Collaborating with Communities

Ending the opioid epidemic requires a coordinated community response. Hospitals and health systems are actively partnering with organizations and people in their communities to address the epidemic together. It is important to connect with community opioid treatment programs, buprenorphine/naloxone providers, and explicitly encourage communitywide conversation. For example, hospitals and health systems are reaching out to other health care providers, state and local health departments, local behavioral health authorities, law enforcement, nonprofit organizations, including those focused on substance use disorders, community mental health centers, federally qualified health centers, faith-based groups, pharmacies, local political leaders, schools and district attorneys. Many hospitals are engaging recovery specialists to help patients admitted for drug overdose to enter treatment, expanding substance use disorder treatment services, providing naloxone to first responders, integrating physical and behavioral health care, joining with law enforcement to facilitate access to treatment, funding public education programs, educating community clinicians, participating in drug take-back days, and more. Below are resources and examples to help facilitate community partnerships and activities.

• Drug Court Teams – New Ulm Medical Center, New Ulm, MN (May 2017): Teams of legal and medical professionals who provide comprehensive support to help those dependent on drugs or alcohol and who have been convicted of a nonviolent criminal offense stay sober, out of jail and participating positively in the community.
• Project Lazarus. (n.d.) This project is a community-based overdose prevention program that focuses on increasing access to naloxone for prescription opioid users by encouraging physicians to prescribe the antidote to patients at highest risk of an overdose. Project Lazarus offers communities and individuals access to a host of resources on many topics, including: coalition formation, capacity building, sustainability, chronic pain management, safe prescribing practices for providers, opioid overdose education, awareness, safe medication usage materials, and project Pill Drop, a community-based medication disposal program.
• Project ECHO – Opioid Addiction Treatment. (2017) Project ECHO (Extension for Community Healthcare Outcomes) is a collaborative model of medical education and care management that empowers clinicians everywhere to provide better care to more people, right where they live. The ECHO model™ dramatically increases access to specialty treatment in rural and underserved areas by providing front-line clinicians with the knowledge and support they need to manage patients with complex conditions. It does this by engaging clinicians in a continuous learning system and partnering them with specialist mentors at an academic medical center or hub.
• Drug Overdose Immunity and Good Samaritan Laws. (2017) The National Conference of State Legislatures has a compilation of resources including the importance of the use of naloxone and Good Samaritan laws.
• Webinar: Strategies Addressing the Opioid Crisis in Tribal Communities. (2017) This webinar highlights effective approaches to addressing the opioid crisis in tribal communities. The webinar includes presentations from the Muckleshoot Tribe, Mashpee Wampanoag Tribe, White Earth Nation and the Indian Health Service National Committee on Heroin, Opioids, and Pain Efforts.
• Opioid Overdose Prevention Toolkit. (2016) This toolkit offers strategies to health care providers, communities, and local governments for developing practices and policies to help prevent opioid-related overdoses and deaths.
• Drug Take Back and Disposal Resources
  • National Drug Take Back Days. The Drug Enforcement Administration (DEA) s hosts two national drug take back days annually. The next take back day is scheduled for October 27, 2018. We recommend that hospitals wishing to support these efforts work with their community coalitions, which should include law enforcement. Collaborating as a coalition enables communities to assess the best potential drop-off locations and work together to publicize the event. It is important to keep in mind that hospitals and others organizations participating in a national drug take back day must work with local law enforcement.
  • Ongoing Take Back Programs. In 2014, DEA finalized a regulation that expanded opportunities for drug disposal. The regulation explicitly describes how hospitals and clinics with on-site pharmacies, narcotic treatment programs, and retail pharmacies can run mail-back programs or maintain collection receptacles at their registered locations. Read AHA’s advisory about the regulation.
• Other Activities: Through newsletters and social media, hospitals can make patients aware of other ways to dispose of unused medications.
  • The DEA’s website has a search tool for authorized collector locations.
  • Disposal of Unused Medicines: What You Should Know. The FDA provides information on what medications can be flushed down the toilet.
  • One state takes a novel approach to opioid addiction: Access to treatment for all inmates. (2017) The Rhode Island Department of Corrections has expanded its medication-assisted treatment program to its entire prison population.

Collaboration with Communities Case Examples

• Rapid Response to the Opioid Crisis. (July 2018) This white paper explores how communities are using location-based approaches to address the opioid epidemic. Download of white paper requires free registration.
• Opioid Misuse in Rural America. (February 2018) The purpose of this website is to assist rural leaders with resources, information and best practices to help rural communities respond to and manage the opioid crisis.
• Our Community Responds to the Opiate Epidemic: Hospitals and Health Systems Impacting the Opiate Crisis. (2016) Senior executives from Oregon Health State University Hospital, Portland, Ore. provide extensive details about a three-county collaborative involving 14 hospitals from four health systems, two CCOs and four health departments, which developed a community standard to reduce the use of and addiction to opiates.
• Hampton Police and Sentara partner to combat opiate overdoses. (2016) This article describes how Sentara CarePlex Hospital partnered with the local police in Hampton, Va., to supply and provide training on using Narcan.
• Morrison County’s Success in Combating Prescription Drug Abuse. (2015) This webinar describes the work and impact of a Controlled Substance Care Team and a community Prescription Drug Task Force. The speakers share how key community partners have collaborated to address chronic opioid use in a rural community.
• The Addiction Crisis: A Community’s Response. (2016) The speakers share how their Northern Shenandoah Valley community in rural Virginia coalesced to develop strategies to effectively respond to the challenge of heroin and opiate use. Initiatives include “Breaking the Code of Silence,” an educational campaign to highlight awareness; installation of drug take-back boxes at various locations; development and access to transitional care after incarceration; establishment of a drug treatment court; and use of a peer recovery network; and more.
• The Safe Passage Initiative: Hospitals and Health Systems Impacting the Opiate Crisis. (2016) Safe Passage is an addiction recovery initiative that allows people seeking treatment to contact police without fear of arrest, as long as they don’t have any outstanding warrants. People can also turn over drugs and paraphernalia without being charged.
• Improving Addiction Care Team. (2017) To address the rise in opioid-related admissions and deaths, the Improving Addiction Care Team (IMPACT) at Oregon Health Sciences University (OHSU) built on existing relationships with OHSU leadership and community partners. Specifically, the IMPACT intervention was built on a program called the Care Transitions Innovation (C-TRAIN), following an assessment of community needs and resources.
• Substance Use Prevention: How to Make it Work in Your Community (January 19, 2017): Joint Webinar with the Association for Community Health Improvement showing research behind substance use prevention and presenting a real-life example of how Utah is using a collaborative state-wide approach to address the opioid epidemic.