 2015. Read more.

Prescription Drug Abuse: Strategies to Stop the Epidemic, Trust for America's Health, October 1st, 2013. Read more.

Treatment or Incarceration, Doug McVay, Vincent Schiraldi, and Jason Ziedenberg, Justice Policy Institute, March 1st, 2004. Read more.

Amid the Opioid Crisis: The Best Ammunition That Public Officials Can Embrace Is Storytelling, Quinn Libson, RouteFifty.com. Read more.

7 Tools to Fight the Opioid Epidemic, James Brooks, Cities Speak. Read more.

Preventing or Reducing Opioid Abuse and Overdose: Selected Resources, SAMHSA Center for the Application of Prevention Technologies. Read more.

Burlington, VT has been leading the way in the opioid crisis- their Mayor set out guiding principles and their Police Department, informed by data, works across agengices, and recently was a part of a coalition to unviel 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 determained to be most meaningful in turning the tide of the opioid crisis. Their work as also been highlighted in the Vera Institute of Justice.


Ithaca, NY has developed a "Public Health and Safety Approach to Drugs and Drug Policy" in moving away from crimilization of addicts. They have also pushed to the forfront through a proposed open and controlled site for Heroine users, which reduces the spread of disease, lowers over doses, and helps guide people into treatment. Overall, their model is one cities look to across the nation to replicate. 


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.


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. 


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.


Dr. Leana Wen, Baltimore, MD’s City Health Commissioner, has led the city in addressing the opioid epidemic. They’ve used what they’ve called 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.


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


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.


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. 


Matthew Braunginn

View presentations and video from the 'Municipal Responses to the Opiate Epidemic' panel here.