A post-mortem on Oregon's drug decriminalization efforts

To address overdose deaths, multiple organizations across Athens County and Ohio University have implemented free Narcan distribution and training programs since 2023, including overdose response training sessions and no-barrier access to free Narcan kits through campus cabinets, health departments, and community organizations partnered with Ohio's Project DAWN network. The programs have helped distribute hundreds of Narcan boxes and to normalize overdose response training and reduce stigma around addiction.

In less than three and a half years, Safeworks, the only supervised drug-use site in Calgary, saved thousands of people from opioid-overdose deaths and helped users for whom abstinence-based treatment didn't work. The government of Alberta deemed the site a scene of "chaos" and ordered it closed once two new sites open. Safeworks supporters oppose the disruption in harm-reduction work that move would bring, considering how critical personal relationships built on trust are to this kind of service.

Supervised injection sites in Canada have prevented hundreds of heroin overdose deaths. Now, New York City is looking to follow Canada's lead with a city-wide initiative to establish safe injection sites. While the Trump Administration is not in support of such sites, experts believe that it is unlikely that the federal government would interfere with a site if a city is in support of it.

The drug crisis has reached new extremes in many parts of the country, as meth and opioids continue to tear families apart and funnel even more children into an already-strapped foster care system. In rural Montana, law enforcement and communities are trying a new approach to battling drug addiction, focusing on supportive family counseling and "drug courts" to help treat - rather than imprison - those struggling with addiction. In Lake County, Family Drug Treatment Courts are working to divert addicts from the vicious cycle and keep more families together.

The over-prescription of pain medicine has been a problem in southwest Colorado. Collective efforts of health care providers to standardize opioid prescriptions, clinics to expand recovery programs, and law enforcement to encourage addicts to enter rehab rather than prison, have reduced over-prescriptions of pain medications. However, they also could be unintentionally causing a rise in heroin use.

Chesterfield County, Virginia implemented a multi-faceted response to the opioid crisis, including a jail-based recovery program, Helping Addicts Recover Progressively (HARP), that brings people in recovery to the local jail to talk about addiction and treatment resources. Combined with other efforts, overdose deaths have dropped by half in a single year, and around 4,000 people have participated in HARP.

CalAIM’s contingency management program gives people gift cards for not using drugs. For every negative drug test, patients receive gift cards, and the payouts increase after each test. Patients who test negative every time over six months can earn up to $599. The treatment style is based on the concept of reinforcement as an effective motivator. Studies suggest the excitement of getting a gift card mimics the dopamine rush from using drugs.

The Cherokee Nation harm reduction program provides supplies like clean needles and Narcan to those using drugs and even offers safe, clean environments for drug use with staff available to assist during overdoses. As opioid addiction has disproportionately impacted Indigenous communities, the program also provides opportunities for people in recovery to participate in cultural activities. So far, the program has encountered several thousand people and has saved 44 lives with Narcan distribution.

Amidst the ever-present opioid crisis, there has been a shift among judges, prosecutors and law enforcement agencies beginning to let go of the stigma associated with medication for opioid use disorder. As of 2022, more than 90% of drug courts in communities with high opioid mortality rates have reported that they allow medications to be used to treat addiction. Some areas have also seen the emergence of drug recovery courts that specialize in helping people facing addiction get treatment, rather than jail time.

Students at Arlington Public Schools are being trained to carry and administer Narcan to help reduce the rising number of opioid overdose deaths, specifically among young people. Programs like this and access to treatment like Suboxone help make it easier for youth to find recovery and prevent drug overdoses.