Campus, city resources offer free Narcan in opioid harm reduction efforts

West Virginia University and Monongalia County's intensive, clinically-integrated harm reduction model and Ohio University and Athens County's community-centered, peer-support program offer two distinct approaches to combating the opioid epidemic in Appalachian communities. Both programs leverage harm reduction practices and have seen significant decreases in overdose deaths.

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.

While the decriminalization effort Measure 110 failed to fully meet the mark, the Health Justice Recovery Alliance joined forces with local law enforcement to create a pilot program that helped locals struggling with addiction. Through the program, police can contact an outreach worker who will come to the scene and connect the person struggling with addiction to support services such as detox care and housing, helping lead them toward long-term recovery. So far, the pilot program has helped over 200 people.

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.

The Mental Health Rebuilding and Restoring Initiative helps those struggling with drug addiction by showing them documentaries of others who have also struggled with addiction and how they managed to overcome it. The documentaries have since helped 50 people to stop using drugs. The Initiative also follows up with, monitors and encourages participants throughout their recovery journey.

Rather than treat opioid users like criminals, Vancouver has deemed it a public health crisis. The city, especially its downtown east side, witnessed 1,500 deaths in just one year from opioid use. Its approach is unique and multi-pronged – making Narcan, an overdose antidote, available to everyone, opening safe injection sites, and having a police presence – without arrests – on blocks where using remains high.

North Carolina has expanded a network of peer-run mental health programs, including peer cafes, respite houses, and support hotlines, staffed by people with lived experience of mental health and substance use challenges. These spaces offer free activities, crisis support, and community connection as alternatives to clinical settings. Research found that peer programs reduce emergency department visits by more than 40% over a three year span.

Los Angeles County’s Homeless Outreach & Mobile Engagement (HOME) program uses street psychiatry to get psychiatric medication to people experiencing homelessness in an effort to get them a step closer to housing. The HOME team has 223 full-time staff members and served 1,919 people last year, 22% of whom ended the year housed.