With support from The Rockefeller Foundation and partnership with the National Association of Counties, the Bipartisan Policy Center has spent months conducting interviews and roundtables across the country with local leaders who are developing innovative solutions to improve economic security in their communities. This post is the second in a series highlighting those innovations, focusing on programs that attempt to mitigate the impacts of crises in the lives of individuals and families.
The opioid crisis has taken a staggering toll on communities, with 116 people dying each day, and 42,249 total deaths in 2016 from opioid-related drug overdoses. From 1999 through 2016, over 367,000 Americans died from opioid-related drug overdoses, more than those who died fighting for the Union during the Civil War.
This public health tragedy has also created barriers to building economic security for individuals and families. In BPC’s interviews and roundtables with local government leaders around the country, discussions of economic security repeatedly returned to the opioid epidemic. City and county governments have difficulty promoting economic opportunity when they are burdened with opioid-related crises, and lack of resources compounds the challenges. The crisis is also placing an increasing burden on finite public health and safety resources resulting in unprecedented strain on health care, criminal justice, and substance use treatment systems.
At the individual level, the toll is even more acute, affecting not only the lives of those addicted, but their families, friends, and loved ones. In certain areas of the country, loss of economic opportunity has been linked to opioid use and so-called “deaths of despair.”
Yet we found that, in at least two areas of the country, health care providers, law enforcement, and others are closely coordinating their efforts which are helping to stem the opioid tide.
In Ohio, one of the states with the highest rates of opioid deaths, the Lucas County Sheriff’s department started the first unit dedicated to linking first response to treatment options in 2014. Drug Abuse Response Team (DART) officers help people suffering from substance abuse with up to two years of follow up. Officers focus on education and intervention, connecting participants with assessment, detoxification, intensive outpatient programming, recovery housing, and support groups.
Since its inception, DART has assisted 2,764 clients with opioid abuse disorders and in 2017 had a 78 percent success rate of getting people into detoxification and treatment programs. This is a huge improvement to rates seen in other hard-hit areas of the opioid crisis: a large National Institutes of Health-funded study in Massachusetts found that less than one third of patients received any medication-assisted treatment following an overdose. DART connects clients with treatment facilities including Zepf Center, Empowered for Excellence, Racing for Recovery, University of Toledo Medical Center, Arrowhead Behavioral, Unison, and Rescue Crisis. DART engaged 815 clients in 2017, with nearly 5,000 follow-up visits to the individuals. Using state grants, 40 other sheriff’s departments across Ohio have replicated DART.
In Buffalo, N.Y., the Opiate Crisis Intervention Court has taken a similarly innovative approach. The city court implemented the first program in the country to immediately offer medication-assisted treatment for charged offenders identified as high risk for opioid overdose. The program, started in May 2017, features inpatient or outpatient care, 8 p.m. curfews, and at least 30 consecutive days of in-person meetings with the judge. This differs from typical drug court programs where meetings are once per week or once per month, and the emphasis of the Buffalo program is on treatment rather than imposing prison sentences. The program also features a partnership with the University of Buffalo treatment coordinators who enforce curfews, do wellness checks, and transport patients.
Since it started in May 2017, over 200 patients have been enrolled in the program, with only one overdose death. The original program goal was to treat 225 people over 3 years. It met that goal in 10 months, and is on track to triple that number of people treated. This program may have played a role in the county drug overdose levels dropping 17 percent in 2017, a three-year low, while the New York statewide rate increased 7 percent.
The President’s Commission on Combating Drug Addiction and the Opioid Crisis draft report highlighted the Buffalo program, recommending that “other jurisdictions should consider adopting a similar strategy.” Eight states—Alaska, Indiana, Kansas, Minnesota, North Carolina, New Jersey, Virginia and Washington—are studying how to expand treatment within the criminal justice system in the mold of the Buffalo program.
The impressive coordination demonstrated thus far in Lucas County and Buffalo has shown that progress against opioids is possible. Applying the lessons of these programs in efforts elsewhere can help reduce the effects of opioid abuse on economic opportunity, particularly as the federal government considers how best to use the over $3 billion approved to combat the opioid epidemic in 2018.