Strengthening Your Community Coalition

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Summary

The substance misuse and SUD epidemic is a complex problem requiring a highly coordinated and cooperative effort within communities to address.  The increase in overdoses and fatal overdoses in recent years has caused many communities to realize that individual organizations cannot afford to work in silos.  There is a clear understanding that local government, commuunity partners of all types, and the private sector must align and work together to develop and implement effective strategies to improve response to the SUD epidemic accross the continuum of care.  This page provides an overview of what it takes to build and strengthen an effective coalition based on the experiences of communities accross the country.

 

Return to Opioid Top-Level Strategy Map

Coalition Building

The opioid coalition process is designed to help build strong communities in order to reduce the trafficking, selling, and use of heroin and diverted prescription opioid painkillers. This can be accomplished if a diverse group of key community stakeholders come together to offer their gifts, knowledge, and resources. [1]
 

Data is a Critical Foundation to Action   The improved collection, distribution, and analysis of data is critically important to the development of a strategy to address areas within a community that are being severely impacted by SUD.  This typically goes far beyond just tracking overdose deaths and non-fatal overdose.  It is important to know where they are occurring to know where more resources need to be deployed.   What data sources are available? How are they being used? Do we have the data we need?  What more might be needed?  How can we expand the data set to help focus resources where they are most needed, and when they are most needed.   Question:  What can be done in a short amount of time, at reasonable expense, to better collect, analyze, and make use of data related to the SUD epidemic in the region?


  Harm Reduction Saves Lives and Should Provide a Linkage to Care   The distribution and training of how to use Narcan continues to be an effective way to reverse opioid overdose and save lives.  Other programs like needle/syringe exchange reduce the risk of infection and prevent the spread of other diseases.  Resistance to these programs is reduced when they are paired with providing information about treatment options and other available support in the community.   What trainings on Narcan administration are available in the area? How is this service being marketed to ensure organizations across the health system know it is available? What are the most effective ways we can expand distribution of Narcan and add other harm reduction measures?  Are there ways to improve linkages to care?   What can the region do to reach more people, especially in areas with the highest rates of overdose, to expand harm reduction efforts?



  Agencies and Community Organizations Need to take on new Roles   There are many examples where organizations need to expand services and take on new roles to address the SUD epidemic - especially in underserved areas of the community. This might include:       - Police working with peer recovery specialists/coaches in cases of overdose.

    - Community organizations taking on prevention/education/training roles.

    - Hospitals coordinating with area treatment providers to help overdose patients   Do new roles need to be taken on by government agencies and/or community groups?  If so who and what new roles would be helpful?   Who should this group focus on to create new or expanded partnerships in the region?  
Ideally what role(s) would they take on in working with this group?
Family Members and Related Support Groups Can be Powerful Partners   Some communities have strong, well organized family support groups that provide volunteers to help carry out the work of the stakeholder group.  Many such groups help raise awareness, reduce stigma, educate and train on the use of Narcan, and advocate for needed policy changes.   Is there an effective family group in the area?  Would greater coordination and involvement with this effort be beneficial?   Peer Support Networks have multiple Areas where they Contribute.   Peer Support Specialists and Recovery Coaches can play a vital role across numerous initiatives.  Working together with police, health services, treatment providers, and recovery support networks, Specialists and Coaches often provide an initial link to care for someone seeking help after an overdose or just wanting help.  In many instances they continue to work with people for longer periods of time - helping them find and get through treatment, and get what they need to help them maintain recovery.   How are peers being utilized in the area?  Is there room to expand current efforts and add more peer support through additional training and funding?   If more peer specialist/coaches could be added in the region, how do you think they would be best utilized?     Finding Ways to Serve Underserved Areas   This is something that has been brought up by people in this group, and is a problem that other communities have faced. Multiple strategies are needed -  several which have been mentioned above.  Data collection leads to accurate focusing, services can then be focused and community partners can be utilized and trained to better address the crisis in their neighborhoods/wards.  Efforts also typically included more targeted education/prevention efforts.   How can we better serve areas of the City that have been underserved?  Who can we partner with to help make this happen?   SUD must be seen as a Disease, not a Crime or Moral Failing   Though the understanding of SUD and the fact that it is a disease has increased in recent years, there is still a stigma present that often prevents individuals and families from seeking help.  This stigma is reduced through education efforts at schools, PSAs, and a wide variety of other programs.   Efforts on this front are taking place - how can we expand them.  What other methods can we use to reach more people?   The Criminal Justice System is another Key Factor   It is generally recognized that a person suffering from SUD can be helped to a far greater degree through various diversion and treatment programs that often lead to a life in recovery as opposed to long-term incarceration.  This is tremendously beneficial to society.   What options are there for those in the criminal justice system in terms of diversion, drug court, treatment while incarcerated, and treatment/support services for those leaving incarceration?  Are there areas that need to be added or improved?   Given what programs currently exist, what improvements could be made within the City/County criminal justice system in terms of additional or expanded programs to help those with SUD find treatment - either through diversion programs or treatment for those incarcerated?   Increasing Recovery Supports are Critical to Long-term Success   Housing, education, child care, job training and job placement assistance are just some of the recovery support services needed to help people in early recovery.  Without these supports, many with limited means and/or a criminal record can become frustrated and hopeless - increasing their chances of relapse.  Communities with strong supports for people newer to recovery have seen positive results.   What types of recovery support services exist in the region?  Who are the key organizations working on one or more recovery supports?  Are area employers engaged?  Area workforce development entities?

 

 

Coalitions Can...

  • Conserve resources
  • Achieve more widespread reach within a community than a single organization ever could attain
  • Accomplish objectives beyond the scope of any single organization
  • Have greater credibility than individual organizations
  • Provide a forum for sharing information
  • Provide a range of advice and perspectives to lead the agency
  • Foster personal satisfaction and help members to understand their jobs in a broader perspective
  • Foster cooperation between grassroots organizations, community members, and diverse sectors of large organizations.[2]

 

Steps to Building a Coalition

  1. Analyze objectives and determine whether a coalition should be formed
  2. Recruit the right people. Think outside of the box to recruit a wide variety of stakeholders from different sectors
  3. Devise a set of preliminary objectives and activities
  4. Convene the coalition
  5. Anticipate necessary resources.
  6. Define success to your coalition. What are you measuring? What are your targets? How and when should they be reached?
  7. Maintain coalition vitality. This can be done through meetings, events, and strong communication
  8. Make improvements through evaluation. Actions done by coalitions should be fluid. Once targets are reached, the actions being taken may change. Consider how actions need to change if targets are not being reached. Don't collect data for the sake of collecting data. Evaluate what this information means and use it to understand and maybe even adapt your actions, measures, and targets to fit the current situation.[3]
  9. Find the right program for your community. Blueprints Programs for Healthy Youth Development have a database of over 1,400 programs already established. See what's working for other communities at their website.

Coalition Examples

Fed Up! Coalition to End the Opioid Epidemic
Platform:

  1. Take all measures necessary to ensure that opioids and other controlled drugs are prescribed more cautiously.
  2. FDA must:
    1. Prohibit marketing of opioids for conditions where risks outweigh benefits
    2. Consult its advisory committees before approving any new opioids.
    3. Add an upper dose and a suggested duration of use on opioid labels.
    4. Designate naloxone an over-the-counter drug.
    5. Ensure that abuse-deterrent opioid formulations are NOT marketed as less addictive.
  3. DEA must mandate prescriber education, free of pharmaceutical industry bias, for all DEA registrants who intend to prescribe more than a 3-day supply of opioids.
  4. HHS, DEA, and Congress should immediately reduce barriers to buprenorphine treatment.
  5. Congress must increase funding for evidence-based addiction treatment.
  6. Congress must incentivize states to mandate prescriber use of Prescription Drug Monitoring Programs.


Coalition to Optimize the Management of Pain Associated with Surgery (COMPAS)
Mission: To educated all those involved in pain management decisions about acute pain management strategies that minimize the need for opioids.
COMPAS also will provide education on how to implement multimodal analgesic strategies and how to measure success for patients and hospitals alike.

Community Anti-Drug Coalitions of America (CADCA)
CADCA is the premier membership-based non-profit organization representing adult and youth coalition leaders throughout the United States and internationally - all working to make their communities safe, healthy, and drug-free. CADCA's model for community change represents a comprehensive, evidence-based, multi-sector approach to reduce underage and binge drinking, tobacco, illicit drugs and the abuse of medicines.
 

Recruiting Non-Traditional Partners

Real Estate Agents

Real estate agents can talk to potential sellers about safe storage, especially during open houses.[4]

Funeral Home Directors

Funeral home directors can carry information about prescription drug misuse and abuse in their parlor.[5]
  Anyone that has family member who passes away and comes through, funeral parlors can talk about safe disposal of unused drugs, prescription drug drop-boxes, and drop-box locations.[6]
 

Veterinarians

Sometimes people will actually injure their animals and request specific drugs from veterinarians.[7]
 

Faith Communities

See Coalition Partner: Faith Communities for more details on how members and leaders of faith communities can support strategies to address opioid abuse and recovery in their community.
  Programs like One Body Collaboratives and software likeMeet the Need can help engage and equip churches to participate in their communities.
See the Opioid Epidemic Practical Toolkit: Helping Faith and Community Leaders Bring Hope and Healing to Our Communities for ideas about what your faith community can do.
 

Tips for Reaching Out

  1. Important to build relationships[8]
  2. Find the gatekeeper - who is someone that other people will trust[9]

Partners and Their Potential Roles

This list of partners links to pages containing ways they can support a comprehensive strategy
 
  1. Local Health Departments
  2. Hospitals
  3. Pharmacists
  4. Primary Care Physicians
  5. Pain Specialists or Pain Centers
  6. Nurses
  7. Health Plans and Insurance Companies
  8. Local Law Enforcement
  9. Corrections
  10. Treatment Providers
  11. Faith Communities

Tools & Resources

TR - Strengthen the Coalition to Reduce Opioid Abuse



PAGE MANAGER: [insert name here]
SUBJECT MATTER EXPERT: [fill out table below]

Reviewer Date Comments
     

Sources

  1. Hazelden Betty Ford Foundation. Heroin and Prescription Painkillers: A Toolkit for Community Action. 2016.
  2. [1]
  3. [2]
  4. [3]
  5. [4]
  6. [5]
  7. [6]
  8. [7]
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