Searching for Solutions as Heroin Claims 10,000 Lives

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.

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.

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.

Project CARA (Care that Advocates Respect/Resilience/Recovery for All) supports pregnant and parenting people with substance use disorders, providing healthcare, addiction resources and obstetrics care in one spot. The program's hub-and-spokes model makes care more accessible, especially for those in remote areas. Data from the Project also indicates that participants of the program are more likely to attend prenatal and postpartum appointments than those outside of the program.

The Olympia Bupe Clinic's walk-in model for treating opioid addiction allows patients to receive medication-assisted treatment with buprenorphine on their first visit without barriers or extensive wait times. This low-barrier approach eliminates the hurdles people often face when seeking treatment. The Clinic also hires staff with lived experience with addiction to build trust and community with patients.

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.

La Sala is a community center that provides harm reduction services to those in need. People can come in to exchange used needles for clean ones and other supplies to make drug use safer. The Center also provides naloxone and testing for HIV and other diseases, all for free. The Center reopened in mid-2019 and has had about 1,900 visits since then.

The Quinault Indian Nation’s Family Wellness Court provides a culturally relevant alternative to traditional Western court systems that focuses on healing rather than punishment. 100 of the 400 tribal courts in the country have wellness courts for adults, families and youth, providing substance use disorder support, mental health care, and other family support services.

First Day Forward provides support and assistance to people with substance use disorders who are reentering the community after incarceration in seven rural counties. The program is driven by peer-support specialists who have lived experience to provide trusting support to those seeking assistance. The program has been shown to work as the recidivism rate for those who’ve successfully completed it has dropped to 23.5%, compared to 53.2% in a nearby county.

Women in Recovery is a diversion program for women who would otherwise face prison time for drug-related offenses. The comprehensive program lasts 18 months and helps participants restore their mental health, reunite with their children, develop skills that help them get jobs, secure housing and reenter the community. Women in Recovery helps reduce recidivism rates and 70% of women who start the program complete it and graduate.