Media Wiki - User contributions [en]

Activating Your Community

2020-12-21T20:18:03Z

Pkalch:

__NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]   
SWITCHING TO "Activating Your Community

__TOC__

 

 

= Background =

There are many barriers that prevent and limit the efforts of communities addressing drug misuse and substance use disorder, but one particular challenge that many communities face is the ability to elevate their initiative above other local competing priorities.  Identifying champions who can publicly support the coalition’s mission can help to build and foster strategic partnerships, generate buy-in, and increase commitment to bolster supports. With a solid understanding of the current programmatic needs in your area, you can build power and mobilize the community by successfully bringing together advocates, policymakers, and professionals to take collective action.

Whether you are developing legislative or regulatory efforts, building and strengthening programs, or attempting to reach a diverse audience with a wide range of needs, communities of all sizes should consider the following principles when activating your community around this crisis:

*Put equity at the center for your efforts
*Engage individuals with lived experience or those directly impacted by substance use disorder in decision-making roles
*Create alliances and form strategic partnerships that build political will and support from a broad range of stakeholders
*Build relationships with federal, state, and locally elected leaders
*Understand your community’s most powerful levers for change 
*Allow data to drive your strategy development and decision-making
*Focus on measurable individual and community-based outcomes
*Empower citizens by increasing public awareness and community engagement opportunities
*'''Strengthen your system or infrastructure in order to achieve impact at scale'''

It’s important to note that any community organizing or political will building strategy should be implemented with regularity - it should not be a single event or effort.  For the greatest impact, communities should show the link or intersection of substance use disorder with other competing community priorities, consistently focus on drumming up new interest, and relay progress made over time back to community stakeholders using a message of hope in order to sustain engagement.

Drug misuse and SUD has consequences for all residents of local communities.  The current epidemic increases costs related to public health, public safety, criminal justice, treatment services, and many more.  Locally elected leaders are typically motivated by the economic impacts to improve local response, but a far greater price comes from the fatalities caused by the epidemic and related overdoses and the loved ones who must face the pain of those lost.  This is what motivates many others to create and join efforts to combat the epidemic within their communities.  Many of these leaders typically work in prevention, harm reduction, treatment, recovery support services, and other efforts that save lives and help those in need find recovery, but it may be necessary for communities to tailor messaging to suit a wide variety of audiences in a manner that speaks to the receiver’s particular interest.  When identifying champions or strategic alliances, communities should consider their most powerful levers for change.  Who or what in your community can unlock opportunity and accelerate change?  What is the backbone of your community?  Is it your local hospital system, community college, or a specific business or company?  Communities may find that some individuals or organizations may have conflicting viewpoints – try to approach them and open a door for conversation.  Sometimes non-traditional partners are only “non-traditional” because we label them as such.

 

= Key Community Members =

== Elected Officials and Local Health Leaders ==

Locally elected leaders and health officials can play a key role in leading efforts to improve the response to the SUD epidemic.  Mayors, County Executives, County Managers, Commissioners, and the local health leaders they appoint, can be powerful allies in raising public awareness about the extent of the problem, the availability of resources, and providing information on specific strategies, like harm reduction, that can help save lives.  In many instances, elected officials and local health officials might already be part of some type of community task force or other group charged with coordinating and improving local response to the epidemic; however, in the absence of such an effort, elected and health leaders can and should be engaged in raising awareness about the issue and solutions while also increasing support within the community.  

Elected leaders, and especially legislators, play an important role in the creation of budgets and ultimately decide on how local revenues are allocated to different programs, so it is critical they are aware of the scope of these issues in their communities and what is being done in response.  In most cases, they have political allies and are regularly invited to speak at community events or participate in meetings with diverse audiences where they can help to relay your message and share information about the response.

Although locally elected leaders are important champions, it’s also critical for a coalition to work alongside its state partners to help align efforts for maximum impact, inform policy, support funding, and make recommendations on scalability of programs that are working on-the-ground to avoid duplication or manage expectations that might not be feasible or sustainable at the local level.

=== Engagement Examples - Elected and Local Health Leaders ===

== Community Stakeholders and Infuencers ==

Anyone in your community can be a leader or a champion.  Drug misuse and substance use disorder affects a substantial number of residents in all communities.  Having a wide variety of stakeholders imbedded within the community can help to advance policies, programs, and systems that can work together and improve local response.  When appropriate, consider engaging other community partners to leverage efforts and boost support within the community.  These individuals in your community who could be key champions or partners along the way, but might not necessarily participate in the coalition.  Some examples might include:

*Health Professionals and Community Health Centers
*Hospital System Administration
*Faith Leaders
*Law Enforcement or other First Responders
*Public and Private School Systems
*Colleges, Universities, and Institutions of Higher Education
*Parent Groups
*Youth and Young Adults
*Local businesses, corporations, or the Chamber of Commerce
*Philanthropic Community

== Individuals with Lived Experience ==

Communities should also engage individuals with lived experience in decision-making roles - meaning those who have had first-hand involvement with substance use disorder and those who are friends or family members of those directly impacted.  Individuals with lived experience bring knowledge, understanding, and experience not learned through formal education.  To be most effective, it is imperative that communities honor and reflect the voices of those most impacted in their programs and systems. If possible, find ways to offer fair compensation for their time.  

= Improving Pubic Awareness And Engagement =

Public education and awareness is essential to activating a local community.  Residents need to know the unvarnished reality of what is taking place.  They need to know what the problem is, and what needs to be done to improve the local response and save lives.  In addition order to be educated, local residents also need to be involved in the process.  The people are the community, and many have first-hand experience with drug misuse and SUD.  Many others have lived experience with family and friends who are struggling with these issues, and their input and participation is needed to create a Comprehensive and effective Community

 

 

== Public Availability of Data ==

Making data available to the public can help increase awareness and move community members to take action.  Local data is particularly effective, as pepe are more likely to care and take action to help their own communities.  Many state and local communities have created data "dashboards" typically hosted and maintained by the state and local health departments.  These dashboards include information about opioids and other substances, and related data on overdoses.  

Most states and localities who have developed dashboards have greatly expanded available information to include additional data and information on other programs and efforts to address the epidemic.  These provide additional opportunities for community members to take action.  Topic covered in by one state include: <ref name="https://www.doh.wa.gov/DataandStatisticalReports/HealthDataVisualization/OpioidDashboards" />

Prescription Monitoring Program

Naloxone (Narcan)

Drug-related Hospital Visits

Crime Statistics

Treatment Statistics

Viral Hepatitis

Neonatal Abstinence Syndrome

An additional example of a state wide dashboard can be seen [https://www.doh.wa.gov/DataandStatisticalReports/HealthDataVisualization/OpioidDashboards here.]

 

 

== Community Education Programs ==

 

== Building Strategic Partnerships ==

 

== Develop Outreach Strategies ==

There are many strategies and options to conduct outreach to the community and decision makers.  Outreach can include a broad public awareness campaign, or something more focused that asks community members to become involved in new or existing programs and campaigns.  Communnities have empoyed numerous outreach strategies to provide education, awareness, and move people to action.  These include:

Public Service TV and Print Ads

Signage in Public Facilities

Outreach within Schools

Outreach to Faith Based Communities and other exisitng Community Groups.

Door to Door Canvassing

Grassroots Letters of Support

 

 

= Overcoming Stigma =

== Anti--Stigma Campaigns: ==

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.  It was designed to include a toolkit for communities who want to replicate the campaign locally and use it a community mobilizing tool to drum up political will and raise awareness about local efforts underway to combat stigma.  By using the pledge as a catalyst, communities can identify new stakeholders who can be activated and drive social impact, as well as help to change behaviors at scale.

State of Massachusetts - Sate Without StigMA. <ref>https://www.mass.gov/state-without-stigma
</ref> The State of Massachusetts has developed a comprehensive anti-stigma campaign at the State level.  This resource provides information about what stigma is, how it contributes to the current epidemic, and personal stories of people who talk about their own experiences with stigma and how they overcame it to find help for themselves and others in a variety of settings.

 

 

[[Category:Community Resources]]

Activating Your Community

2020-12-21T19:59:03Z

Pkalch:

__NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]   
SWITCHING TO "Activating Your Community

__TOC__

 

 

= Background =

There are many barriers that prevent and limit the efforts of communities addressing drug misuse and substance use disorder, but one particular challenge that many communities face is the ability to elevate their initiative above other local competing priorities.  Identifying champions who can publicly support the coalition’s mission can help to build and foster strategic partnerships, generate buy-in, and increase commitment to bolster supports. With a solid understanding of the current programmatic needs in your area, you can build power and mobilize the community by successfully bringing together advocates, policymakers, and professionals to take collective action.

Whether you are developing legislative or regulatory efforts, building and strengthening programs, or attempting to reach a diverse audience with a wide range of needs, communities of all sizes should consider the following principles when activating your community around this crisis:

*Put equity at the center for your efforts
*Engage individuals with lived experience or those directly impacted by substance use disorder in decision-making roles
*Create alliances and form strategic partnerships that build political will and support from a broad range of stakeholders
*Build relationships with federal, state, and locally elected leaders
*Understand your community’s most powerful levers for change 
*Allow data to drive your strategy development and decision-making
*Focus on measurable individual and community-based outcomes
*Empower citizens by increasing public awareness and community engagement opportunities
*'''Strengthen your system or infrastructure in order to achieve impact at scale'''

It’s important to note that any community organizing or political will building strategy should be implemented with regularity - it should not be a single event or effort.  For the greatest impact, communities should show the link or intersection of substance use disorder with other competing community priorities, consistently focus on drumming up new interest, and relay progress made over time back to community stakeholders using a message of hope in order to sustain engagement.

Drug misuse and SUD has consequences for all residents of local communities.  The current epidemic increases costs related to public health, public safety, criminal justice, treatment services, and many more.  Locally elected leaders are typically motivated by the economic impacts to improve local response, but a far greater price comes from the fatalities caused by the epidemic and related overdoses and the loved ones who must face the pain of those lost.  This is what motivates many others to create and join efforts to combat the epidemic within their communities.  Many of these leaders typically work in prevention, harm reduction, treatment, recovery support services, and other efforts that save lives and help those in need find recovery, but it may be necessary for communities to tailor messaging to suit a wide variety of audiences in a manner that speaks to the receiver’s particular interest.  When identifying champions or strategic alliances, communities should consider their most powerful levers for change.  Who or what in your community can unlock opportunity and accelerate change?  What is the backbone of your community?  Is it your local hospital system, community college, or a specific business or company?  Communities may find that some individuals or organizations may have conflicting viewpoints – try to approach them and open a door for conversation.  Sometimes non-traditional partners are only “non-traditional” because we label them as such.

 

= Key Community Members =

== Elected Officials and Local Health Leaders ==

Locally elected leaders and health officials can play a key role in leading efforts to improve the response to the SUD epidemic.  Mayors, County Executives, County Managers, Commissioners, and the local health leaders they appoint, can be powerful allies in raising public awareness about the extent of the problem, the availability of resources, and providing information on specific strategies, like harm reduction, that can help save lives.  In many instances, elected officials and local health officials might already be part of some type of community task force or other group charged with coordinating and improving local response to the epidemic; however, in the absence of such an effort, elected and health leaders can and should be engaged in raising awareness about the issue and solutions while also increasing support within the community.  

Elected leaders, and especially legislators, play an important role in the creation of budgets and ultimately decide on how local revenues are allocated to different programs, so it is critical they are aware of the scope of these issues in their communities and what is being done in response.  In most cases, they have political allies and are regularly invited to speak at community events or participate in meetings with diverse audiences where they can help to relay your message and share information about the response.

Although locally elected leaders are important champions, it’s also critical for a coalition to work alongside its state partners to help align efforts for maximum impact, inform policy, support funding, and make recommendations on scalability of programs that are working on-the-ground to avoid duplication or manage expectations that might not be feasible or sustainable at the local level.

=== Engagement Examples - Elected and Local Health Leaders ===

== Community Stakeholders and Infuencers ==

Anyone in your community can be a leader or a champion.  Drug misuse and substance use disorder affects a substantial number of residents in all communities.  Having a wide variety of stakeholders imbedded within the community can help to advance policies, programs, and systems that can work together and improve local response.  When appropriate, consider engaging other community partners to leverage efforts and boost support within the community.  These individuals in your community who could be key champions or partners along the way, but might not necessarily participate in the coalition.  Some examples might include:

*Health Professionals and Community Health Centers
*Hospital System Administration
*Faith Leaders
*Law Enforcement or other First Responders
*Public and Private School Systems
*Colleges, Universities, and Institutions of Higher Education
*Parent Groups
*Youth and Young Adults
*Local businesses, corporations, or the Chamber of Commerce
*Philanthropic Community

== Individuals with Lived Experience ==

Communities should also engage individuals with lived experience in decision-making roles - meaning those who have had first-hand involvement with substance use disorder and those who are friends or family members of those directly impacted.  Individuals with lived experience bring knowledge, understanding, and experience not learned through formal education.  To be most effective, it is imperative that communities honor and reflect the voices of those most impacted in their programs and systems. If possible, find ways to offer fair compensation for their time.  

= Improving Pubic Awareness And Engagement =

Public education and awareness is essential to activating a local community.  Residents need to know the unvarnished reality of what is taking place.  They need to know what the problem is, and what needs to be done to improve the local response and save lives.  In addition order to be educated, local residents also need to be involved in the process.  The people are the community, and many have first-hand experience with drug misuse and SUD.  Many others have lived experience with family and friends who are struggling with these issues, and their input and participation is needed to create a Comprehensive and effective Community

 

== Public Availability of Data ==

Making data available to the public can help increase awareness and move community members to take action.  Local data is particularly effective, as pepe are more likely to care and take action to help their own communities.  Many state and local communities have created data "dashboards" typically hosted and maintained by the state and local health departments.  These dashboards include information about opioids and other substances, and related data on overdoses.  

Most states and localities who have developed dashboards have greatly expanded available information to include additional data and information on other programs and efforts to address the epidemic.  These provide additional opportunities for community members to take action.  Topic covered in by one state include: <ref name="https://www.doh.wa.gov/DataandStatisticalReports/HealthDataVisualization/OpioidDashboards" />

Prescription Monitoring Program

Naloxone (Narcan)

Drug-related Hospital Visits

Crime Statistics

Treatment Statistics

Viral Hepatitis

Neonatal Abstinence Syndrome

An additional example of a state wide dashboard can be seen [https://www.doh.wa.gov/DataandStatisticalReports/HealthDataVisualization/OpioidDashboards here.]

 

== Community Education Programs ==

 

== Building Strategic Partnerships ==

 

== Develop Outreach Strategies ==

 

 

= Overcoming Stigma =

== Anti--Stigma Campaigns: ==

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.  It was designed to include a toolkit for communities who want to replicate the campaign locally and use it a community mobilizing tool to drum up political will and raise awareness about local efforts underway to combat stigma.  By using the pledge as a catalyst, communities can identify new stakeholders who can be activated and drive social impact, as well as help to change behaviors at scale.

State of Massachusetts - Sate Without StigMA. <ref>https://www.mass.gov/state-without-stigma
</ref> The State of Massachusetts has developed a comprehensive anti-stigma campaign at the State level.  This resource provides information about what stigma is, how it contributes to the current epidemic, and personal stories of people who talk about their own experiences with stigma and how they overcame it to find help for themselves and others in a variety of settings.

 

 <br/>

[[Category:Community Resources]]

Activating Your Community

2020-12-21T19:01:51Z

Pkalch:

__NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]   
SWITCHING TO "Activating Your Community

__TOC__

 

 

= Background =

There are many barriers that prevent and limit the efforts of communities addressing drug misuse and substance use disorder, but one particular challenge that many communities face is the ability to elevate their initiative above other local competing priorities.  Identifying champions who can publicly support the coalition’s mission can help to build and foster strategic partnerships, generate buy-in, and increase commitment to bolster supports. With a solid understanding of the current programmatic needs in your area, you can build power and mobilize the community by successfully bringing together advocates, policymakers, and professionals to take collective action.

Whether you are developing legislative or regulatory efforts, building and strengthening programs, or attempting to reach a diverse audience with a wide range of needs, communities of all sizes should consider the following principles when activating your community around this crisis:

*Put equity at the center for your efforts
*Engage individuals with lived experience or those directly impacted by substance use disorder in decision-making roles
*Create alliances and form strategic partnerships that build political will and support from a broad range of stakeholders
*Build relationships with federal, state, and locally elected leaders
*Understand your community’s most powerful levers for change 
*Allow data to drive your strategy development and decision-making
*Focus on measurable individual and community-based outcomes
*Empower citizens by increasing public awareness and community engagement opportunities
*'''Strengthen your system or infrastructure in order to achieve impact at scale'''

It’s important to note that any community organizing or political will building strategy should be implemented with regularity - it should not be a single event or effort.  For the greatest impact, communities should show the link or intersection of substance use disorder with other competing community priorities, consistently focus on drumming up new interest, and relay progress made over time back to community stakeholders using a message of hope in order to sustain engagement.

Drug misuse and SUD has consequences for all residents of local communities.  The current epidemic increases costs related to public health, public safety, criminal justice, treatment services, and many more.  Locally elected leaders are typically motivated by the economic impacts to improve local response, but a far greater price comes from the fatalities caused by the epidemic and related overdoses and the loved ones who must face the pain of those lost.  This is what motivates many others to create and join efforts to combat the epidemic within their communities.  Many of these leaders typically work in prevention, harm reduction, treatment, recovery support services, and other efforts that save lives and help those in need find recovery, but it may be necessary for communities to tailor messaging to suit a wide variety of audiences in a manner that speaks to the receiver’s particular interest.  When identifying champions or strategic alliances, communities should consider their most powerful levers for change.  Who or what in your community can unlock opportunity and accelerate change?  What is the backbone of your community?  Is it your local hospital system, community college, or a specific business or company?  Communities may find that some individuals or organizations may have conflicting viewpoints – try to approach them and open a door for conversation.  Sometimes non-traditional partners are only “non-traditional” because we label them as such.

 

= Key Community Members =

== Elected Officials and Local Health Leaders ==

Locally elected leaders and health officials can play a key role in leading efforts to improve the response to the SUD epidemic.  Mayors, County Executives, County Managers, Commissioners, and the local health leaders they appoint, can be powerful allies in raising public awareness about the extent of the problem, the availability of resources, and providing information on specific strategies, like harm reduction, that can help save lives.  In many instances, elected officials and local health officials might already be part of some type of community task force or other group charged with coordinating and improving local response to the epidemic; however, in the absence of such an effort, elected and health leaders can and should be engaged in raising awareness about the issue and solutions while also increasing support within the community.  

Elected leaders, and especially legislators, play an important role in the creation of budgets and ultimately decide on how local revenues are allocated to different programs, so it is critical they are aware of the scope of these issues in their communities and what is being done in response.  In most cases, they have political allies and are regularly invited to speak at community events or participate in meetings with diverse audiences where they can help to relay your message and share information about the response.

Although locally elected leaders are important champions, it’s also critical for a coalition to work alongside its state partners to help align efforts for maximum impact, inform policy, support funding, and make recommendations on scalability of programs that are working on-the-ground to avoid duplication or manage expectations that might not be feasible or sustainable at the local level.

=== Engagement Examples - Elected and Local Health Leaders ===

== Community Stakeholders and Infuencers ==

Anyone in your community can be a leader or a champion.  Drug misuse and substance use disorder affects a substantial number of residents in all communities.  Having a wide variety of stakeholders imbedded within the community can help to advance policies, programs, and systems that can work together and improve local response.  When appropriate, consider engaging other community partners to leverage efforts and boost support within the community.  These individuals in your community who could be key champions or partners along the way, but might not necessarily participate in the coalition.  Some examples might include:

*Health Professionals and Community Health Centers
*Hospital System Administration
*Faith Leaders
*Law Enforcement or other First Responders
*Public and Private School Systems
*Colleges, Universities, and Institutions of Higher Education
*Parent Groups
*Youth and Young Adults
*Local businesses, corporations, or the Chamber of Commerce
*Philanthropic Community

== Individuals with Lived Experience ==

Communities should also engage individuals with lived experience in decision-making roles - meaning those who have had first-hand involvement with substance use disorder and those who are friends or family members of those directly impacted.  Individuals with lived experience bring knowledge, understanding, and experience not learned through formal education.  To be most effective, it is imperative that communities honor and reflect the voices of those most impacted in their programs and systems. If possible, find ways to offer fair compensation for their time.  

= Improving Pubic Awareness And Engagement =

Public education and awareness is essential to activating a local community.  Residents need to know the unvarnished reality of what is taking place.  They need to know what the problem is, and what needs to be done to improve the local response and save lives.  In addition order to be educated, local residents also need to be involved in the process.  The people are the community, and many have first-hand experience with drug misuse and SUD.  Many others have lived experience with family and friends who are struggling with these issues, and their input and participation is needed to create a Comprehensive and effective Community

 

== Public Availability of Data ==

Making data available to the public can help increase awareness and move community members to take action.  Local data is particularly effective, as pepe are more likely to care and take action to help their own communities.  Many state and local communities have created data "dashboards" typically hosted and maintained by the state and local health departments.  These dashboards include information about opioids and other substances, and related data on overdoses.  

Most states and localities who have developed dashboards have greatly expanded available information to include additional data and information on other programs and efforts to address the epidemic.  These provide additional opportunities for community members to take action.  Topic covered in by one state include: <ref name="https://www.doh.wa.gov/DataandStatisticalReports/HealthDataVisualization/OpioidDashboards" />

Prescription Monitoring Program

Naloxone (Narcan)

Drug-related Hospital Visits

Crime Statistics

Treatment Statistics

Viral Hepatitis

Neonatal Abstinence Syndrome

An additional example of a state wide dashboard can be seen [https://www.doh.wa.gov/DataandStatisticalReports/HealthDataVisualization/OpioidDashboards here.]

 

== Community Education Programs ==

 

== Building Strategic Partnerships ==

 

== Develop Outreach Strategies ==

 

 

= Overcoming Stigma =

== Anti--Stigma Campaigns: ==

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.  It was designed to include a toolkit for communities who want to replicate the campaign locally and use it a community mobilizing tool to drum up political will and raise awareness about local efforts underway to combat stigma.  By using the pledge as a catalyst, communities can identify new stakeholders who can be activated and drive social impact, as well as help to change behaviors at scale.

State of Massachusetts - Sate Without StigMA. <ref>https://www.mass.gov/state-without-stigma
</ref> The State of Massachusetts has developed a comprehensive anti-stigma campaign at the State level.  This resource provides information about what stigma is, how it contributes to the current epidemic, and personal stories of people who talk about their own experiences with stigma and how they overcame it to find help for themselves and others in a variety of settings.

 

 <br/>

[[Category:Community Resources]]

Prevent First Time Use and Misuse through Education

2020-12-18T15:57:43Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

 

 

 

 

= Overview =

Prevention is defined as the action of stopping something from happening or arising.  Prevention through education can be an effective way to prevent drug misuse and substance use disorder, which will reduce the numbers of overdose and fatal overdose within a community.  These are often longer term strategies, especially within the context of educating young people about the dangers and realities of starting to use substances.  

Educational prevention programs can - and should - start at an early age.  Society often promotes and glamorizes substance use, and young people are often exposed to substance use within their families and often feel peer pressure from friends who are using substances.  These are powerful forces in a young person's life that can be counteracted with effective education programs.

Education and prevention is an important part of helping individuals understand the dangers of drugs and alcohol. The main focus of drug education and prevention is teaching individuals about drug and alcohol abuse and the harmful impacts it has on people's lives.  For this reason hearing stories from those with lived experience is a powerful prevention tool.  There is no substitute from being face to face with someone and hearing first hand what their experience was like. These and other types of programs can help a person learn how to avoid, stop, or get help for addiction. 

Efforts also include those that target parents and provide them with the tools needed to educate their children about the dangers of drug use.  Parents are also educated to bet aware of warning signs that their child may already be using.  This can lead to an early intervention that often prevents the progression into substance use disorder.

The types of prevention programs are nearly endless.  Many successful approaches have been developed to target all types of populations.  Programs have been developed to focus on different age groups, different racial and ethnic backgrounds, schools, families, faith-based organizations, doctors, pharmacists, and the wider community.  The types of prevention programs are also extensive.  While many focus on the impacts of drug use (including different drugs like prescription medications), others focus on building up the individual and helping them address risk factors like anxiety and trauma that often lead to drug use.  Other prevention programs take the form of public awareness campaigns that seek to educate and warn large numbers of people. A good overview of prevention programs can be found [https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf here].

 

 

= Key Topics and Strategies =

The following resources pages focus on a number of key strategies that have been effective in preventing first time use and abuse.

One area of focus involves know the <u>dangers of prescription medications</u>, especially opioids and other pain medications.  The "first wave" of te current epidemic started when powerful pain medications were developed, heavily marketed, and often over-prescribed.  The addictive nature of these medications was largely unknown, and millions of people developed substance use disorder as a result.  Strategies include how to educate both patients who are prescribed these medications and parents of children who may be prescribed - or given the option to be prescribed - pain medication.

Young people are perhaps the most critical population to target with prevention programs.  Strategies included target where young people are located and the unseen risk factors that often lead to drug misuse and substance use disorder.  School based prevention programs are highlighted, including how to educate youth and create resistance to peer pressure to use drugs.

Looking at the underlying trauma and other mental health challenges many youth face is truly at the core of effective prevention.  Many people first start misusing drug to self-medicate and escape the depression, anxiety, and anger caused by traumatic events they have experienced.  Even without major trauma, an increasing number of young people are feeling stress and anxiety at high levels where again they seek relief by using drugs.  Educating youth about this reality and encouraging them to express these feeling and get needed help can achieve tremendous benefits for the individuals and entire community,

 

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

Hanley Foundation.  The [https://hanleyfoundation.org/prevention/ Hanley Foundation] is a national non-profit with a variety of prevention initiatives.  

United Nations Educational, Scientific and Cultural Organization. Good Policy and Practice in Health Education - "[https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf Education Sector Responses to use of Alcohol, Tobacco and Drugs]."

 

 

 

Prevent First Time Use and Misuse through Education

2020-12-18T15:54:33Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

 

 

 

 

= Overview =

Prevention is defined as the action of stopping something from happening or arising.  Prevention through education can be an effective way to prevent drug misuse and substance use disorder, which will reduce the numbers of overdose and fatal overdose within a community.  These are often longer term strategies, especially within the context of educating young people about the dangers and realities of starting to use substances.  

Educational prevention programs can - and should - start at an early age.  Society often promotes and glamorizes substance use, and young people are often exposed to substance use within their families and often feel peer pressure from friends who are using substances.  These are powerful forces in a young person's life that can be counteracted with effective education programs.

Education and prevention is an important part of helping individuals understand the dangers of drugs and alcohol. The main focus of drug education and prevention is teaching individuals about drug and alcohol abuse and the harmful impacts it has on people's lives.  For this reason hearing stories from those with lived experience is a powerful prevention tool.  There is no substitute from being face to face with someone and hearing first hand what their experience was like. These and other types of programs can help a person learn how to avoid, stop, or get help for addiction. 

Efforts also include those that target parents and provide them with the tools needed to educate their children about the dangers of drug use.  Parents are also educated to bet aware of warning signs that their child may already be using.  This can lead to an early intervention that often prevents the progression into substance use disorder.

The types of prevention programs are nearly endless.  Many successful approaches have been developed to target all types of populations.  Programs have been developed to focus on different age groups, different racial and ethnic backgrounds, schools, families, faith-based organizations, doctors, pharmacists, and the wider community.  The types of prevention programs are also extensive.  While many focus on the impacts of drug use (including different drugs like prescription medications), others focus on building up the individual and helping them address risk factors like anxiety and trauma that often lead to drug use.  Other prevention programs take the form of public awareness campaigns that seek to educate and warn large numbers of people. A good overview of prevention programs can be found [https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf here].

 

= Key Topics and Strategies =

The following resources pages focus on a number of key strategeis that have been effective in preventing first time use and abuse.

One area of focus involves know the <u>dangers of prescription medications</u>, especially opioids and other pain medications.  The "first wave" of te current epedimic started when powerful pain medications were developed, heavily marketed, and often over-prescribed.  The addictive nature of these medications was largely unknown, and millions of people developed substance use disorder as a result.  Strateegies include how to educate both patients who are prescribed these medications and parents of children who may be prescribed - or given the option to be prescribed - pain medication.

Young people are perhaps the most critical population to target with prevention programs.  Strategies included target where young people are located and the unseen risk factors that oftern lead to drug misuse and substance use disorder.  School based prevention programs are higlighted, including how to educate youth and create resistance to peer pressure to use drugs.

Looking at the underlying trauma and other mental health challenges many youth face is truly at the core of effective prevention.  Many people first start misusing drug to self-medicate and escape the depression, anxiety, and anger caused by traumatic events they have experienced.  Even without major trauma, an increasing number of young perople are feeling stress and anxiety at hiigh levels where again they seek relief by using drugs.  Educating youth about this reality and encouraging them to express these feeling and get needed help can achive tremendous benefiits for the individuals and entire community,

 

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

Hanley Foundation.  The [https://hanleyfoundation.org/prevention/ Hanley Foundation] is a national non-profit with a variety of prevention initiatives.  

United Nations Educational, Scientific and Cultural Organization. Good Policy and Practice in Health Education - "[https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf Education Sector Responses to use of Alcohol, Tobacco and Drugs]."

 

 

 

Prevent First Time Use and Misuse through Education

2020-12-18T15:44:40Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

 

 

 

 

= Overview =

Prevention is defined as the action of stopping something from happening or arising.  Prevention through education can be an effective way to prevent drug misuse and substance use disorder, which will reduce the numbers of overdose and fatal overdose within a community.  These are often longer term strategies, especially within the context of educating young people about the dangers and realities of starting to use substances.  

Educational prevention programs can - and should - start at an early age.  Society often promotes and glamorizes substance use, and young people are often exposed to substance use within their families and often feel peer pressure from friends who are using substances.  These are powerful forces in a young person's life that can be counteracted with effective education programs.

Education and prevention is an important part of helping individuals understand the dangers of drugs and alcohol. The main focus of drug education and prevention is teaching individuals about drug and alcohol abuse and the harmful impacts it has on people's lives.  For this reason hearing stories from those with lived experience is a powerful prevention tool.  There is no substitute from being face to face with someone and hearing first hand what their experience was like. These and other types of programs can help a person learn how to avoid, stop, or get help for addiction. 

Efforts also include those that target parents and provide them with the tools needed to educate their children about the dangers of drug use.  Parents are also educated to bet aware of warning signs that their child may already be using.  This can lead to an early intervention that often prevents the progression into substance use disorder.

The types of prevention programs are nearly endless.  Many successful approaches have been developed to target all types of populations.  Programs have been developed to focus on different age groups, different racial and ethnic backgrounds, schools, families, faith-based organizations, doctors, pharmacists, and the wider community.  The types of prevention programs are also extensive.  While many focus on the impacts of drug use (including different drugs like prescription medications), others focus on building up the individual and helping them address risk factors like anxiety and trauma that often lead to drug use.  Other prevention programs take the form of public awareness campaigns that seek to educate and warn large numbers of people. A good overview of prevention programs can be found [https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf here].

 

= Key Topics and Strategies =

The following resources pages focus on a number of key strategeis that have been effective in preventing first time use and abuse.

One area of focus involves know the <u>dangers of prescription medications</u>, especially opioids and other pain medications.  The "first wave" of te current epedimic started when powerful pain medications were developed, heavily marketed, and often over-prescribed.  The addictive nature of these medications was largely unknown, and millions of people developed substance use disorder as a result.  Strateegies include how to educate both patients who are prescribed these medications and parents of children who may be prescribed - or given the option to be prescribed - pain medication.

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

Hanley Foundation.  The [https://hanleyfoundation.org/prevention/ Hanley Foundation] is a national non-profit with a variety of prevention initiatives.  

United Nations Educational, Scientific and Cultural Organization. Good Policy and Practice in Health Education - "[https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf Education Sector Responses to use of Alcohol, Tobacco and Drugs]."

 

 

 

Prevent First Time Use and Misuse through Education

2020-12-18T15:41:00Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

 

 

 

 

= Overview =

Prevention is defined as the action of stopping something from happening or arising.  Prevention through education can be an effective way to prevent drug misuse and substance use disorder, which will reduce the numbers of overdose and fatal overdose within a community.  These are often longer term strategies, especially within the context of educating young people about the dangers and realities of starting to use substances.  

Educational prevention programs can - and should - start at an early age.  Society often promotes and glamorizes substance use, and young people are often exposed to substance use within their families and often feel peer pressure from friends who are using substances.  These are powerful forces in a young person's life that can be counteracted with effective education programs.

Education and prevention is an important part of helping individuals understand the dangers of drugs and alcohol. The main focus of drug education and prevention is teaching individuals about drug and alcohol abuse and the harmful impacts it has on people's lives.  For this reason hearing stories from those with lived experience is a powerful prevention tool.  There is no substitute from being face to face with someone and hearing first hand what their experience was like. These and other types of programs can help a person learn how to avoid, stop, or get help for addiction. 

Efforts also include those that target parents and provide them with the tools needed to educate their children about the dangers of drug use.  Parents are also educated to bet aware of warning signs that their child may already be using.  This can lead to an early intervention that often prevents the progression into substance use disorder.

The types of prevention programs are nearly endless.  Many successful approaches have been developed to target all types of populations.  Programs have been developed to focus on different age groups, different racial and ethnic backgrounds, schools, families, faith-based organizations, doctors, pharmacists, and the wider community.  The types of prevention programs are also extensive.  While many focus on the impacts of drug use (including different drugs like prescription medications), others focus on building up the individual and helping them address risk factors like anxiety and trauma that often lead to drug use.  Other prevention programs take the form of public awareness campaigns that seek to educate and warn large numbers of people. A good overview of prevention programs can be found [https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf here].

 

= Key Topics and Strategies =

The following resources pages focus on a number of key strategeis that have been effective in preventing first time use and abuse.

One area of focus involves know the <u>dangers of prescription medications</u>, especially opioids and other pain medications.  The "first wave" of te current epedimic started when powerful pain medications were developed, heavily marketed, and often over-prescribed.  The addictive nature of these medications was largely unknown, and millions of people developed substance use disorder as a result. 

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

Hanley Foundation.  The [https://hanleyfoundation.org/prevention/ Hanley Foundation] is a national non-profit with a variety of prevention initiatives.  

United Nations Educational, Scientific and Cultural Organization. Good Policy and Practice in Health Education - "[https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf Education Sector Responses to use of Alcohol, Tobacco and Drugs]."

 

 

 

Prevent First Time Use and Misuse through Education

2020-12-18T15:29:12Z

Pkalch:

Prevent First Time Use and Misuse through Education

2020-12-18T14:59:05Z

Pkalch:

Prevent First Time Use and Misuse through Education

2020-12-18T14:57:57Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

 

= Overview =

Prevention is defined as the action of stpping something from happening or arising.  Prevention through education can be an effective way to prevent drug misuse and substance use disorder, which will reduce the numbers of overdose and fatal overdose witin a community.  These are often longer term strategies, especially withn the context of educating young people about the dangers and realites of starting to use substances.  

Educational prevention programs can - and should - start at an early age.  Society often promotes and glamorizes substance use, and young people are often exposed to substance use within their families and often feel peer pressure from friends who are using substances.  These are powerful forces in a young person's life that can be counteracted with effective education programs.

Education and prevention is an important part of helping individuals understand the dangers of drugs and alcohol. The main focus of drug education and prevention is teaching individuals about drug and alcohol abuse and the harmful impacts it has on people's lives.  For this reason haearing stories from those with lived experience is a powerful prevention tool.  There is no substitute from being face to face with someone and hearing first hand what teir experience was like. These and other types of programs can help a person learn how to avoid, stop, or get help for addiction. 

Efforts also include those that target parents and provide them wiith the tools needed to educate their children about the dangeers of drug use.  Parents are also educated to bet aware of warning signs that their child may already be using.  This can lead to an early intervention that often prevents the progression into substance use disorder.

The types of prevention programs are nearly endless.  Many successful approaches have been developed to target all types of populations.  Programs have been developed to focus on different age groups, different racial and ethnic backgrounds, schools, families, faith-based organizations, and the wider community.  The types of prevention programs are also extensive.  Wile many focus on the impacts of drug use, others focus on building up the individual and helping them address risk factors like anxiety and trauma that often lead to drug use.  Other prevention programs take the form of public awareness campaigns that seek to eduacate and warn large numbers of people.

 

 

 

= Key Topics and Strategies =

 

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

Hanley Foundation.  The [https://hanleyfoundation.org/prevention/ Hanley Foundation] is a national non-profit with a variety of prevention initiatives.  

United Nations Educational, Scientific and Cultural Organization. Good Policy and Practice in Health Education - "[https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf Education Sector Responses to use of Alcohol, Tobacco and Drugs]."

 

 

 

Prevent First Time Use and Misuse through Education

2020-12-18T14:52:51Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

 

= Overview =

Prevention is defined as the action of stpping something from happening or arising.  Prevention through education can be an effective way to prevent drug misuse and substance use disorder, which will reduce the numbers of overdose and fatal overdose witin a community.  These are often longer term strategies, especially withn the context of educating young people about the dangers and realites of starting to use substances.  

Educational prevention programs can - and should - start at an early age.  Society often promotes and glamorizes substance use, and young people are often exposed to substance use within their families and often feel peer pressure from friends who are using substances.  These are powerful forces in a young person's life that can be counteracted with effective education programs.

Education and prevention is an important part of helping individuals understand the dangers of drugs and alcohol. The main focus of drug education and prevention is teaching individuals about drug and alcohol abuse and the harmful impacts it has on people's lives.  For this reason haearing stories from those with lived experience is a powerful prevention tool.  There is no substitute from being face to face with someone and hearing first hand what teir experience was like. These and other types of programs can help a person learn how to avoid, stop, or get help for addiction. 

Efforts also include those that target parents and provide them wiith the tools needed to educate their children about the dangeers of drug use.  Parents are also educated to bet aware of warning signs that their child may already be using.  This can lead to an early intervention that often prevents the progression into substance use disorder.

The types of prevention programs are nearly endless.  Many successful approaches have been developed to target all types of populations.  Programs are built to focus on different age groups, different racial and ethnic backgrounds, schools, faith-based organizations, and the wider community.

 

 

 

= Key Topics and Strategies =

 

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

Hanley Foundation.  The [https://hanleyfoundation.org/prevention/ Hanley Foundation] is a national non-profit with a variety of prevention initiatives.  

United Nations Educational, Scientific and Cultural Organization. Good Policy and Practice in Health Education - "[https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf Education Sector Responses to use of Alcohol, Tobacco and Drugs]."

 

 

 

Prevent First Time Use and Misuse through Education

2020-12-18T00:03:19Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

 

= Overview =

Prevention is defined as the action of stpping something from happening or arising.  Prevention through education can be an effective way to stop drug misuse and substance use disorder, which will reduce the numbers of overdose and fatal overdose witin a community.  These are often longer term strategies, especially withn the context of educating young people about the dangers and realites of starting to use substances.  

Educational prevention programs can - and should - start at an early age.  Society often promotes and glamorizes substance use, and young people are often exposed to substance use within their families and often feel peer pressure from friends who are using substances.  These are powerful forces in a young person's life that can be counteracted with effective education programs.

Education and prevention is an important part of helping individuals understand the dangers of drugs and alcohol. The main focus of drug education and prevention is teaching individuals about drug and alcohol abuse. Education can help a person learn how to avoid, stop, or get help for addiction.  Effort include those that target parents and provide them wiith the tools needed to educating their children about the dangeers of drug use.  Parents are also educated so they are aware of warning signs that their child may already be using.  This can lead to an early intervention that often prevents the progression into substance use disorder.

Drug education and prevention for adolescents is typically part of most school curriculums. Adults can also benefit from drug education and prevention and can attend classes, group meetings, and research information online in order to learn more about the topic. Generally, drug education and prevention are important for children, teens, and adults alike. There are countless misconceptions about commonly used legal and illegal substances like alcohol and marijuana. When children become educated about drugs and alcohol early in life, it does prevent future use.

 

 

 

= Key Topics and Strategies =

 

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

Hanley Foundation.  The [https://hanleyfoundation.org/prevention/ Hanley Foundation] is a national non-profit with a variety of prevention initiatives.  

United Nations Educational, Scientific and Cultural Organization. Good Policy and Practice in Health Education - "[https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf Education Sector Responses to use of Alcohol, Tobacco and Drugs]."

 

 

 

Prevent First Time Use and Misuse through Education

2020-12-17T23:44:39Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

 

= Overview =

Education about substance misuse and substance use disorder is a powerful prevention tool.

Drug education and prevention is an important part of helping individuals understand the dangers of drugs and alcohol. The main focus of drug education and prevention is teaching individuals about drug and alcohol abuse. Education should help a person learn how to avoid, stop, or get help for addiction. The ideal time for drug education and prevention is early childhood. Education can start with parents educating their children and primary school programming that provides drug education and prevention.

Drug education and prevention for adolescents is typically part of most school curriculums. Adults can also benefit from drug education and prevention and can attend classes, group meetings, and research information online in order to learn more about the topic. Generally, drug education and prevention are important for children, teens, and adults alike. There are countless misconceptions about commonly used legal and illegal substances like alcohol and marijuana. When children become educated about drugs and alcohol early in life, it does prevent future use.

 

 

 

= Key Topics and Strategies =

 

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

Hanley Foundation.  The [https://hanleyfoundation.org/prevention/ Hanley Foundation] is a national non-profit with a variety of prevention initiatives.  

United Nations Educational, Scientific and Cultural Organization. Good Policy and Practice in Health Education - "[https://www.unodc.org/documents/drug-prevention-and-treatment/UNODC_UNESCO_WHO_GoodPolicyAndPracticeInHealthEducation.pdf Education Sector Responses to use of Alcohol, Tobacco and Drugs]."

 

 

 

Prevent First Time Use and Misuse through Education

2020-12-17T23:44:12Z

Pkalch:

Prevent First Time Use and Misuse through Education

2020-12-17T23:27:11Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

= Overview =

Education about substance misuse and substance use disorder is a powerful prevention tool.

Drug education and prevention is an important part of helping individuals understand the dangers of drugs and alcohol. The main focus of drug education and prevention is teaching individuals about drug and alcohol abuse. Education should help a person learn how to avoid, stop, or get help for addiction. The ideal time for drug education and prevention is early childhood. Education can start with parents educating their children and primary school programming that provides drug education and prevention.

Drug education and prevention for adolescents is typically part of most school curriculums. Adults can also benefit from drug education and prevention and can attend classes, group meetings, and research information online in order to learn more about the topic. Generally, drug education and prevention are important for children, teens, and adults alike. There are countless misconceptions about commonly used legal and illegal substances like alcohol and marijuana. When children become educated about drugs and alcohol early in life, it does prevent future use.

 

 

 

= Key Topics and Strategies =

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

Hanley Foundation.  The [https://hanleyfoundation.org/prevention/ Hanley Foundation] is a national non-profit with a variety of prevention initiatives.  

 

 

= Sources =

Prevent First Time Use and Misuse through Education

2020-12-17T23:25:28Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

= Overview =

Education about substance misuse and substance use disorder is a powerful prevention tool.

Drug education and prevention is an important part of helping individuals understand the dangers of drugs and alcohol. The main focus of drug education and prevention is teaching individuals about drug and alcohol abuse. Education should help a person learn how to avoid, stop, or get help for addiction. The ideal time for drug education and prevention is early childhood. Education can start with parents educating their children and primary school programming that provides drug education and prevention.

Drug education and prevention for adolescents is typically part of most school curriculums. Adults can also benefit from drug education and prevention and can attend classes, group meetings, and research information online in order to learn more about the topic. Generally, drug education and prevention are important for children, teens, and adults alike. There are countless misconceptions about commonly used legal and illegal substances like alcohol and marijuana. When children become educated about drugs and alcohol early in life, it does prevent future use.

 

 

 

= Key Topics and Strategies =

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

 

 

 

= Sources =

Prevent First Time Use and Misuse through Education

2020-12-17T23:22:17Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] ''

----

= Overview =

Education about substance misuse and substance use disorder is a powerful prevention tool.

 

 

= Key Topics and Strategies =

 

 

= References and Related Articles =

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, [https://www.ncbi.nlm.nih.gov/books/NBK424857/pdf/Bookshelf_NBK424857.pdf Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health]. Washington, DC: HHS, November 2016.

 

 

 

= Sources =

Improve Recovery Supports

2020-12-16T19:45:21Z

Pkalch:

''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]''

----

 

= Overview =

Recovery support can look like many different things for a person and their individual pathway to recovery. This is a crucial component of viewing SUD as a chronic disorder requiring long-term care.  Individuals entering recovery through treatment, the criminal justice system, or on there own often face many challenges in early recovery.  It is important that communities examine what supports are available, identify further needs, and ensure those with the greatest need have access to these supports.

Individuals who do not have these needs met are more likely to relapse.  Communities that fund these supports help those in early recovery re-engage with the community, increase self-esteem, and become highly productive members of their communities.  Providing effective recovery supports prevents relapse, the need to engage additional treatment and other services, and reduces the numbers of overdose.  Communities that have invested in recovery supports have seen a substantial return on their investment both in financial and human terms.

== Recovery Defined ==

SAMHSA defines recovery as:

'''Recovery is a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential.''' <ref name="https://www.samhsa.gov/find-help/recovery" />

SAMHSA also identifies four major dimensions that support recovery:

*Health—overcoming or managing one’s disease(s) or symptoms and making informed, healthy choices that support physical and emotional well-being.
*Home—having a stable and safe place to live.
*Purpose—conducting meaningful daily activities and having the independence, income, and resources to participate in society.
*Community—having relationships and social networks that provide support, friendship, love, and hope.

 

= Key Topics and Strategies =

The resources pages that follow address the key of support.  These include:

=== Recovery Housing ===

Perhaps the most basic support needed is housing and food.  Without this there can be no security or the ability for focus on health and recovery.  In many cases going home is not a safe option for those new to recovery.  A stable housing situation is foundational and allows growth and progress in other areas to take place.  Resources included focus on how to find safe, affordable, and supportive recovery housing options in communities across the country.

=== Education and Job Training.   ===

Finding meaning and purpose in one's life is important to all, but is especially critical to a person who has not found, or has lost, that purpose.  The ability to get and hold a job, get a promotion, improve one's education, and become independent are all important needs for many in early recovery.  Safe Solutions includes resources and information designed to help people in recovery develop the tools they need to find that purpose and achieve their goals.

=== Collegiate and High School Recovery Support ===

Many in early recovery find recovery while still in high school or college.  Many others enter high school or college after beginning their recovery journey.  Building an infrastructure of recovery support withing these specific communities is another area of focus, where it is possible to learn both where programs currently exist and the tools used by others to create these supports at colleges and high schools.

=== Improving Connections. ===

Many of the strategies come under the broad umbrella of improving connections.  Isolation is the enemy of recovery.  Connections include those to others in recovery across a number of peer-led support organizations and others that can help support the recovery of an individuals - including peer recovery specialists and recovery coaches. Family connections are also addressed and resources focus on helping the family recover and be able to support members in recovery

Other connections include those made in the wider community and even regional/national organizations that can help foster connection to others who provide support for individuals in recovery.

 

= References and Related Articles =

=== SAMHSA - [https://www.samhsa.gov/find-help/recovery Recovery and Recovery Supports] ===

 

 

Improve Data Sharing, Analysis, and Monitoring

2020-12-16T15:01:20Z

Pkalch:

Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]

 

Data collection, analysis, and reporting are critical components to strengthening a community’s response to drug misuse and substance use disorder.  By sharing and regularly monitoring data, communities can build credibility, raise awareness and political will, share knowledge, identify more effective interventions and strategies, guide decision making, and allow for better budgeting and allocation of funds.  For a community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets in your community.

 

__TOC__

 

= Understanding the Problem =

A key goal of any effort to address the current epidemic is to use multi-sector data to inform assessment, planning, and implementation.  It is not uncommon for most communities to have to break down existing data silos so that various public, private, and community partners can engage effectively.  This process is important because it increases understanding and fosters collaboration.  All participants need to understand what is happening in their community in order to have agreement about what strategies would be most effective. 

== Where to Start and Key Questions to Consider ==

Substance use disorder and drug misuse are complex problems requiring a complete set of solutions.  Data collection and building a sufficient data set can often be challenging, so communities should expect to be met with some level of resistance.  Many agencies who represent important sources of data are often not accustomed to working with others and sharing the data they have available.  There might be questions of confidentiality and many communities work hard to establish trusting relationships with outside entities.  One way to overcome this challenge is to first establish an identified leader(s) to coordinate and gather needed data and regularly summarize and report on data findings.  These are often individuals in the public health sector, who have the experience and expertise necessary to collect, analyze, and present data in a way that is clear and easy to understand.  Once leadership of the data effort is determined, discussions can take place between agencies and other sources to determine what data each has, if they are willing and able to share it, and what restriction may exist in doing so.  In most cases all parties want to help save lives and improve their community, and any issues can be worked out with little difficulty.  

In some communities, there may not already be a data collection effort across the entire system.  In that case, start with your exploration of data by looking at the most severe harms - including fatal and non-fatal overdoses.  Knowing the numbers is important to understand the scope of the problem, but to guide response more data is required.  For example, where are the geographic regions of where overdoses occurring?  What are the demographics of those areas?  What type of substance, or combination, is involved?  How often are we collecting data?

This starting point typically leads to other questions that require additional data in order to identify gaps in services and the implementation of strategies to fill such gaps.  Some examples might include:

'''For non-fatal overdoses, how many go to a hospital or community health center?'''

'''How many non-fatal overdoses are revived with naloxone?  Who administers naloxone - first responders or others?'''

'''Are there clusters of overdoses occurring in specific areas and neighborhoods?'''

'''What are we currently doing?  Are overdose prevention services being offered in areas with high overdose rates?  '''

'''What drugs are residents using?  What are the trends?  What are youth substance use rates?  '''

'''What are the local opioid prescribing practices?'''

'''Are people experiencing overdose being connected to services?  How is this being done, and by whom?'''

'''Are area treatment and other support services at capacity?  Are there wait times or wait lists to get in?'''

'''How many who need MAT are receiving it?  Does this include the criminal justice system?'''

'''Are recovery support services - including housing, job training, coaching, and education - available and do they meet the needs of the community?'''

'''For those involved in the criminal justice system, is there a history or presence of substance use problems?'''

== Data Sharing Agreements ==

Collaboration across systems is crucial for any community’s response efforts.  It is important for communities to understand the federal and state legal framework since some data might contain protected health information.  For more information about best practices for sharing data across behavioral health and criminal justice systems, please see [https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/CSG_CJMH_Info_Sharing.pdf here].  

Even in situations where agencies wish to share data, often some type of data sharing agreement is required.  Parties will want to know that confidential or other sensitive data will not be disclosed publicly or beyond a limited number of participants.  While the creating of such documents is often done by counsel in order to address privacy issues and compliance with laws and regulations, there are many boiler-plate examples that can be used and altered to meet the requirements of most agencies and other community partners.

Examples of data sharing agreements related to healthcare can be found [https://www.neighborhoodindicators.org/library/catalog/collection-example-data-sharing-agreements-health-healthcare here].

This[https://www.hhs.gov/sites/default/files/new-faqs-on-sharing-information.pdf FAQ] resource from HHS provides information about requiements and limits to information sharing agreements.

== Other Potential Data Sources ==

Before collecting any new data, the next step is to scan existing sources and locate the data.  Identify where the data is currently being captured and who has access to the needed data.  Perhaps, your community has already conducted a recent needs assessment?  During this process, you may find that some data is missing or interpreted differently across organizations.  Spend time with administrators discussing how they compile their data and what data elements are comprised of specific indicators.  To make sure your data is statistically sound and there are no errors, it is important that administrators are working from the same definitions and make an effort to link potential data sources where applicable.  

'''In some cases, you may be able to access local data through public records, but common sources and the types of data organizations can typically provide include:'''

'''Local and State Health Departments (number of overdoses, locations, demographics)'''

'''Fire/EMS Services (portion of overdoses, connection to services, naloxone administration)'''

'''Police and Public Safety Departments (number of overdoses, drug seizures, drug-related crime, diversion, and MAT in correctional facilities)'''

'''Medical Examiner/Corners Reports (cause of death from overdose, type of substance(s) involved)'''

'''911 Calls (calls related to suspected overdose)'''

'''Local Hospitals and Community Health Organizations (number of non-fatal overdoses, connection to services, naloxone administration)'''

'''Local Harm Reduction Service Providers (naloxone and needle distribution, connection to services)'''

'''Treatment Providers (treatment capacity and availability, wait times, MAT providers)'''

'''Pharmacies (records on naloxone distribution to indicate awareness and/or increased use)'''

'''Prescription Drug Monitoring Program (PDMP) (identify high risk prescribers)'''

'''Recovery Support Services (amount and adequacy of peers, availability of housing, access to job training, tracking data on clients remaining in recovery)'''

 

== The Story Behind the Data ==

Communities should explore the ultimate root cause of the problem that might not be immediately apparent.  In addition to the availability of quantitative data, communities may capture and track qualitative data to describe the story behind the numbers through community surveys, listening sessions, public forums, interviews, observations, case studies, or focus groups that analyze trends in drug use, types of drugs, and community perception of the problem.  For deeper examination, ask questions about accessibility, affordability, availability, and cultural relevance of programs and policies.  As you seek input, honor the perspectives and voice of those who will be most impacted by the coalition’s decisions and engage with individuals who you are directly trying to serve in discussions and decision-making in order to understand barriers that residents face.  And, if you are able, provide compensation for their time.  For more information about qualitative and quantitative methods and the role of ethics in research, please see [https://press.rebus.community/introductiontocommunitypsychology/chapter/community-research/ here]. 

The [https://www.safeproject.us/resource/community-pulse-survey/ SAFE Community Pulse Survey] examines your community’s perceptions of the opioid and addiction crisis through a short survey.  It is not mean to be a scientific analysis of attitudes and perceptions, but rather to give you a snapshot of how the community as a whole perceives the issues your coalition will be tacking.  This is also a great way to let the broader community know about your coalition’s focus and to engage with other community members.  Not everyone will agree on the best approaches; the climate survey allows the community to “speak for itself.”  

== Scanning Community Resources ==

Sometimes when individual community sectors do their work to mitigate the opioid and addiction crisis, they are so busy doing good work that they aren’t aware of other services the community offers and how they might interact.  They don’t have the time to survey the landscape and see what else is available.  Focusing your community’s efforts does not mean doing only one thing to combat the epidemic.  By identifying your community’s attitudes and perceptions, as well as gaps in services, you will be better able to focus your available time and energy on paths that have the most opportunity for impact.  [https://www.safeproject.us/resource/community-resources-exercise/ The SAFE Community Resources Exercise] seeks to address this issue by helping coalition members understand the resources their fellow members bring to the table as well as educate the coalition about the depth and breadth of other services that are offered in the community.

== Reviewing Your Assessment ==

Once you have reviewed any existing data, work alongside your stakeholder group or coalition to identify any gaps in data and determine if any new data should be collected.  Did you find everything you were looking for?  How will we know when we have enough data?  Communities can spend a lot of time analyzing and discussing data.  While data should be at the forefront of the coalition’s decision-making, it’s important to balance how much time is dedicated to data discussions and move from planning toward prioritization and action.

 

= Tracking and Monitoring Data =

Communities might initially collect only baseline data, but the benefits of tracking data trends over time include accountability, monitoring changes with statistical significance to act more swiftly, to influence policy, and to communicate and raise awareness about a particular problem.  The identified lead should determine the frequency on how often to collect data and coordinate collection efforts to regularly monitor data.  

Where communities are able, they should disaggregate population level data by race and ethnicity to identify disparities.  Other options for how to disaggregate data include: age, sex, veteran status, marital status, education, citizenship, disability status, primary language spoken at home, and employment status.  Similarly, communities can use their data to drill down to specific areas in the community to explore gaps in access to services and ensure appropriate allocation of resources by analyzing data by city, village, service area, neighborhood, district, or even Census tract.

To help put your community data into context of the bigger picture, you may consider comparing your data or benchmarking across other communities with a similar makeup, your state, and even national levels.  Some national sources of data might include:  

[https://www.cdc.gov/datastatistics/index.html Centers for Disease Control]

[https://www.datafiles.samhsa.gov/info/data-portal-nid17200 SAMHSA] Annual Survey Data

[https://www.census.gov/programs-surveys/acs/data.html Census ACS]

Robert Woods Johnson Foundation - [https://www.countyhealthrankings.org/ County Health Rankings]

 

== Building Performance Measures ==

Developing and tracking performance measures allows community groups to track the impacts of their efforts and help them determine which strategies are working well and which my need to be modified.  It may demonstrate that new approaches are needed.  Tracking progress is also helpful to keeping up momentum - allowing the group to see the beneficial results of their efforts.  Celebrating progress made is important. 

=== Reporting Data ===

It will be up to each community to decide what data to collect and report about, and what data should be made public.  The data report should continually educate and drive informed decision making related to addressing the crises.  Data tracking the number and locations of overdoses, for example, can provide the community with the knowledge of where overdoses are taking place, what hot spots exist, and therefore where focus is needed.  This allows a community to focus resources where they are needed by adding or expanding services like those related to prevention, harm reduction, and connection to services through peers or other means.  Other parts of the reports may include available treatment and recovery housing beds, naloxone distribution numbers, number of prescribed MAT in various setting, number of interventions, and so forth.  What is required is what is needed to first guide strategy and then be able to track the effectiveness of those strategies over time.

Analysts may choose a variety of methods for sharing their data to include Geographic Information Systems (GIS), line graphs, bar charts, tables, and pie charts.  It is critical for an analyst to use care when displaying and illustrating data because it is important to find a balance between creating a visualization that is effective for the reader and providing a picture, but also doing it in a way that accurately displays the data rather than skews the interpretation.  Charts and graphs should be easy to read, aesthetically pleasing, well-labeled, include the totals for columns and rows, be scaled accurately, and developed with the audience in mind.  Illustrate the most important information and keep the graphic simple and ask for help and research best practices if you are not well versed in the creation of charts and graphs.

=== Data Systems ===

To maintain a strong data infrastructure, communities have a variety of options.  Investments in off-the-shelf software systems are available for purchase and can help to combine and monitor data from various state and local organizations, provide a connection to services, and serve as a tool for tracking system performance indicators and outcomes over time.  If there is limited funding available, communities can do this using spreadsheet or database software (like Microsoft Excel or Access).

=== Public Reporting Examples ===

In many cases not all data collected will be made public.  However, developing a data report that is made public is done by most communities due to the fact that it raises awareness about the problem and the real impacts it is having within the community.  This can be done through a dashboard or other regularly updated report made available by local government or a local task force/opioid response team where they exist.

Here are some links to different dashboards and data mapping efforts:

New Hampshire Drug Monitoring Initiative

Allegheny County Data Warehouse

 

= Making Data Informed Decisions =

A targeted data collection and analysis effort will enable decision makers to develop effective approaches to achieve results.  Continued communication and sharing of data is key and will lead to greater collaboration between agencies that have and share data as well as other community stakeholders involved with developing and implementing strategies and programs.  These community stakeholders can help "translate" the data from multiple sources to help with decision-making.  Often new partnerships are forged when the data reveals what needs to be addressed and who can effectively address those identified needs.

Another common lesson learned from experience is that decision makers need to be willing to experiment and constantly adjust the approaches they take.  Even at the local level aspects of this epidemic change and sometimes change rapidly.  Leaders need to continually collect and analyze data in order to detect these changes and make adjustment.

= Additional Resources =

=== New Jersey Overdose Data Dashboard - [https://www.state.nj.us/health/populationhealth/opioid/ https://www.state.nj.us/health/populationhealth/opioid/] ===

=== Cincinnati Overdose Response - [https://insights.cincinnati-oh.gov/stories/s/Heroin-Overdose-Responses/dm3s-ep3u/ https://insights.cincinnati-oh.gov/stories/s/Heroin-Overdose-Responses/dm3s-ep3u/] ===

=== Harvard Institute for Excellence in Government  (Case studies on data driven approaches) ===

[https://scholar.harvard.edu/files/janewiseman/files/data_driven_approaches_to_fighting_the_opioid_crisis_jane_wiseman_april_2019.pdf https://scholar.harvard.edu/files/janewiseman/files/data_driven_approaches_to_fighting_the_opioid_crisis_jane_wiseman_april_2019.pdf]

=== ''RxStat (New York, NY)''<sup>[3]</sup> ===

*'''Partners''': the New York City Department of Health and Mental Hygiene with their public safety partners.
*'''Approach''': RxStat consists of two general phases: collecting timely and accurate data and using the data to develop targeted interventions aimed at reducing overdose deaths.
*'''Outcomes''': Staten Island has seen a 29 percent decrease in prescription opioid deaths since officials first began implementing RxStat.

 

=== ''Project Vision (Rutland, VT)''<sup>[4]</sup> ===

*'''Partners''': Rutland Police Department (led by Chief Brian Kilcullen), elected officials, representatives from the medical field, social service providers, local businesses, criminal justice agencies, schools, nonprofit organizations, mental health providers, faith-based groups, federal and state law enforcement agencies, and other stakeholders.
*'''How it works''': RuStat meetings every other week. During the meetings, representatives from the police department present specific addresses within the community that have been the subject of three or more police visits during the previous two-week period. Project VISION members can then determine whether they are familiar with the addresses through their own work—for example, a social worker who is at the meeting may have a client at the address. From there, Project VISION partners can devise a plan to provide the person identified with the appropriate services. According to Scott Tucker, Executive Director of Project VISION, many of the crimes associated with drug use have decreased since the program started.
*'''Outcomes''': From 2014-2016, burglaries decreased by 60 percent, shoplifting decreased by 36 percent, and larcenies went down by 40 percent.
*'''Website''': [http://projectvisionrutland.com/ [1]]
*'''Contact''': [http://projectvisionrutland.com/contact/ [2]]

 

=== ''Local Overdose Fatality Review program (Maryland)'' ===

*'''Partners''': Maryland Department of Health and Mental Hygeine (DHMH), overdose fatality review teams in each county in the state.
*'''How it works''': For each overdose incident, the DHMH provides the local review team with information from the state medical examiner’s office including raw information about the death and any substances found during the medical examination and other information it can gather such as the deceased’s drug treatment records. Team members must sign a confidentiality agreement to obtain access to protected health information. The local review teams examine these data and all other information they receive about each case. Based on this review, the team develops a set of findings about what potentially could have been done to prevent the death including any missed opportunities for prevention, gaps in the system, and areas for increased collaboration among agencies and stakeholders at the local level. The team also develops recommendations for how these deficiencies could be addressed through changes in laws, policies, and protocols.The review team’s findings and recommendations are shared with officials at the state level, who use the information to inform policies and programs aimed at preventing future overdose deaths.<sup>[5]</sup>
*'''Outcomes''':
**Quality of referral systems improved
**Increased focus on outreach to families to provide overdose prevention & treatment services by local health departments and other providers
**Identification of new target audiences for Overdose Response Program (naloxone) trainings
**Increased awareness of member agency staff of overdose related issues and Overdose Response Program training for member agency staff
**Changes to intake questionnaires to include questions about overdose history
*'''Website:''' [http://bha.dhmh.maryland.gov/OVERDOSE_PREVENTION/Pages/OFR-.aspx [3]]
*'''Contact''': Erin Haas (Program Manager) [[mailto:erin.haas@maryland.gov.%20|erin.haas@maryland.gov [4]]]

=== Deloitte Center for Health Solutions (DCHS) ===

The Deloitte Center for Health Solutions, part of Deloitte LPP's Life Sciences and Health Care practice, is a source for fresh perspectives in health care. It looks deeper at the biggest industry issues and provides new thinking around complex challenges. Cutting-edge research and thought-provoking analysis give their clients the insights they need to see things differently, and address the changing landscape.<sup>[7]</sup> DCHS developed a report called, "[http://www.modernhealthcare.com/assets/pdf/CH115670524.PDF Strategies for stemming the opioid crisis]" that describes how data analytics can help health plans and pharmacy benefit managers chart their course. To learn more about the DCHS and their research, visit [http://www.deloitte.com/centerforhealthsolutions [5]].

  According to their major findings, potential strategies for health plans and pharmacy benefit managers (PBMs) include:<sup>[8]</sup>

*Leveraging data and emerging technologies
*Working toward more streamlined data collection and sharing
*Supporting the development of evidence-based standards and quality metrics to define and encourage successful treatment
*Advocating for policy changes at the federal level

<br/> This complex, multifaceted problem calls for systematic solutions across the healthcare system.<sup>[9]</sup> Read more about [https://www2.deloitte.com/insights/us/en/industry/health-care/strategies-health-plans-pbms-to-stem-opioid-crisis-with-data-technology.html#interactive?id=us:2el:3dp:mdrnhlth:eng:lshc:060118 strategies for stemming the opioid crisis].

 

<span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

Improve Data Sharing, Analysis, and Monitoring

2020-12-16T15:00:25Z

Pkalch:

Improve Data Sharing, Analysis, and Monitoring

2020-12-16T14:54:08Z

Pkalch:

Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]

 

Data collection, analysis, and reporting are critical components to strengthening a community’s response to drug misuse and substance use disorder.  By sharing and regularly monitoring data, communities can build credibility, raise awareness and political will, share knowledge, identify more effective interventions and strategies, guide decision making, and allow for better budgeting and allocation of funds.  For a community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets in your community.

 

__TOC__

 

= Understanding the Problem =

A key goal of any effort to address the current epidemic is to use multi-sector data to inform assessment, planning, and implementation.  It is not uncommon for most communities to have to break down existing data silos so that various public, private, and community partners can engage effectively.  This process is important because it increases understanding and fosters collaboration.  All participants need to understand what is happening in their community in order to have agreement about what strategies would be most effective. 

== Where to Start and Key Questions to Consider ==

Substance use disorder and drug misuse are complex problems requiring a complete set of solutions.  Data collection and building a sufficient data set can often be challenging, so communities should expect to be met with some level of resistance.  Many agencies who represent important sources of data are often not accustomed to working with others and sharing the data they have available.  There might be questions of confidentiality and many communities work hard to establish trusting relationships with outside entities.  One way to overcome this challenge is to first establish an identified leader(s) to coordinate and gather needed data and regularly summarize and report on data findings.  These are often individuals in the public health sector, who have the experience and expertise necessary to collect, analyze, and present data in a way that is clear and easy to understand.  Once leadership of the data effort is determined, discussions can take place between agencies and other sources to determine what data each has, if they are willing and able to share it, and what restriction may exist in doing so.  In most cases all parties want to help save lives and improve their community, and any issues can be worked out with little difficulty.  

In some communities, there may not already be a data collection effort across the entire system.  In that case, start with your exploration of data by looking at the most severe harms - including fatal and non-fatal overdoses.  Knowing the numbers is important to understand the scope of the problem, but to guide response more data is required.  For example, where are the geographic regions of where overdoses occurring?  What are the demographics of those areas?  What type of substance, or combination, is involved?  How often are we collecting data?

This starting point typically leads to other questions that require additional data in order to identify gaps in services and the implementation of strategies to fill such gaps.  Some examples might include:

'''For non-fatal overdoses, how many go to a hospital or community health center?'''

'''How many non-fatal overdoses are revived with naloxone?  Who administers naloxone - first responders or others?'''

'''Are there clusters of overdoses occurring in specific areas and neighborhoods?'''

'''What are we currently doing?  Are overdose prevention services being offered in areas with high overdose rates?  '''

'''What drugs are residents using?  What are the trends?  What are youth substance use rates?  '''

'''What are the local opioid prescribing practices?'''

'''Are people experiencing overdose being connected to services?  How is this being done, and by whom?'''

'''Are area treatment and other support services at capacity?  Are there wait times or wait lists to get in?'''

'''How many who need MAT are receiving it?  Does this include the criminal justice system?'''

'''Are recovery support services - including housing, job training, coaching, and education - available and do they meet the needs of the community?'''

'''For those involved in the criminal justice system, is there a history or presence of substance use problems?'''

== Data Sharing Agreements ==

Collaboration across systems is crucial for any community’s response efforts.  It is important for communities to understand the federal and state legal framework since some data might contain protected health information.  For more information about best practices for sharing data across behavioral health and criminal justice systems, please see [https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/CSG_CJMH_Info_Sharing.pdf here].  

Even in situations where agencies wish to share data, often some type of data sharing agreement is required.  Parties will want to know that confidential or other sensitive data will not be disclosed publicly or beyond a limited number of participants.  While the creating of such documents is often done by counsel in order to address privacy issues and compliance with laws and regulations, there are many boiler-plate examples that can be used and altered to meet the requirements of most agencies and other community partners.

Examples of data sharing agreements related to healthcare can be found [https://www.neighborhoodindicators.org/library/catalog/collection-example-data-sharing-agreements-health-healthcare here].

This[https://www.hhs.gov/sites/default/files/new-faqs-on-sharing-information.pdf FAQ] resource from HHS provides information about requiements and limits to information sharing agreements.

== Other Potential Data Sources ==

Before collecting any new data, the next step is to scan existing sources and locate the data.  Identify where the data is currently being captured and who has access to the needed data.  Perhaps, your community has already conducted a recent needs assessment?  During this process, you may find that some data is missing or interpreted differently across organizations.  Spend time with administrators discussing how they compile their data and what data elements are comprised of specific indicators.  To make sure your data is statistically sound and there are no errors, it is important that administrators are working from the same definitions and make an effort to link potential data sources where applicable.  

'''In some cases, you may be able to access local data through public records, but common sources and the types of data organizations can typically provide include:'''

'''Local and State Health Departments (number of overdoses, locations, demographics)'''

'''Fire/EMS Services (portion of overdoses, connection to services, naloxone administration)'''

'''Police and Public Safety Departments (number of overdoses, drug seizures, drug-related crime, diversion, and MAT in correctional facilities)'''

'''Medical Examiner/Corners Reports (cause of death from overdose, type of substance(s) involved)'''

'''911 Calls (calls related to suspected overdose)'''

'''Local Hospitals and Community Health Organizations (number of non-fatal overdoses, connection to services, naloxone administration)'''

'''Local Harm Reduction Service Providers (naloxone and needle distribution, connection to services)'''

'''Treatment Providers (treatment capacity and availability, wait times, MAT providers)'''

'''Pharmacies (records on naloxone distribution to indicate awareness and/or increased use)'''

'''Prescription Drug Monitoring Program (PDMP) (identify high risk prescribers)'''

'''Recovery Support Services (amount and adequacy of peers, availability of housing, access to job training, tracking data on clients remaining in recovery)'''

 

== The Story Behind the Data ==

Communities should explore the ultimate root cause of the problem that might not be immediately apparent.  In addition to the availability of quantitative data, communities may capture and track qualitative data to describe the story behind the numbers through community surveys, listening sessions, public forums, interviews, observations, case studies, or focus groups that analyze trends in drug use, types of drugs, and community perception of the problem.  For deeper examination, ask questions about accessibility, affordability, availability, and cultural relevance of programs and policies.  As you seek input, honor the perspectives and voice of those who will be most impacted by the coalition’s decisions and engage with individuals who you are directly trying to serve in discussions and decision-making in order to understand barriers that residents face.  And, if you are able, provide compensation for their time.  For more information about qualitative and quantitative methods and the role of ethics in research, please see [https://press.rebus.community/introductiontocommunitypsychology/chapter/community-research/ here]. 

The [https://www.safeproject.us/resource/community-pulse-survey/ SAFE Community Pulse Survey] examines your community’s perceptions of the opioid and addiction crisis through a short survey.  It is not mean to be a scientific analysis of attitudes and perceptions, but rather to give you a snapshot of how the community as a whole perceives the issues your coalition will be tacking.  This is also a great way to let the broader community know about your coalition’s focus and to engage with other community members.  Not everyone will agree on the best approaches; the climate survey allows the community to “speak for itself.”  

== Scanning Community Resources ==

Sometimes when individual community sectors do their work to mitigate the opioid and addiction crisis, they are so busy doing good work that they aren’t aware of other services the community offers and how they might interact.  They don’t have the time to survey the landscape and see what else is available.  Focusing your community’s efforts does not mean doing only one thing to combat the epidemic.  By identifying your community’s attitudes and perceptions, as well as gaps in services, you will be better able to focus your available time and energy on paths that have the most opportunity for impact.  [https://www.safeproject.us/resource/community-resources-exercise/ The SAFE Community Resources Exercise] seeks to address this issue by helping coalition members understand the resources their fellow members bring to the table as well as educate the coalition about the depth and breadth of other services that are offered in the community.

== Reviewing Your Assessment ==

Once you have reviewed any existing data, work alongside your stakeholder group or coalition to identify any gaps in data and determine if any new data should be collected.  Did you find everything you were looking for?  How will we know when we have enough data?  Communities can spend a lot of time analyzing and discussing data.  While data should be at the forefront of the coalition’s decision-making, it’s important to balance how much time is dedicated to data discussions and move from planning toward prioritization and action.

 

= Tracking and Monitoring Data =

Communities might initially collect only baseline data, but the benefits of tracking data trends over time include accountability, monitoring changes with statistical significance to act more swiftly, to influence policy, and to communicate and raise awareness about a particular problem.  The identified lead should determine the frequency on how often to collect data and coordinate collection efforts to regularly monitor data.  

Where communities are able, they should disaggregate population level data by race and ethnicity to identify disparities.  Other options for how to disaggregate data include: age, sex, veteran status, marital status, education, citizenship, disability status, primary language spoken at home, and employment status.  Similarly, communities can use their data to drill down to specific areas in the community to explore gaps in access to services and ensure appropriate allocation of resources by analyzing data by city, village, service area, neighborhood, district, or even Census tract.

To help put your community data into context of the bigger picture, you may consider comparing your data or benchmarking across other communities with a similar makeup, your state, and even national levels.  Some national sources of data might include:  

[https://www.cdc.gov/datastatistics/index.html Centers for Disease Control]

[https://www.datafiles.samhsa.gov/info/data-portal-nid17200 SAMHSA] Annual Survey Data

[https://www.census.gov/programs-surveys/acs/data.html Census ACS]

Robert Woods Johnson Foundation - [https://www.countyhealthrankings.org/ County Health Rankings]

 

== Building Performance Measures ==

=== Reporting Data ===

It will be up to each community to decide what data to collect and report about, and what data should be made public.  The data report should continually educate and drive informed decision making related to addressing the crises.  Data tracking the number and locations of overdoses, for example, can provide the community with the knowledge of where overdoses are taking place, what hot spots exist, and therefore where focus is needed.  This allows a community to focus resources where they are needed by adding or expanding services like those related to prevention, harm reduction, and connection to services through peers or other means.  Other parts of the reports may include available treatment and recovery housing beds, naloxone distribution numbers, number of prescribed MAT in various setting, number of interventions, and so forth.  What is required is what is needed to first guide strategy and then be able to track the effectiveness of those strategies over time.

Analysts may choose a variety of methods for sharing their data to include Geographic Information Systems (GIS), line graphs, bar charts, tables, and pie charts.  It is critical for an analyst to use care when displaying and illustrating data because it is important to find a balance between creating a visualization that is effective for the reader and providing a picture, but also doing it in a way that accurately displays the data rather than skews the interpretation.  Charts and graphs should be easy to read, aesthetically pleasing, well-labeled, include the totals for columns and rows, be scaled accurately, and developed with the audience in mind.  Illustrate the most important information and keep the graphic simple and ask for help and research best practices if you are not well versed in the creation of charts and graphs.

=== Data Systems ===

To maintain a strong data infrastructure, communities have a variety of options.  Investments in off-the-shelf software systems are available for purchase and can help to combine and monitor data from various state and local organizations, provide a connection to services, and serve as a tool for tracking system performance indicators and outcomes over time.  If there is limited funding available, communities can do this using spreadsheet or database software (like Microsoft Excel or Access).

=== Public Reporting Examples ===

In many cases not all data collected will be made public.  However, developing a data report that is made public is done by most communities due to the fact that it raises awareness about the problem and the real impacts it is having within the community.  This can be done through a dashboard or other regularly updated report made available by local government or a local task force/opioid response team where they exist.

Here are some links to different dashboards and data mapping efforts:

New Hampshire Drug Monitoring Initiative

Allegheny County Data Warehouse

 

= Making Data Informed Decisions =

A targeted data collection and analysis effort will enable decision makers to develop effective approaches to achieve results.  Continued communication and sharing of data is key and will lead to greater collaboration between agencies that have and share data as well as other community stakeholders involved with developing and implementing strategies and programs.  These community stakeholders can help "translate" the data from multiple sources to help with decision-making.  Often new partnerships are forged when the data reveals what needs to be addressed and who can effectively address those identified needs.

Another common lesson learned from experience is that decision makers need to be willing to experiment and constantly adjust the approaches they take.  Even at the local level aspects of this epidemic change and sometimes change rapidly.  Leaders need to continually collect and analyze data in order to detect these changes and make adjustment.

= Additional Resources =

=== New Jersey Overdose Data Dashboard - [https://www.state.nj.us/health/populationhealth/opioid/ https://www.state.nj.us/health/populationhealth/opioid/] ===

=== Cincinnati Overdose Response - [https://insights.cincinnati-oh.gov/stories/s/Heroin-Overdose-Responses/dm3s-ep3u/ https://insights.cincinnati-oh.gov/stories/s/Heroin-Overdose-Responses/dm3s-ep3u/] ===

=== Harvard Institute for Excellence in Government  (Case studies on data driven approaches) ===

[https://scholar.harvard.edu/files/janewiseman/files/data_driven_approaches_to_fighting_the_opioid_crisis_jane_wiseman_april_2019.pdf https://scholar.harvard.edu/files/janewiseman/files/data_driven_approaches_to_fighting_the_opioid_crisis_jane_wiseman_april_2019.pdf]

=== ''RxStat (New York, NY)''<sup>[3]</sup> ===

*'''Partners''': the New York City Department of Health and Mental Hygiene with their public safety partners.
*'''Approach''': RxStat consists of two general phases: collecting timely and accurate data and using the data to develop targeted interventions aimed at reducing overdose deaths.
*'''Outcomes''': Staten Island has seen a 29 percent decrease in prescription opioid deaths since officials first began implementing RxStat.

 

=== ''Project Vision (Rutland, VT)''<sup>[4]</sup> ===

*'''Partners''': Rutland Police Department (led by Chief Brian Kilcullen), elected officials, representatives from the medical field, social service providers, local businesses, criminal justice agencies, schools, nonprofit organizations, mental health providers, faith-based groups, federal and state law enforcement agencies, and other stakeholders.
*'''How it works''': RuStat meetings every other week. During the meetings, representatives from the police department present specific addresses within the community that have been the subject of three or more police visits during the previous two-week period. Project VISION members can then determine whether they are familiar with the addresses through their own work—for example, a social worker who is at the meeting may have a client at the address. From there, Project VISION partners can devise a plan to provide the person identified with the appropriate services. According to Scott Tucker, Executive Director of Project VISION, many of the crimes associated with drug use have decreased since the program started.
*'''Outcomes''': From 2014-2016, burglaries decreased by 60 percent, shoplifting decreased by 36 percent, and larcenies went down by 40 percent.
*'''Website''': [http://projectvisionrutland.com/ [1]]
*'''Contact''': [http://projectvisionrutland.com/contact/ [2]]

 

=== ''Local Overdose Fatality Review program (Maryland)'' ===

*'''Partners''': Maryland Department of Health and Mental Hygeine (DHMH), overdose fatality review teams in each county in the state.
*'''How it works''': For each overdose incident, the DHMH provides the local review team with information from the state medical examiner’s office including raw information about the death and any substances found during the medical examination and other information it can gather such as the deceased’s drug treatment records. Team members must sign a confidentiality agreement to obtain access to protected health information. The local review teams examine these data and all other information they receive about each case. Based on this review, the team develops a set of findings about what potentially could have been done to prevent the death including any missed opportunities for prevention, gaps in the system, and areas for increased collaboration among agencies and stakeholders at the local level. The team also develops recommendations for how these deficiencies could be addressed through changes in laws, policies, and protocols.The review team’s findings and recommendations are shared with officials at the state level, who use the information to inform policies and programs aimed at preventing future overdose deaths.<sup>[5]</sup>
*'''Outcomes''':
**Quality of referral systems improved
**Increased focus on outreach to families to provide overdose prevention & treatment services by local health departments and other providers
**Identification of new target audiences for Overdose Response Program (naloxone) trainings
**Increased awareness of member agency staff of overdose related issues and Overdose Response Program training for member agency staff
**Changes to intake questionnaires to include questions about overdose history
*'''Website:''' [http://bha.dhmh.maryland.gov/OVERDOSE_PREVENTION/Pages/OFR-.aspx [3]]
*'''Contact''': Erin Haas (Program Manager) [[mailto:erin.haas@maryland.gov.%20|erin.haas@maryland.gov [4]]]

=== Deloitte Center for Health Solutions (DCHS) ===

The Deloitte Center for Health Solutions, part of Deloitte LPP's Life Sciences and Health Care practice, is a source for fresh perspectives in health care. It looks deeper at the biggest industry issues and provides new thinking around complex challenges. Cutting-edge research and thought-provoking analysis give their clients the insights they need to see things differently, and address the changing landscape.<sup>[7]</sup> DCHS developed a report called, "[http://www.modernhealthcare.com/assets/pdf/CH115670524.PDF Strategies for stemming the opioid crisis]" that describes how data analytics can help health plans and pharmacy benefit managers chart their course. To learn more about the DCHS and their research, visit [http://www.deloitte.com/centerforhealthsolutions [5]].

  According to their major findings, potential strategies for health plans and pharmacy benefit managers (PBMs) include:<sup>[8]</sup>

*Leveraging data and emerging technologies
*Working toward more streamlined data collection and sharing
*Supporting the development of evidence-based standards and quality metrics to define and encourage successful treatment
*Advocating for policy changes at the federal level

<br/> This complex, multifaceted problem calls for systematic solutions across the healthcare system.<sup>[9]</sup> Read more about [https://www2.deloitte.com/insights/us/en/industry/health-care/strategies-health-plans-pbms-to-stem-opioid-crisis-with-data-technology.html#interactive?id=us:2el:3dp:mdrnhlth:eng:lshc:060118 strategies for stemming the opioid crisis].

 

<span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

Improve Data Sharing, Analysis, and Monitoring

2020-12-16T14:48:40Z

Pkalch:

Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]

 

Data collection, analysis, and reporting are critical components to strengthening a community’s response to drug misuse and substance use disorder.  By sharing and regularly monitoring data, communities can build credibility, raise awareness and political will, share knowledge, identify more effective interventions and strategies, guide decision making, and allow for better budgeting and allocation of funds.  For a community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets in your community.

 

__TOC__

 

= Understanding the Problem =

A key goal of any effort to address the current epidemic is to use multi-sector data to inform assessment, planning, and implementation.  It is not uncommon for most communities to have to break down existing data silos so that various public, private, and community partners can engage effectively.  This process is important because it increases understanding and fosters collaboration.  All participants need to understand what is happening in their community in order to have agreement about what strategies would be most effective. 

== Where to Start and Key Questions to Consider ==

Substance use disorder and drug misuse are complex problems requiring a complete set of solutions.  Data collection and building a sufficient data set can often be challenging, so communities should expect to be met with some level of resistance.  Many agencies who represent important sources of data are often not accustomed to working with others and sharing the data they have available.  There might be questions of confidentiality and many communities work hard to establish trusting relationships with outside entities.  One way to overcome this challenge is to first establish an identified leader(s) to coordinate and gather needed data and regularly summarize and report on data findings.  These are often individuals in the public health sector, who have the experience and expertise necessary to collect, analyze, and present data in a way that is clear and easy to understand.  Once leadership of the data effort is determined, discussions can take place between agencies and other sources to determine what data each has, if they are willing and able to share it, and what restriction may exist in doing so.  In most cases all parties want to help save lives and improve their community, and any issues can be worked out with little difficulty.  

In some communities, there may not already be a data collection effort across the entire system.  In that case, start with your exploration of data by looking at the most severe harms - including fatal and non-fatal overdoses.  Knowing the numbers is important to understand the scope of the problem, but to guide response more data is required.  For example, where are the geographic regions of where overdoses occurring?  What are the demographics of those areas?  What type of substance, or combination, is involved?  How often are we collecting data?

This starting point typically leads to other questions that require additional data in order to identify gaps in services and the implementation of strategies to fill such gaps.  Some examples might include:

'''For non-fatal overdoses, how many go to a hospital or community health center?'''

'''How many non-fatal overdoses are revived with naloxone?  Who administers naloxone - first responders or others?'''

'''Are there clusters of overdoses occurring in specific areas and neighborhoods?'''

'''What are we currently doing?  Are overdose prevention services being offered in areas with high overdose rates?  '''

'''What drugs are residents using?  What are the trends?  What are youth substance use rates?  '''

'''What are the local opioid prescribing practices?'''

'''Are people experiencing overdose being connected to services?  How is this being done, and by whom?'''

'''Are area treatment and other support services at capacity?  Are there wait times or wait lists to get in?'''

'''How many who need MAT are receiving it?  Does this include the criminal justice system?'''

'''Are recovery support services - including housing, job training, coaching, and education - available and do they meet the needs of the community?'''

'''For those involved in the criminal justice system, is there a history or presence of substance use problems?'''

== Data Sharing Agreements ==

Collaboration across systems is crucial for any community’s response efforts.  It is important for communities to understand the federal and state legal framework since some data might contain protected health information.  For more information about best practices for sharing data across behavioral health and criminal justice systems, please see [https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/CSG_CJMH_Info_Sharing.pdf here].  

Even in situations where agencies wish to share data, often some type of data sharing agreement is required.  Parties will want to know that confidential or other sensitive data will not be disclosed publicly or beyond a limited number of participants.  While the creating of such documents is often done by counsel in order to address privacy issues and compliance with laws and regulations, there are many boiler-plate examples that can be used and altered to meet the requirements of most agencies and other community partners.

Examples of data sharing agreements related to healthcare can be found [https://www.neighborhoodindicators.org/library/catalog/collection-example-data-sharing-agreements-health-healthcare here].

This[https://www.hhs.gov/sites/default/files/new-faqs-on-sharing-information.pdf FAQ] resource from HHS provides information about requiements and limits to information sharing agreements.

== Other Potential Data Sources ==

Before collecting any new data, the next step is to scan existing sources and locate the data.  Identify where the data is currently being captured and who has access to the needed data.  Perhaps, your community has already conducted a recent needs assessment?  During this process, you may find that some data is missing or interpreted differently across organizations.  Spend time with administrators discussing how they compile their data and what data elements are comprised of specific indicators.  To make sure your data is statistically sound and there are no errors, it is important that administrators are working from the same definitions and make an effort to link potential data sources where applicable.  

'''In some cases, you may be able to access local data through public records, but common sources and the types of data organizations can typically provide include:'''

'''Local and State Health Departments (number of overdoses, locations, demographics)'''

'''Fire/EMS Services (portion of overdoses, connection to services, naloxone administration)'''

'''Police and Public Safety Departments (number of overdoses, drug seizures, drug-related crime, diversion, and MAT in correctional facilities)'''

'''Medical Examiner/Corners Reports (cause of death from overdose, type of substance(s) involved)'''

'''911 Calls (calls related to suspected overdose)'''

'''Local Hospitals and Community Health Organizations (number of non-fatal overdoses, connection to services, naloxone administration)'''

'''Local Harm Reduction Service Providers (naloxone and needle distribution, connection to services)'''

'''Treatment Providers (treatment capacity and availability, wait times, MAT providers)'''

'''Pharmacies (records on naloxone distribution to indicate awareness and/or increased use)'''

'''Prescription Drug Monitoring Program (PDMP) (identify high risk prescribers)'''

'''Recovery Support Services (amount and adequacy of peers, availability of housing, access to job training, tracking data on clients remaining in recovery)'''

 

== The Story Behind the Data ==

Communities should explore the ultimate root cause of the problem that might not be immediately apparent.  In addition to the availability of quantitative data, communities may capture and track qualitative data to describe the story behind the numbers through community surveys, listening sessions, public forums, interviews, observations, case studies, or focus groups that analyze trends in drug use, types of drugs, and community perception of the problem.  For deeper examination, ask questions about accessibility, affordability, availability, and cultural relevance of programs and policies.  As you seek input, honor the perspectives and voice of those who will be most impacted by the coalition’s decisions and engage with individuals who you are directly trying to serve in discussions and decision-making in order to understand barriers that residents face.  And, if you are able, provide compensation for their time.  For more information about qualitative and quantitative methods and the role of ethics in research, please see [https://press.rebus.community/introductiontocommunitypsychology/chapter/community-research/ here]. 

The [https://www.safeproject.us/resource/community-pulse-survey/ SAFE Community Pulse Survey] examines your community’s perceptions of the opioid and addiction crisis through a short survey.  It is not mean to be a scientific analysis of attitudes and perceptions, but rather to give you a snapshot of how the community as a whole perceives the issues your coalition will be tacking.  This is also a great way to let the broader community know about your coalition’s focus and to engage with other community members.  Not everyone will agree on the best approaches; the climate survey allows the community to “speak for itself.”  

== Scanning Community Resources ==

Sometimes when individual community sectors do their work to mitigate the opioid and addiction crisis, they are so busy doing good work that they aren’t aware of other services the community offers and how they might interact.  They don’t have the time to survey the landscape and see what else is available.  Focusing your community’s efforts does not mean doing only one thing to combat the epidemic.  By identifying your community’s attitudes and perceptions, as well as gaps in services, you will be better able to focus your available time and energy on paths that have the most opportunity for impact.  [https://www.safeproject.us/resource/community-resources-exercise/ The SAFE Community Resources Exercise] seeks to address this issue by helping coalition members understand the resources their fellow members bring to the table as well as educate the coalition about the depth and breadth of other services that are offered in the community.

== Reviewing Your Assessment ==

Once you have reviewed any existing data, work alongside your stakeholder group or coalition to identify any gaps in data and determine if any new data should be collected.  Did you find everything you were looking for?  How will we know when we have enough data?  Communities can spend a lot of time analyzing and discussing data.  While data should be at the forefront of the coalition’s decision-making, it’s important to balance how much time is dedicated to data discussions and move from planning toward prioritization and action.

 

= Tracking and Monitoring Data =

Communities might initially collect only baseline data, but the benefits of tracking data trends over time include accountability, monitoring changes with statistical significance to act more swiftly, to influence policy, and to communicate and raise awareness about a particular problem.  The identified lead should determine the frequency on how often to collect data and coordinate collection efforts to regularly monitor data.  

Where communities are able, they should disaggregate population level data by race and ethnicity to identify disparities.  Other options for how to disaggregate data include: age, sex, veteran status, marital status, education, citizenship, disability status, primary language spoken at home, and employment status.  Similarly, communities can use their data to drill down to specific areas in the community to explore gaps in access to services and ensure appropriate allocation of resources by analyzing data by city, village, service area, neighborhood, district, or even Census tract.

To help put your community data into context of the bigger picture, you may consider comparing your data or benchmarking across other communities with a similar makeup, your state, and even national levels.  Some national sources of data might include:  

Centers for Disease Control

HHS/SAMHSA

Census ACS

Robert Woods Johnson Foundation - [https://www.countyhealthrankings.org/ County Health Rankings]

 

== Building Performance Measures ==

=== Reporting Data ===

It will be up to each community to decide what data to collect and report about, and what data should be made public.  The data report should continually educate and drive informed decision making related to addressing the crises.  Data tracking the number and locations of overdoses, for example, can provide the community with the knowledge of where overdoses are taking place, what hot spots exist, and therefore where focus is needed.  This allows a community to focus resources where they are needed by adding or expanding services like those related to prevention, harm reduction, and connection to services through peers or other means.  Other parts of the reports may include available treatment and recovery housing beds, naloxone distribution numbers, number of prescribed MAT in various setting, number of interventions, and so forth.  What is required is what is needed to first guide strategy and then be able to track the effectiveness of those strategies over time.

Analysts may choose a variety of methods for sharing their data to include Geographic Information Systems (GIS), line graphs, bar charts, tables, and pie charts.  It is critical for an analyst to use care when displaying and illustrating data because it is important to find a balance between creating a visualization that is effective for the reader and providing a picture, but also doing it in a way that accurately displays the data rather than skews the interpretation.  Charts and graphs should be easy to read, aesthetically pleasing, well-labeled, include the totals for columns and rows, be scaled accurately, and developed with the audience in mind.  Illustrate the most important information and keep the graphic simple and ask for help and research best practices if you are not well versed in the creation of charts and graphs.

=== Data Systems ===

To maintain a strong data infrastructure, communities have a variety of options.  Investments in off-the-shelf software systems are available for purchase and can help to combine and monitor data from various state and local organizations, provide a connection to services, and serve as a tool for tracking system performance indicators and outcomes over time.  If there is limited funding available, communities can do this using spreadsheet or database software (like Microsoft Excel or Access).

=== Public Reporting Examples ===

In many cases not all data collected will be made public.  However, developing a data report that is made public is done by most communities due to the fact that it raises awareness about the problem and the real impacts it is having within the community.  This can be done through a dashboard or other regularly updated report made available by local government or a local task force/opioid response team where they exist.

Here are some links to different dashboards and data mapping efforts:

New Hampshire Drug Monitoring Initiative

Allegheny County Data Warehouse

 

= Making Data Informed Decisions =

A targeted data collection and analysis effort will enable decision makers to develop effective approaches to achieve results.  Continued communication and sharing of data is key and will lead to greater collaboration between agencies that have and share data as well as other community stakeholders involved with developing and implementing strategies and programs.  These community stakeholders can help "translate" the data from multiple sources to help with decision-making.  Often new partnerships are forged when the data reveals what needs to be addressed and who can effectively address those identified needs.

Another common lesson learned from experience is that decision makers need to be willing to experiment and constantly adjust the approaches they take.  Even at the local level aspects of this epidemic change and sometimes change rapidly.  Leaders need to continually collect and analyze data in order to detect these changes and make adjustment.

= Additional Resources =

=== New Jersey Overdose Data Dashboard - [https://www.state.nj.us/health/populationhealth/opioid/ https://www.state.nj.us/health/populationhealth/opioid/] ===

=== Cincinnati Overdose Response - [https://insights.cincinnati-oh.gov/stories/s/Heroin-Overdose-Responses/dm3s-ep3u/ https://insights.cincinnati-oh.gov/stories/s/Heroin-Overdose-Responses/dm3s-ep3u/] ===

=== Harvard Institute for Excellence in Government  (Case studies on data driven approaches) ===

[https://scholar.harvard.edu/files/janewiseman/files/data_driven_approaches_to_fighting_the_opioid_crisis_jane_wiseman_april_2019.pdf https://scholar.harvard.edu/files/janewiseman/files/data_driven_approaches_to_fighting_the_opioid_crisis_jane_wiseman_april_2019.pdf]

=== ''RxStat (New York, NY)''<sup>[3]</sup> ===

*'''Partners''': the New York City Department of Health and Mental Hygiene with their public safety partners.
*'''Approach''': RxStat consists of two general phases: collecting timely and accurate data and using the data to develop targeted interventions aimed at reducing overdose deaths.
*'''Outcomes''': Staten Island has seen a 29 percent decrease in prescription opioid deaths since officials first began implementing RxStat.

 

=== ''Project Vision (Rutland, VT)''<sup>[4]</sup> ===

*'''Partners''': Rutland Police Department (led by Chief Brian Kilcullen), elected officials, representatives from the medical field, social service providers, local businesses, criminal justice agencies, schools, nonprofit organizations, mental health providers, faith-based groups, federal and state law enforcement agencies, and other stakeholders.
*'''How it works''': RuStat meetings every other week. During the meetings, representatives from the police department present specific addresses within the community that have been the subject of three or more police visits during the previous two-week period. Project VISION members can then determine whether they are familiar with the addresses through their own work—for example, a social worker who is at the meeting may have a client at the address. From there, Project VISION partners can devise a plan to provide the person identified with the appropriate services. According to Scott Tucker, Executive Director of Project VISION, many of the crimes associated with drug use have decreased since the program started.
*'''Outcomes''': From 2014-2016, burglaries decreased by 60 percent, shoplifting decreased by 36 percent, and larcenies went down by 40 percent.
*'''Website''': [http://projectvisionrutland.com/ [1]]
*'''Contact''': [http://projectvisionrutland.com/contact/ [2]]

 

=== ''Local Overdose Fatality Review program (Maryland)'' ===

*'''Partners''': Maryland Department of Health and Mental Hygeine (DHMH), overdose fatality review teams in each county in the state.
*'''How it works''': For each overdose incident, the DHMH provides the local review team with information from the state medical examiner’s office including raw information about the death and any substances found during the medical examination and other information it can gather such as the deceased’s drug treatment records. Team members must sign a confidentiality agreement to obtain access to protected health information. The local review teams examine these data and all other information they receive about each case. Based on this review, the team develops a set of findings about what potentially could have been done to prevent the death including any missed opportunities for prevention, gaps in the system, and areas for increased collaboration among agencies and stakeholders at the local level. The team also develops recommendations for how these deficiencies could be addressed through changes in laws, policies, and protocols.The review team’s findings and recommendations are shared with officials at the state level, who use the information to inform policies and programs aimed at preventing future overdose deaths.<sup>[5]</sup>
*'''Outcomes''':
**Quality of referral systems improved
**Increased focus on outreach to families to provide overdose prevention & treatment services by local health departments and other providers
**Identification of new target audiences for Overdose Response Program (naloxone) trainings
**Increased awareness of member agency staff of overdose related issues and Overdose Response Program training for member agency staff
**Changes to intake questionnaires to include questions about overdose history
*'''Website:''' [http://bha.dhmh.maryland.gov/OVERDOSE_PREVENTION/Pages/OFR-.aspx [3]]
*'''Contact''': Erin Haas (Program Manager) [[mailto:erin.haas@maryland.gov.%20|erin.haas@maryland.gov [4]]]

=== Deloitte Center for Health Solutions (DCHS) ===

The Deloitte Center for Health Solutions, part of Deloitte LPP's Life Sciences and Health Care practice, is a source for fresh perspectives in health care. It looks deeper at the biggest industry issues and provides new thinking around complex challenges. Cutting-edge research and thought-provoking analysis give their clients the insights they need to see things differently, and address the changing landscape.<sup>[7]</sup> DCHS developed a report called, "[http://www.modernhealthcare.com/assets/pdf/CH115670524.PDF Strategies for stemming the opioid crisis]" that describes how data analytics can help health plans and pharmacy benefit managers chart their course. To learn more about the DCHS and their research, visit [http://www.deloitte.com/centerforhealthsolutions [5]].

  According to their major findings, potential strategies for health plans and pharmacy benefit managers (PBMs) include:<sup>[8]</sup>

*Leveraging data and emerging technologies
*Working toward more streamlined data collection and sharing
*Supporting the development of evidence-based standards and quality metrics to define and encourage successful treatment
*Advocating for policy changes at the federal level

<br/> This complex, multifaceted problem calls for systematic solutions across the healthcare system.<sup>[9]</sup> Read more about [https://www2.deloitte.com/insights/us/en/industry/health-care/strategies-health-plans-pbms-to-stem-opioid-crisis-with-data-technology.html#interactive?id=us:2el:3dp:mdrnhlth:eng:lshc:060118 strategies for stemming the opioid crisis].

 

<span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

Improve Data Sharing, Analysis, and Monitoring

2020-12-16T14:43:16Z

Pkalch:

Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]

 

Data collection, analysis, and reporting are critical components to strengthening a community’s response to drug misuse and substance use disorder.  By sharing and regularly monitoring data, communities can build credibility, raise awareness and political will, share knowledge, identify more effective interventions and strategies, guide decision making, and allow for better budgeting and allocation of funds.  For a community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets in your community.

 

__TOC__

 

= Understanding the Problem =

A key goal of any effort to address the current epidemic is to use multi-sector data to inform assessment, planning, and implementation.  It is not uncommon for most communities to have to break down existing data silos so that various public, private, and community partners can engage effectively.  This process is important because it increases understanding and fosters collaboration.  All participants need to understand what is happening in their community in order to have agreement about what strategies would be most effective. 

== Where to Start and Key Questions to Consider ==

Substance use disorder and drug misuse are complex problems requiring a complete set of solutions.  Data collection and building a sufficient data set can often be challenging, so communities should expect to be met with some level of resistance.  Many agencies who represent important sources of data are often not accustomed to working with others and sharing the data they have available.  There might be questions of confidentiality and many communities work hard to establish trusting relationships with outside entities.  One way to overcome this challenge is to first establish an identified leader(s) to coordinate and gather needed data and regularly summarize and report on data findings.  These are often individuals in the public health sector, who have the experience and expertise necessary to collect, analyze, and present data in a way that is clear and easy to understand.  Once leadership of the data effort is determined, discussions can take place between agencies and other sources to determine what data each has, if they are willing and able to share it, and what restriction may exist in doing so.  In most cases all parties want to help save lives and improve their community, and any issues can be worked out with little difficulty.  

In some communities, there may not already be a data collection effort across the entire system.  In that case, start with your exploration of data by looking at the most severe harms - including fatal and non-fatal overdoses.  Knowing the numbers is important to understand the scope of the problem, but to guide response more data is required.  For example, where are the geographic regions of where overdoses occurring?  What are the demographics of those areas?  What type of substance, or combination, is involved?  How often are we collecting data?

This starting point typically leads to other questions that require additional data in order to identify gaps in services and the implementation of strategies to fill such gaps.  Some examples might include:

'''For non-fatal overdoses, how many go to a hospital or community health center?'''

'''How many non-fatal overdoses are revived with naloxone?  Who administers naloxone - first responders or others?'''

'''Are there clusters of overdoses occurring in specific areas and neighborhoods?'''

'''What are we currently doing?  Are overdose prevention services being offered in areas with high overdose rates?  '''

'''What drugs are residents using?  What are the trends?  What are youth substance use rates?  '''

'''What are the local opioid prescribing practices?'''

'''Are people experiencing overdose being connected to services?  How is this being done, and by whom?'''

'''Are area treatment and other support services at capacity?  Are there wait times or wait lists to get in?'''

'''How many who need MAT are receiving it?  Does this include the criminal justice system?'''

'''Are recovery support services - including housing, job training, coaching, and education - available and do they meet the needs of the community?'''

'''For those involved in the criminal justice system, is there a history or presence of substance use problems?'''

== Data Sharing Agreements ==

Collaboration across systems is crucial for any community’s response efforts.  It is important for communities to understand the federal and state legal framework since some data might contain protected health information.  For more information about best practices for sharing data across behavioral health and criminal justice systems, please see [https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/CSG_CJMH_Info_Sharing.pdf here].  

Even in situations where agencies wish to share data, often some type of data sharing agreement is required.  Parties will want to know that confidential or other sensitive data will not be disclosed publicly or beyond a limited number of participants.  While the creating of such documents is often done by counsel in order to address privacy issues and compliance with laws and regulations, there are many boiler-plate examples that can be used and altered to meet the requirements of most agencies and other community partners.

Examples of data sharing agreements related to healthcare can be found [https://www.neighborhoodindicators.org/library/catalog/collection-example-data-sharing-agreements-health-healthcare here].

This[https://www.hhs.gov/sites/default/files/new-faqs-on-sharing-information.pdf FAQ] resource from HHS provides information about requiements and limits to information sharing agreements.

== Other Potential Data Sources ==

Before collecting any new data, the next step is to scan existing sources and locate the data.  Identify where the data is currently being captured and who has access to the needed data.  Perhaps, your community has already conducted a recent needs assessment?  During this process, you may find that some data is missing or interpreted differently across organizations.  Spend time with administrators discussing how they compile their data and what data elements are comprised of specific indicators.  To make sure your data is statistically sound and there are no errors, it is important that administrators are working from the same definitions and make an effort to link potential data sources where applicable.  

'''In some cases, you may be able to access local data through public records, but common sources and the types of data organizations can typically provide include:'''

'''Local and State Health Departments (number of overdoses, locations, demographics)'''

'''Fire/EMS Services (portion of overdoses, connection to services, naloxone administration)'''

'''Police and Public Safety Departments (number of overdoses, drug seizures, drug-related crime, diversion, and MAT in correctional facilities)'''

'''Medical Examiner/Corners Reports (cause of death from overdose, type of substance(s) involved)'''

'''911 Calls (calls related to suspected overdose)'''

'''Local Hospitals and Community Health Organizations (number of non-fatal overdoses, connection to services, naloxone administration)'''

'''Local Harm Reduction Service Providers (naloxone and needle distribution, connection to services)'''

'''Treatment Providers (treatment capacity and availability, wait times, MAT providers)'''

'''Pharmacies (records on naloxone distribution to indicate awareness and/or increased use)'''

'''Prescription Drug Monitoring Program (PDMP) (identify high risk prescribers)'''

'''Recovery Support Services (amount and adequacy of peers, availability of housing, access to job training, tracking data on clients remaining in recovery)'''

 

== The Story Behind the Data ==

Communities should explore the ultimate root cause of the problem that might not be immediately apparent.  In addition to the availability of quantitative data, communities may capture and track qualitative data to describe the story behind the numbers through community surveys, listening sessions, public forums, interviews, observations, case studies, or focus groups that analyze trends in drug use, types of drugs, and community perception of the problem.  For deeper examination, ask questions about accessibility, affordability, availability, and cultural relevance of programs and policies.  As you seek input, honor the perspectives and voice of those who will be most impacted by the coalition’s decisions and engage with individuals who you are directly trying to serve in discussions and decision-making in order to understand barriers that residents face.  And, if you are able, provide compensation for their time.  For more information about qualitative and quantitative methods and the role of ethics in research, please see [https://press.rebus.community/introductiontocommunitypsychology/chapter/community-research/ here]. 

The [https://www.safeproject.us/resource/community-pulse-survey/ SAFE Community Pulse Survey] examines your community’s perceptions of the opioid and addiction crisis through a short survey.  It is not mean to be a scientific analysis of attitudes and perceptions, but rather to give you a snapshot of how the community as a whole perceives the issues your coalition will be tacking.  This is also a great way to let the broader community know about your coalition’s focus and to engage with other community members.  Not everyone will agree on the best approaches; the climate survey allows the community to “speak for itself.”  

== Scanning Community Resources ==

Sometimes when individual community sectors do their work to mitigate the opioid and addiction crisis, they are so busy doing good work that they aren’t aware of other services the community offers and how they might interact.  They don’t have the time to survey the landscape and see what else is available.  Focusing your community’s efforts does not mean doing only one thing to combat the epidemic.  By identifying your community’s attitudes and perceptions, as well as gaps in services, you will be better able to focus your available time and energy on paths that have the most opportunity for impact.  [https://www.safeproject.us/resource/community-resources-exercise/ The SAFE Community Resources Exercise] seeks to address this issue by helping coalition members understand the resources their fellow members bring to the table as well as educate the coalition about the depth and breadth of other services that are offered in the community.

== Reviewing Your Assessment ==

Once you have reviewed any existing data, work alongside your stakeholder group or coalition to identify any gaps in data and determine if any new data should be collected.  Did you find everything you were looking for?  How will we know when we have enough data?  Communities can spend a lot of time analyzing and discussing data.  While data should be at the forefront of the coalition’s decision-making, it’s important to balance how much time is dedicated to data discussions and move from planning toward prioritization and action.

 

= Tracking and Monitoring Data =

Communities might initially collect only baseline data, but the benefits of tracking data trends over time include accountability, monitoring changes with statistical significance to act more swiftly, to influence policy, and to communicate and raise awareness about a particular problem.  The identified lead should determine the frequency on how often to collect data and coordinate collection efforts to regularly monitor data.  

Where communities are able, they should disaggregate population level data by race and ethnicity to identify disparities.  Other options for how to disaggregate data include: age, sex, veteran status, marital status, education, citizenship, disability status, primary language spoken at home, and employment status.  Similarly, communities can use their data to drill down to specific areas in the community to explore gaps in access to services and ensure appropriate allocation of resources by analyzing data by city, village, service area, neighborhood, district, or even Census tract.

To help put your community data into context of the bigger picture, you may consider comparing your data or benchmarking across other communities with a similar makeup, your state, and even national levels.  Some national sources of data might include:  

 

== Building Performance Measures ==

=== Reporting Data ===

It will be up to each community to decide what data to collect and report about, and what data should be made public.  The data report should continually educate and drive informed decision making related to addressing the crises.  Data tracking the number and locations of overdoses, for example, can provide the community with the knowledge of where overdoses are taking place, what hot spots exist, and therefore where focus is needed.  This allows a community to focus resources where they are needed by adding or expanding services like those related to prevention, harm reduction, and connection to services through peers or other means.  Other parts of the reports may include available treatment and recovery housing beds, naloxone distribution numbers, number of prescribed MAT in various setting, number of interventions, and so forth.  What is required is what is needed to first guide strategy and then be able to track the effectiveness of those strategies over time.

Analysts may choose a variety of methods for sharing their data to include Geographic Information Systems (GIS), line graphs, bar charts, tables, and pie charts.  It is critical for an analyst to use care when displaying and illustrating data because it is important to find a balance between creating a visualization that is effective for the reader and providing a picture, but also doing it in a way that accurately displays the data rather than skews the interpretation.  Charts and graphs should be easy to read, aesthetically pleasing, well-labeled, include the totals for columns and rows, be scaled accurately, and developed with the audience in mind.  Illustrate the most important information and keep the graphic simple and ask for help and research best practices if you are not well versed in the creation of charts and graphs.

=== Data Systems ===

To maintain a strong data infrastructure, communities have a variety of options.  Investments in off-the-shelf software systems are available for purchase and can help to combine and monitor data from various state and local organizations, provide a connection to services, and serve as a tool for tracking system performance indicators and outcomes over time.  If there is limited funding available, communities can do this using spreadsheet or database software (like Microsoft Excel or Access).

=== Public Reporting Examples ===

In many cases not all data collected will be made public.  However, developing a data report that is made public is done by most communities due to the fact that it raises awareness about the problem and the real impacts it is having within the community.  This can be done through a dashboard or other regularly updated report made available by local government or a local task force/opioid response team where they exist.

Here are some links to different dashboards and data mapping efforts:

New Hampshire Drug Monitoring Initiative

Allegheny County Data Warehouse

 

= Making Data Informed Decisions =

A targeted data collection and analysis effort will enable decision makers to develop effective approaches to achieve results.  Continued communication and sharing of data is key and will lead to greater collaboration between agencies that have and share data as well as other community stakeholders involved with developing and implementing strategies and programs.  These community stakeholders can help "translate" the data from multiple sources to help with decision-making.  Often new partnerships are forged when the data reveals what needs to be addressed and who can effectively address those identified needs.

Another common lesson learned from experience is that decision makers need to be willing to experiment and constantly adjust the approaches they take.  Even at the local level aspects of this epidemic change and sometimes change rapidly.  Leaders need to continually collect and analyze data in order to detect these changes and make adjustment.

= Additional Resources =

=== New Jersey Overdose Data Dashboard - [https://www.state.nj.us/health/populationhealth/opioid/ https://www.state.nj.us/health/populationhealth/opioid/] ===

=== Cincinnati Overdose Response - [https://insights.cincinnati-oh.gov/stories/s/Heroin-Overdose-Responses/dm3s-ep3u/ https://insights.cincinnati-oh.gov/stories/s/Heroin-Overdose-Responses/dm3s-ep3u/] ===

=== Harvard Institute for Excellence in Government  (Case studies on data driven approaches) ===

[https://scholar.harvard.edu/files/janewiseman/files/data_driven_approaches_to_fighting_the_opioid_crisis_jane_wiseman_april_2019.pdf https://scholar.harvard.edu/files/janewiseman/files/data_driven_approaches_to_fighting_the_opioid_crisis_jane_wiseman_april_2019.pdf]

=== ''RxStat (New York, NY)''<sup>[3]</sup> ===

*'''Partners''': the New York City Department of Health and Mental Hygiene with their public safety partners.
*'''Approach''': RxStat consists of two general phases: collecting timely and accurate data and using the data to develop targeted interventions aimed at reducing overdose deaths.
*'''Outcomes''': Staten Island has seen a 29 percent decrease in prescription opioid deaths since officials first began implementing RxStat.

 

=== ''Project Vision (Rutland, VT)''<sup>[4]</sup> ===

*'''Partners''': Rutland Police Department (led by Chief Brian Kilcullen), elected officials, representatives from the medical field, social service providers, local businesses, criminal justice agencies, schools, nonprofit organizations, mental health providers, faith-based groups, federal and state law enforcement agencies, and other stakeholders.
*'''How it works''': RuStat meetings every other week. During the meetings, representatives from the police department present specific addresses within the community that have been the subject of three or more police visits during the previous two-week period. Project VISION members can then determine whether they are familiar with the addresses through their own work—for example, a social worker who is at the meeting may have a client at the address. From there, Project VISION partners can devise a plan to provide the person identified with the appropriate services. According to Scott Tucker, Executive Director of Project VISION, many of the crimes associated with drug use have decreased since the program started.
*'''Outcomes''': From 2014-2016, burglaries decreased by 60 percent, shoplifting decreased by 36 percent, and larcenies went down by 40 percent.
*'''Website''': [http://projectvisionrutland.com/ [1]]
*'''Contact''': [http://projectvisionrutland.com/contact/ [2]]

 

=== ''Local Overdose Fatality Review program (Maryland)'' ===

*'''Partners''': Maryland Department of Health and Mental Hygeine (DHMH), overdose fatality review teams in each county in the state.
*'''How it works''': For each overdose incident, the DHMH provides the local review team with information from the state medical examiner’s office including raw information about the death and any substances found during the medical examination and other information it can gather such as the deceased’s drug treatment records. Team members must sign a confidentiality agreement to obtain access to protected health information. The local review teams examine these data and all other information they receive about each case. Based on this review, the team develops a set of findings about what potentially could have been done to prevent the death including any missed opportunities for prevention, gaps in the system, and areas for increased collaboration among agencies and stakeholders at the local level. The team also develops recommendations for how these deficiencies could be addressed through changes in laws, policies, and protocols.The review team’s findings and recommendations are shared with officials at the state level, who use the information to inform policies and programs aimed at preventing future overdose deaths.<sup>[5]</sup>
*'''Outcomes''':
**Quality of referral systems improved
**Increased focus on outreach to families to provide overdose prevention & treatment services by local health departments and other providers
**Identification of new target audiences for Overdose Response Program (naloxone) trainings
**Increased awareness of member agency staff of overdose related issues and Overdose Response Program training for member agency staff
**Changes to intake questionnaires to include questions about overdose history
*'''Website:''' [http://bha.dhmh.maryland.gov/OVERDOSE_PREVENTION/Pages/OFR-.aspx [3]]
*'''Contact''': Erin Haas (Program Manager) [[mailto:erin.haas@maryland.gov.%20|erin.haas@maryland.gov [4]]]

=== Deloitte Center for Health Solutions (DCHS) ===

The Deloitte Center for Health Solutions, part of Deloitte LPP's Life Sciences and Health Care practice, is a source for fresh perspectives in health care. It looks deeper at the biggest industry issues and provides new thinking around complex challenges. Cutting-edge research and thought-provoking analysis give their clients the insights they need to see things differently, and address the changing landscape.<sup>[7]</sup> DCHS developed a report called, "[http://www.modernhealthcare.com/assets/pdf/CH115670524.PDF Strategies for stemming the opioid crisis]" that describes how data analytics can help health plans and pharmacy benefit managers chart their course. To learn more about the DCHS and their research, visit [http://www.deloitte.com/centerforhealthsolutions [5]].

  According to their major findings, potential strategies for health plans and pharmacy benefit managers (PBMs) include:<sup>[8]</sup>

*Leveraging data and emerging technologies
*Working toward more streamlined data collection and sharing
*Supporting the development of evidence-based standards and quality metrics to define and encourage successful treatment
*Advocating for policy changes at the federal level

<br/> This complex, multifaceted problem calls for systematic solutions across the healthcare system.<sup>[9]</sup> Read more about [https://www2.deloitte.com/insights/us/en/industry/health-care/strategies-health-plans-pbms-to-stem-opioid-crisis-with-data-technology.html#interactive?id=us:2el:3dp:mdrnhlth:eng:lshc:060118 strategies for stemming the opioid crisis].

 

<span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

Strengthening Your Community Coalition

2020-12-16T10:00:28Z

Pkalch:

 

 

= Summary =

The substance misuse and SUD epidemic is a complex problem requiring a highly coordinated and cooperative response from communities.  The increase in non-fatal and fatal overdoses in recent years has caused many communities to realize that individual organizations cannot afford to work in silos.  Without a unified strategy and a focus on common goals, communities addressing a crisis as large as the addiction epidemic will not be poised for success. There is a clear understanding that local government, community partners of all types, and the private sector must align and work together to develop and implement effective strategies to improve their collective response to the SUD epidemic across the continuum of care.  By bringing together and working with a broad range of stakeholders, communities large and small can develop solutions that work for all those touched by the opioid and addiction crisis.  

Creating a community coalition is one of the most effective ways to solve complex problems and it is at the core of creating a local movement.  A coalition is simply a group of individuals and organizations with a common interest, who agree to see the problem through each other’s eyes and work together toward a common goal.  A coalition concentrates a community’s focus on a particular problem, creates alliances among those who might not normally work together, and keeps the community’s approach consistent. 

This page provides an overview of what it takes to build and strengthen an effective coalition based on the experiences of communities across the country.

__TOC__

= Building Your Coalition =

Many local communities have assembled coalitions to improve response to the SUD epidemic.  There is no one-size-fits-all set of practices for creating an effective coalition.  The suggestions that follow are based on the experiences of many communities and are meant to serve as a guide for those looking to form a new coalition or expand and improve upon one that already exists.  One important aspect when looking to create a coalition is to realize that, historically, substance use disorder has been seen by many as a moral failing and not a disease.  

As Mayor Nan Whaley from Dayton, Ohio, puts it, "When we began our work in Dayton, there was no blueprint for treating a substance misuse epidemic because the United States has never treated addiction as it treats other chronic illnesses."  [http://ifi-wikis.com/IFI-OpioidCrisis/Strengthen_the_Coalition_to_Reduce_Substance_Use#cite_note-1 [1]]

Dayton and other communities who have found success have embraced the fact that SUD is a chronic health illness, not a choice.  This outlook, in turn, has informed a new set of strategies that includes compassion and meeting those suffering from SUD where they are at the moment.  

 

= Getting Started =

Who can start a coalition to address SUD?  Anyone can.  Coalitions and task forces are often started by local elected leaders, public health departments, public safety agencies, community organizations, or even passionate individuals engaged in the fight to save lives and reduce harm created by drug misuse and SUD.  Typically, coalitions are formed as a response to higher rates of overdose and overdose deaths.  Regardless of who takes the initiative, it is important to be inclusive and identify stakeholders whose ultimate goals align.  Get started by looking around the community and determining if there are similar existing efforts in which to get involved or add value.  It’s important not to duplicate efforts.  Is there a mechanism or coalition body already taking a comprehensive approach to addiction that can be leveraged?  

== Potential Partners and Their Roles ==
<div class="_">
There are many potential partners that can be invited to join the coalition and improve the community response to SUD.  The following list is not intended to be all inclusive and it is not a requirement to have all of these individuals at the table.  These are suggestions based on the types of partners that are most often brought together.  Highlighted categories contain links to what roles they might play within the coalition.  Keep in mind it’s important to establish a team of optimal size and with sufficient authority to plan and implement ideas and strategies effectively and efficiently.  Does the team include leaders with the authority to make decisions and drive the implementation of new strategies?
</div>
#Local Health Departments
#Hospitals
#Pharmacists
#Primary Care Physicians
#Pain Specialists or Pain Centers
#Nurses
#Health Plans and Insurance Companies
#Local Elected Officials
#Local Law Enforcement
#Corrections
#Treatment Providers
#Faith Based Communities
#Persons with lived experience, including those in recovery and still using substances
#Local Harm Reduction Organizations
#Education Leaders
#Business Leaders
#Recovery Support Organizations
#Family Support Groups and Recovery Allies
#Local Philanthropic Organizations

== Working with Partners  ==

=== Faith-Based Communities ===

See [[Coalition_Partner_-_Faith_Communities|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.  <span style="font-size:small;"><span style="font-family:Arial,Helvetica,sans-serif;"><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">[http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&103&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Opioid Epidemic Practical Toolkit: Helping Faith and][http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&104&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Community Leaders Bring Hope and Healing to Our Communities] may also be helpful.</span></span></span><br/> Programs like [http://www.onebodycollaboratives.org/ One Body Coll][http://www.onebodycollaboratives.org/ aboratives] and software like [https://meettheneed.org/ Meet the Need] can help engage and equip churches to participate in their communities.
<div class="_">
=== Public Health and Public Safety ===

<u>'''Principles for Building Better Relationships'''</u><br/> The Police Executive Research forum reports 5 principles for building better partnerships between law enforcement agencies, public health organizations, treatment providers, and other stakeholders from their April 2016 meeting. The five principles are:

#Find common ground and work toward shared goals.
#Respect and Learn from one another's positions and perspectives
#Involve people from all levels within an organization
#Be open to expanding your perspective and accepting new roles.
#Maintain a community focus.<sup>[1]</sup>

= Organization, Structure, and Meetings =

This is another area where each coalition will determine for itself what works best for them.  However, some guidelines based on experience may be helpful.  Questions of leadership, frequency of meetings, who else should be included, the need for some type of by-laws or governance document, and the roles of participants are just some of the questions that typically arise during planning. 

Working through these and other issues requires patience and cooperation.  Many involved with this effort will be passionate and have strong opinions that others may disagree with.  Differences will arise.  How they are resolved is what matters.  It is important to have procedures that allow people to be heard and for a respectful debate to take place.  This is balanced with the need to make decisions and mover forward.  Either the group or designated leadership needs to be assertive, end debate, and make a decision by vote or executive decision.  Leaders need to remind all involved that all involved want the same thing - to save lives and reduce suffering.

== Initial Outreach ==

Getting your desired partners to the table is not always easy.  Keep in mind that while there are a number of ways to contact these groups, in-person and direct contact is always best.  You may have to overcome resistance of several types.  Organizers of local coalitions to improve response to drug misuse and SUD have often found that some potential partners are suspicious or even defensive.  Some organizations are not naturally inclined to work with others.  For example, the harm reduction and law enforcement communities are not always natural allies.  However, we have found that where these two groups come together and see the problem through each other’s lenses, some very powerful work can be done.  Some organizations might not want to get involved because of their own perception of capacity (this is more work for me) or stigma (this is not my problem).  You may have to expend considerable effort to convince these groups that reversing the epidemic is in the entire community’s interest and that everyone has a contribution to make.

It is important to build trust from the outset.  Some common advice heard from those who have been through the process of bringing together a coalition include:

     - Honoring the Work that has Been Done.  Everyone fighting this epidemic is doing their best and should always be recognized for their efforts.

     - No Judgement.  The rise of the current epidemic has been created by a series of events outside of any local jurisdiction.  It is not the fault of local government and community leaders fighting the epidemic.

     - Common Goals.  As part of initial discussions, it is important to talk about what all partners typically have in common - the desire to save lives and reduce suffering.  While partners will vary in the approaches they use, and which they may feel are more effective, all involved want to see the same end result.  It is important to focus on what the partners share in terms of outcomes they want to see and discuss how greater collaboration will benefit the efforts of all involved. 

== Initial Actions ==

Hold your first meeting.  Don’t worry if you have as few as five community leaders or as many as 20.  The important thing is, you have found people who are willing to work together to thoughtfully and comprehensively address the particular problem in your community.  Although the topic that brings all of the stakeholders together is difficult, it is the coalition leader’s job to bring energy and optimism to the movement.  Because solutions might look different to each of your stakeholders, focus on defining the common problem you are looking to solve.  A goal of your first meeting should be to establish a meeting rhythm in which the coalition frequently gathers to review progress, update your plan, and share success stories.   

== Evaluate the State of Your Community ==

For your community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets within your community.  One way to evaluate perception and resources is through the SAFE Community Pulse Survey and SAFE Community Resources Exercise.  These tools are designed specifically to provide you with the insight your coalition needs to focus and prioritize your work.  These tools can be found in [[SAFE_Project’s|SAFE Project’s Community Playbook]] – a framework for communities to organization, evaluate, and create change in their community to impact the addiction epidemic.  

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise?  

= Lessons Learned and Related Questions =

As you consider who to reach out to in order to create or expand a coalition, we have provided below some lessons learned by communities that have gone through - and continue to go through - this process.  As you proceed you will likely find that the needs of the coalition, as expressed by the members, will change over time.  Most often, the composition of the coalition will change as well.  The lessons are followed by questions that should be asked when considering which potential partners to include.  As a coalition leader, it might also be helpful to track lessons learned over time to help maintain institutional knowledge as staffing changes over time.

== Data is a Critical Foundation to Action   ==
<div class="_">
The improved collection, distribution, and rapid 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 in order to know where more resources need to be deployed.  What data sources are currently available?  How are they being used?  Does the coalition have the partners to provide the necessary data?  How can the coalition expand the data set to help focus resources where they are most needed, and when they are most needed?  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?  Use local data disaggregated by population characteristics like race, ethnicity, immigration status, language, and household levels of income to identify disparities in outcomes and inform policies and practice for specific populations, neighborhoods, and zip codes.

== Prevention Efforts Reduce First Time Use and Support other Coalition Stakeholders ==

Prevention efforts that focus on educating the community - especially youth and young adults - about the risks of drug use are an important component of an effective community coalition.  Prevention organizations have experience with messaging and building awareness campaigns that educate the community about the impacts of drug use on individuals and families.  This knowledge and experience is often helpful in developing strategies to reach specific populations and the community at large.  Prevention reaches into many other areas along the continuum of care, and they often help provide information on linkages to care, treatment options, and recovery supports.  </div>

== Harm Reduction Saves Lives and Should Provide a Linkage to Care   ==

The distribution and training of how to use naloxone continues to be an effective way to reverse opioid overdose and save lives.  Other programs, like needle/syringe exchanges, 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 training on naloxone administration is 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 to expand distribution of naloxone and add other harm reduction measures?  Are there ways to improve linkages to care?  What can the coalition do to reach more people, especially in areas with the highest rates of overdose, to expand harm reduction efforts?

== Agencies and Community Organizations May 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 the coalition include to create new or expanded partnerships in the region?  Ideally what role(s) would they take on?

== <br/> 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 coalition.  Many such groups help raise awareness, reduce stigma, educate and train on the use of naloxone, and advocate for needed policy changes.   Is there an effective family group in the area?  Would greater coordination and involvement with the coalition be beneficial?  

== The Contribution of Peer Support Networks  ==

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, Peer Support Specialists and Recovery 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, as well as 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, who is needed to help make that a reality?   

== Finding Ways to Serve Underserved Areas   ==

This is an issue of major concern in most communities, and often, multiple strategies are necessary.  Stronger data collection efforts can help to more effectively direct the appropriate services to targeted areas within the community where they are most needed.  This will also help community partners in better addressing the crisis in their neighborhoods.  How can the coalition better serve areas of the community that have been underserved?  What partnerships can help make this happen effectively?  

== SUD must be seen as a Disease, not a Crime or Moral Failing   ==

Although there is growing understanding that SUD is a disease, there is still a stigma present that often prevents individuals and families from seeking help.  Stigma can also impact the type and quality of care provided by clinicians.  Stigma can be reduced through public awareness campaigns and education efforts.  If these are taking place in the community - how can these be expanded?  What organizations in the community can help this effort as part of the coalition? 

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.

== The Criminal Justice System Plays a Key Role   ==

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 can lead to a life in recovery, as opposed to long-term incarceration.  Socially and economically, 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 state and local criminal justice systems in terms of additional or expanded programs to help those with SUD find treatment - either through diversion programs or treatment for those incarcerated?  Are key figures who are part of the system willing to participate in a coalition?

== 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?  What about area workforce development entities?  Who can help expand these efforts as part of the coalition?

= National Coalitions =

There are many national coalitions and organization that can provide useful information and resources for local coalitions.  These national groups are widely varied and numerous.  It is therefore important to research these organizations so local coalitions can verify that their goals and priorities are aligned with any national organization they choose to become involved with.  A few examples follow, but there are many more at the national and even regional level.

'''Fed Up! Coalition to End the Opioid Epidemic'''<br/> Platform:

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

<br/> '''Coalition to Optimize the Management of Pain Associated with Surgery ([http://compasfoundation.org/ COMPAS])'''<br/> Mission: To educated all those involved in pain management decisions about acute pain management strategies that minimize the need for opioids.<br/> COMPAS also will provide education on how to implement multimodal analgesic strategies and how to measure success for patients and hospitals alike.<br/> <br/> '''Community Anti-Drug Coalitions of America ([http://www.cadca.org/ CADCA])'''<br/> 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.

= Local Coalition Examples and Resources =

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 

== Dayton Ohio - Community Overdose Action Team (COAT) ==

Dayton provides an example of a highly structured coalition.  The chart below details this structure and summarizes the role of each component within the COAT.  Other local coalitions might not bas complex or highly structured, but this example helps to provide ideas of what could be considered. 

[https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png]

<br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

= <br/> Sources =
</div>
[[Category:Community Resources]]

Strengthening Your Community Coalition

2020-12-16T09:59:15Z

Pkalch:

 

 

= Summary =

The substance misuse and SUD epidemic is a complex problem requiring a highly coordinated and cooperative response from communities.  The increase in non-fatal and fatal overdoses in recent years has caused many communities to realize that individual organizations cannot afford to work in silos.  Without a unified strategy and a focus on common goals, communities addressing a crisis as large as the addiction epidemic will not be poised for success. There is a clear understanding that local government, community partners of all types, and the private sector must align and work together to develop and implement effective strategies to improve their collective response to the SUD epidemic across the continuum of care.  By bringing together and working with a broad range of stakeholders, communities large and small can develop solutions that work for all those touched by the opioid and addiction crisis.  

Creating a community coalition is one of the most effective ways to solve complex problems and it is at the core of creating a local movement.  A coalition is simply a group of individuals and organizations with a common interest, who agree to see the problem through each other’s eyes and work together toward a common goal.  A coalition concentrates a community’s focus on a particular problem, creates alliances among those who might not normally work together, and keeps the community’s approach consistent. 

This page provides an overview of what it takes to build and strengthen an effective coalition based on the experiences of communities across the country.

__TOC__

= Building Your Coalition =

Many local communities have assembled coalitions to improve response to the SUD epidemic.  There is no one-size-fits-all set of practices for creating an effective coalition.  The suggestions that follow are based on the experiences of many communities and are meant to serve as a guide for those looking to form a new coalition or expand and improve upon one that already exists.  One important aspect when looking to create a coalition is to realize that, historically, substance use disorder has been seen by many as a moral failing and not a disease.  

As Mayor Nan Whaley from Dayton, Ohio, puts it, "When we began our work in Dayton, there was no blueprint for treating a substance misuse epidemic because the United States has never treated addiction as it treats other chronic illnesses."  [http://ifi-wikis.com/IFI-OpioidCrisis/Strengthen_the_Coalition_to_Reduce_Substance_Use#cite_note-1 [1]]

Dayton and other communities who have found success have embraced the fact that SUD is a chronic health illness, not a choice.  This outlook, in turn, has informed a new set of strategies that includes compassion and meeting those suffering from SUD where they are at the moment.  

 

= Getting Started =

Who can start a coalition to address SUD?  Anyone can.  Coalitions and task forces are often started by local elected leaders, public health departments, public safety agencies, community organizations, or even passionate individuals engaged in the fight to save lives and reduce harm created by drug misuse and SUD.  Typically, coalitions are formed as a response to higher rates of overdose and overdose deaths.  Regardless of who takes the initiative, it is important to be inclusive and identify stakeholders whose ultimate goals align.  Get started by looking around the community and determining if there are similar existing efforts in which to get involved or add value.  It’s important not to duplicate efforts.  Is there a mechanism or coalition body already taking a comprehensive approach to addiction that can be leveraged?  

== Potential Partners and Their Roles ==
<div class="_">
There are many potential partners that can be invited to join the coalition and improve the community response to SUD.  The following list is not intended to be all inclusive and it is not a requirement to have all of these individuals at the table.  These are suggestions based on the types of partners that are most often brought together.  Highlighted categories contain links to what roles they might play within the coalition.  Keep in mind it’s important to establish a team of optimal size and with sufficient authority to plan and implement ideas and strategies effectively and efficiently.  Does the team include leaders with the authority to make decisions and drive the implementation of new strategies?
</div>
#Local Health Departments
#Hospitals
#Pharmacists
#Primary Care Physicians
#Pain Specialists or Pain Centers
#Nurses
#Health Plans and Insurance Companies
#Local Elected Officials
#Local Law Enforcement
#Corrections
#Treatment Providers
#Faith Based Communities
#Persons with lived experience, including those in recovery and still using substances
#Local Harm Reduction Organizations
#Education Leaders
#Business Leaders
#Recovery Support Organizations
#Family Support Groups and Recovery Allies
#Local Philanthropic Organizations

== Working with Partners  ==

=== Faith-Based Communities ===

See [[Coalition_Partner_-_Faith_Communities|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.  <span style="font-size:small;"><span style="font-family:Arial,Helvetica,sans-serif;"><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">[http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&103&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Opioid Epidemic Practical Toolkit: Helping Faith and][http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&104&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Community Leaders Bring Hope and Healing to Our Communities] may also be helpful.</span></span></span><br/> Programs like [http://www.onebodycollaboratives.org/ One Body Coll][http://www.onebodycollaboratives.org/ aboratives] and software like [https://meettheneed.org/ Meet the Need] can help engage and equip churches to participate in their communities.
<div class="_">
=== Public Health and Public Safety ===

<u>'''Principles for Building Better Relationships'''</u><br/> The Police Executive Research forum reports 5 principles for building better partnerships between law enforcement agencies, public health organizations, treatment providers, and other stakeholders from their April 2016 meeting. The five principles are:

#Find common ground and work toward shared goals.
#Respect and Learn from one another's positions and perspectives
#Involve people from all levels within an organization
#Be open to expanding your perspective and accepting new roles.
#Maintain a community focus.<sup>[1]</sup>

= Organization, Structure, and Meetings =

This is another area where each coalition will determine for itself what works best for them.  However, some guidelines based on experience may be helpful.  Questions of leadership, frequency of meetings, who else should be included, the need for some type of by-laws or governance document, and the roles of participants are just some of the questions that typically arise during planning. 

Working through these and other issues requires patience and cooperation.  Many involved with this effort will be passionate and have strong opionions that others may disagree with.  Differences will arise.  How they are resolved is what matters.  It is important to have procedures that allow people to be heard and for a respectful debate to take place.  This is balanced with the need to make decisions and mover forward.  Either the group or designated leadership needs to be assertive, end debate, and make a decision by vote or executive decision.  Leaders need to remind all involved that all involved want the same thing - to save lives and reduce suffering.

== Initial Outreach ==

Getting your desired partners to the table is not always easy.  Keep in mind that while there are a number of ways to contact these groups, in-person and direct contact is always best.  You may have to overcome resistance of several types.  Organizers of local coalitions to improve response to drug misuse and SUD have often found that some potential partners are suspicious or even defensive.  Some organizations are not naturally inclined to work with others.  For example, the harm reduction and law enforcement communities are not always natural allies.  However, we have found that where these two groups come together and see the problem through each other’s lenses, some very powerful work can be done.  Some organizations might not want to get involved because of their own perception of capacity (this is more work for me) or stigma (this is not my problem).  You may have to expend considerable effort to convince these groups that reversing the epidemic is in the entire community’s interest and that everyone has a contribution to make.

It is important to build trust from the outset.  Some common advice heard from those who have been through the process of bringing together a coalition include:

     - Honoring the Work that has Been Done.  Everyone fighting this epidemic is doing their best and should always be recognized for their efforts.

     - No Judgement.  The rise of the current epidemic has been created by a series of events outside of any local jurisdiction.  It is not the fault of local government and community leaders fighting the epidemic.

     - Common Goals.  As part of initial discussions, it is important to talk about what all partners typically have in common - the desire to save lives and reduce suffering.  While partners will vary in the approaches they use, and which they may feel are more effective, all involved want to see the same end result.  It is important to focus on what the partners share in terms of outcomes they want to see and discuss how greater collaboration will benefit the efforts of all involved. 

== Initial Actions ==

Hold your first meeting.  Don’t worry if you have as few as five community leaders or as many as 20.  The important thing is, you have found people who are willing to work together to thoughtfully and comprehensively address the particular problem in your community.  Although the topic that brings all of the stakeholders together is difficult, it is the coalition leader’s job to bring energy and optimism to the movement.  Because solutions might look different to each of your stakeholders, focus on defining the common problem you are looking to solve.  A goal of your first meeting should be to establish a meeting rhythm in which the coalition frequently gathers to review progress, update your plan, and share success stories.   

== Evaluate the State of Your Community ==

For your community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets within your community.  One way to evaluate perception and resources is through the SAFE Community Pulse Survey and SAFE Community Resources Exercise.  These tools are designed specifically to provide you with the insight your coalition needs to focus and prioritize your work.  These tools can be found in [[SAFE_Project’s|SAFE Project’s Community Playbook]] – a framework for communities to organization, evaluate, and create change in their community to impact the addiction epidemic.  

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise?  

= Lessons Learned and Related Questions =

As you consider who to reach out to in order to create or expand a coalition, we have provided below some lessons learned by communities that have gone through - and continue to go through - this process.  As you proceed you will likely find that the needs of the coalition, as expressed by the members, will change over time.  Most often, the composition of the coalition will change as well.  The lessons are followed by questions that should be asked when considering which potential partners to include.  As a coalition leader, it might also be helpful to track lessons learned over time to help maintain institutional knowledge as staffing changes over time.

== Data is a Critical Foundation to Action   ==
<div class="_">
The improved collection, distribution, and rapid 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 in order to know where more resources need to be deployed.  What data sources are currently available?  How are they being used?  Does the coalition have the partners to provide the necessary data?  How can the coalition expand the data set to help focus resources where they are most needed, and when they are most needed?  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?  Use local data disaggregated by population characteristics like race, ethnicity, immigration status, language, and household levels of income to identify disparities in outcomes and inform policies and practice for specific populations, neighborhoods, and zip codes.

== Prevention Efforts Reduce First Time Use and Support other Coalition Stakeholders ==

Prevention efforts that focus on educating the community - especially youth and young adults - about the risks of drug use are an important component of an effective community coalition.  Prevention organizations have experience with messaging and building awareness campaigns that educate the community about the impacts of drug use on individuals and families.  This knowledge and experience is often helpful in developing strategies to reach specific populations and the community at large.  Prevention reaches into many other areas along the continuum of care, and they often help provide information on linkages to care, treatment options, and recovery supports.  </div>

== Harm Reduction Saves Lives and Should Provide a Linkage to Care   ==

The distribution and training of how to use naloxone continues to be an effective way to reverse opioid overdose and save lives.  Other programs, like needle/syringe exchanges, 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 training on naloxone administration is 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 to expand distribution of naloxone and add other harm reduction measures?  Are there ways to improve linkages to care?  What can the coalition do to reach more people, especially in areas with the highest rates of overdose, to expand harm reduction efforts?

== Agencies and Community Organizations May 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 the coalition include to create new or expanded partnerships in the region?  Ideally what role(s) would they take on?

== <br/> 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 coalition.  Many such groups help raise awareness, reduce stigma, educate and train on the use of naloxone, and advocate for needed policy changes.   Is there an effective family group in the area?  Would greater coordination and involvement with the coalition be beneficial?  

== The Contribution of Peer Support Networks  ==

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, Peer Support Specialists and Recovery 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, as well as 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, who is needed to help make that a reality?   

== Finding Ways to Serve Underserved Areas   ==

This is an issue of major concern in most communities, and often, multiple strategies are necessary.  Stronger data collection efforts can help to more effectively direct the appropriate services to targeted areas within the community where they are most needed.  This will also help community partners in better addressing the crisis in their neighborhoods.  How can the coalition better serve areas of the community that have been underserved?  What partnerships can help make this happen effectively?  

== SUD must be seen as a Disease, not a Crime or Moral Failing   ==

Although there is growing understanding that SUD is a disease, there is still a stigma present that often prevents individuals and families from seeking help.  Stigma can also impact the type and quality of care provided by clinicians.  Stigma can be reduced through public awareness campaigns and education efforts.  If these are taking place in the community - how can these be expanded?  What organizations in the community can help this effort as part of the coalition? 

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.

== The Criminal Justice System Plays a Key Role   ==

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 can lead to a life in recovery, as opposed to long-term incarceration.  Socially and economically, 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 state and local criminal justice systems in terms of additional or expanded programs to help those with SUD find treatment - either through diversion programs or treatment for those incarcerated?  Are key figures who are part of the system willing to participate in a coalition?

== 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?  What about area workforce development entities?  Who can help expand these efforts as part of the coalition?

= National Coalitions =

There are many national coalitions and organization that can provide useful information and resources for local coalitions.  These national groups are widely varied and numerous.  It is therefore important to research these organizations so local coalitions can verify that their goals and priorities are aligned with any national organization they choose to become involved with.  A few examples follow, but there are many more at the national and even regional level.

'''Fed Up! Coalition to End the Opioid Epidemic'''<br/> Platform:

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

<br/> '''Coalition to Optimize the Management of Pain Associated with Surgery ([http://compasfoundation.org/ COMPAS])'''<br/> Mission: To educated all those involved in pain management decisions about acute pain management strategies that minimize the need for opioids.<br/> COMPAS also will provide education on how to implement multimodal analgesic strategies and how to measure success for patients and hospitals alike.<br/> <br/> '''Community Anti-Drug Coalitions of America ([http://www.cadca.org/ CADCA])'''<br/> 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.

= Local Coalition Examples and Resources =

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 

== Dayton Ohio - Community Overdose Action Team (COAT) ==

Dayton provides an example of a highly structured coalition.  The chart below details this structure and summarizes the role of each component within the COAT.  Other local coalitions might not bas complex or highly structured, but this example helps to provide ideas of what could be considered. 

[https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png]

<br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

= <br/> Sources =
</div>
[[Category:Community Resources]]

Strengthening Your Community Coalition

2020-12-16T09:44:44Z

Pkalch:

 

 

= Summary =

The substance misuse and SUD epidemic is a complex problem requiring a highly coordinated and cooperative response from communities.  The increase in non-fatal and fatal overdoses in recent years has caused many communities to realize that individual organizations cannot afford to work in silos.  Without a unified strategy and a focus on common goals, communities addressing a crisis as large as the addiction epidemic will not be poised for success. There is a clear understanding that local government, community partners of all types, and the private sector must align and work together to develop and implement effective strategies to improve their collective response to the SUD epidemic across the continuum of care.  By bringing together and working with a broad range of stakeholders, communities large and small can develop solutions that work for all those touched by the opioid and addiction crisis.  

Creating a community coalition is one of the most effective ways to solve complex problems and it is at the core of creating a local movement.  A coalition is simply a group of individuals and organizations with a common interest, who agree to see the problem through each other’s eyes and work together toward a common goal.  A coalition concentrates a community’s focus on a particular problem, creates alliances among those who might not normally work together, and keeps the community’s approach consistent. 

This page provides an overview of what it takes to build and strengthen an effective coalition based on the experiences of communities across the country.

__TOC__

= Building Your Coalition =

Many local communities have assembled coalitions to improve response to the SUD epidemic.  There is no one-size-fits-all set of practices for creating an effective coalition.  The suggestions that follow are based on the experiences of many communities and are meant to serve as a guide for those looking to form a new coalition or expand and improve upon one that already exists.  One important aspect when looking to create a coalition is to realize that, historically, substance use disorder has been seen by many as a moral failing and not a disease.  

As Mayor Nan Whaley from Dayton, Ohio, puts it, "When we began our work in Dayton, there was no blueprint for treating a substance misuse epidemic because the United States has never treated addiction as it treats other chronic illnesses."  [http://ifi-wikis.com/IFI-OpioidCrisis/Strengthen_the_Coalition_to_Reduce_Substance_Use#cite_note-1 [1]]

Dayton and other communities who have found success have embraced the fact that SUD is a chronic health illness, not a choice.  This outlook, in turn, has informed a new set of strategies that includes compassion and meeting those suffering from SUD where they are at the moment.  

 

= Getting Started =

Who can start a coalition to address SUD?  Anyone can.  Coalitions and task forces are often started by local elected leaders, public health departments, public safety agencies, community organizations, or even passionate individuals engaged in the fight to save lives and reduce harm created by drug misuse and SUD.  Typically, coalitions are formed as a response to higher rates of overdose and overdose deaths.  Regardless of who takes the initiative, it is important to be inclusive and identify stakeholders whose ultimate goals align.  Get started by looking around the community and determining if there are similar existing efforts in which to get involved or add value.  It’s important not to duplicate efforts.  Is there a mechanism or coalition body already taking a comprehensive approach to addiction that can be leveraged?  

== Potential Partners and Their Roles ==
<div class="_">
There are many potential partners that can be invited to join the coalition and improve the community response to SUD.  The following list is not intended to be all inclusive and it is not a requirement to have all of these individuals at the table.  These are suggestions based on the types of partners that are most often brought together.  Highlighted categories contain links to what roles they might play within the coalition.  Keep in mind it’s important to establish a team of optimal size and with sufficient authority to plan and implement ideas and strategies effectively and efficiently.  Does the team include leaders with the authority to make decisions and drive the implementation of new strategies?
</div>
#Local Health Departments
#Hospitals
#Pharmacists
#Primary Care Physicians
#Pain Specialists or Pain Centers
#Nurses
#Health Plans and Insurance Companies
#Local Elected Officials
#Local Law Enforcement
#Corrections
#Treatment Providers
#Faith Based Communities
#Persons with lived experience, including those in recovery and still using substances
#Local Harm Reduction Organizations
#Education Leaders
#Business Leaders
#Recovery Support Organizations
#Family Support Groups and Recovery Allies
#Local Philanthropic Organizations

== Working with Partners  ==

=== Faith-Based Communities ===

See [[Coalition_Partner_-_Faith_Communities|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.  <span style="font-size:small;"><span style="font-family:Arial,Helvetica,sans-serif;"><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">[http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&103&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Opioid Epidemic Practical Toolkit: Helping Faith and][http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&104&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Community Leaders Bring Hope and Healing to Our Communities] may also be helpful.</span></span></span><br/> Programs like [http://www.onebodycollaboratives.org/ One Body Coll][http://www.onebodycollaboratives.org/ aboratives] and software like [https://meettheneed.org/ Meet the Need] can help engage and equip churches to participate in their communities.
<div class="_">
=== Public Health and Public Safety ===

<u>'''Principles for Building Better Relationships'''</u><br/> The Police Executive Research forum reports 5 principles for building better partnerships between law enforcement agencies, public health organizations, treatment providers, and other stakeholders from their April 2016 meeting. The five principles are:

#Find common ground and work toward shared goals.
#Respect and Learn from one another's positions and perspectives
#Involve people from all levels within an organization
#Be open to expanding your perspective and accepting new roles.
#Maintain a community focus.<sup>[1]</sup>

= Organization, Structure, and Meetings =

This is another area where each coalition will determine for itself what works best for them.  However, some guidelines based on experience may be helpful.  Questions of leadership, frequency of meetings, who else should be included, the need for some type of by-laws or governance document, and the roles of participants are just some of the questions that typically arise during planning.  Working through these and other issues requires patience and cooperation.

== Initial Outreach ==

Getting your desired partners to the table is not always easy.  Keep in mind that while there are a number of ways to contact these groups, in-person and direct contact is always best.  You may have to overcome resistance of several types.  Organizers of local coalitions to improve response to drug misuse and SUD have often found that some potential partners are suspicious or even defensive.  Some organizations are not naturally inclined to work with others.  For example, the harm reduction and law enforcement communities are not always natural allies.  However, we have found that where these two groups come together and see the problem through each other’s lenses, some very powerful work can be done.  Some organizations might not want to get involved because of their own perception of capacity (this is more work for me) or stigma (this is not my problem).  You may have to expend considerable effort to convince these groups that reversing the epidemic is in the entire community’s interest and that everyone has a contribution to make.

It is important to build trust from the outset.  Some common advice heard from those who have been through the process of bringing together a coalition include:

     - Honoring the Work that has Been Done.  Everyone fighting this epidemic is doing their best and should always be recognized for their efforts.

     - No Judgement.  The rise of the current epidemic has been created by a series of events outside of any local jurisdiction.  It is not the fault of local government and community leaders fighting the epidemic.

     - Common Goals.  As part of initial discussions, it is important to talk about what all partners typically have in common - the desire to save lives and reduce suffering.  While partners will vary in the approaches they use, and which they may feel are more effective, all involved want to see the same end result.  It is important to focus on what the partners share in terms of outcomes they want to see and discuss how greater collaboration will benefit the efforts of all involved. 

== Initial Actions ==

Hold your first meeting.  Don’t worry if you have as few as five community leaders or as many as 20.  The important thing is, you have found people who are willing to work together to thoughtfully and comprehensively address the particular problem in your community.  Although the topic that brings all of the stakeholders together is difficult, it is the coalition leader’s job to bring energy and optimism to the movement.  Because solutions might look different to each of your stakeholders, focus on defining the common problem you are looking to solve.  A goal of your first meeting should be to establish a meeting rhythm in which the coalition frequently gathers to review progress, update your plan, and share success stories.   

== Evaluate the State of Your Community ==

For your community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets within your community.  One way to evaluate perception and resources is through the SAFE Community Pulse Survey and SAFE Community Resources Exercise.  These tools are designed specifically to provide you with the insight your coalition needs to focus and prioritize your work.  These tools can be found in [[SAFE_Project’s|SAFE Project’s Community Playbook]] – a framework for communities to organization, evaluate, and create change in their community to impact the addiction epidemic.  

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise?  

= Lessons Learned and Related Questions =

As you consider who to reach out to in order to create or expand a coalition, we have provided below some lessons learned by communities that have gone through - and continue to go through - this process.  As you proceed you will likely find that the needs of the coalition, as expressed by the members, will change over time.  Most often, the composition of the coalition will change as well.  The lessons are followed by questions that should be asked when considering which potential partners to include.  As a coalition leader, it might also be helpful to track lessons learned over time to help maintain institutional knowledge as staffing changes over time.

== Data is a Critical Foundation to Action   ==
<div class="_">
The improved collection, distribution, and rapid 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 in order to know where more resources need to be deployed.  What data sources are currently available?  How are they being used?  Does the coalition have the partners to provide the necessary data?  How can the coalition expand the data set to help focus resources where they are most needed, and when they are most needed?  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?  Use local data disaggregated by population characteristics like race, ethnicity, immigration status, language, and household levels of income to identify disparities in outcomes and inform policies and practice for specific populations, neighborhoods, and zip codes.

== Prevention Efforts Reduce First Time Use and Support other Coalition Stakeholders ==

Prevention efforts that focus on educating the community - especially youth and young adults - about the risks of drug use are an important component of an effective community coalition.  Prevention organizations have experience with messaging and building awareness campaigns that educate the community about the impacts of drug use on individuals and families.  This knowledge and experience is often helpful in developing strategies to reach specific populations and the community at large.  Prevention reaches into many other areas along the continuum of care, and they often help provide information on linkages to care, treatment options, and recovery supports.  </div>

== Harm Reduction Saves Lives and Should Provide a Linkage to Care   ==

The distribution and training of how to use naloxone continues to be an effective way to reverse opioid overdose and save lives.  Other programs, like needle/syringe exchanges, 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 training on naloxone administration is 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 to expand distribution of naloxone and add other harm reduction measures?  Are there ways to improve linkages to care?  What can the coalition do to reach more people, especially in areas with the highest rates of overdose, to expand harm reduction efforts?

== Agencies and Community Organizations May 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 the coalition include to create new or expanded partnerships in the region?  Ideally what role(s) would they take on?

== <br/> 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 coalition.  Many such groups help raise awareness, reduce stigma, educate and train on the use of naloxone, and advocate for needed policy changes.   Is there an effective family group in the area?  Would greater coordination and involvement with the coalition be beneficial?  

== The Contribution of Peer Support Networks  ==

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, Peer Support Specialists and Recovery 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, as well as 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, who is needed to help make that a reality?   

== Finding Ways to Serve Underserved Areas   ==

This is an issue of major concern in most communities, and often, multiple strategies are necessary.  Stronger data collection efforts can help to more effectively direct the appropriate services to targeted areas within the community where they are most needed.  This will also help community partners in better addressing the crisis in their neighborhoods.  How can the coalition better serve areas of the community that have been underserved?  What partnerships can help make this happen effectively?  

== SUD must be seen as a Disease, not a Crime or Moral Failing   ==

Although there is growing understanding that SUD is a disease, there is still a stigma present that often prevents individuals and families from seeking help.  Stigma can also impact the type and quality of care provided by clinicians.  Stigma can be reduced through public awareness campaigns and education efforts.  If these are taking place in the community - how can these be expanded?  What organizations in the community can help this effort as part of the coalition? 

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.

== The Criminal Justice System Plays a Key Role   ==

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 can lead to a life in recovery, as opposed to long-term incarceration.  Socially and economically, 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 state and local criminal justice systems in terms of additional or expanded programs to help those with SUD find treatment - either through diversion programs or treatment for those incarcerated?  Are key figures who are part of the system willing to participate in a coalition?

== 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?  What about area workforce development entities?  Who can help expand these efforts as part of the coalition?

= National Coalitions =

There are many national coalitions and organization that can provide useful information and resources for local coalitions.  These national groups are widely varied and numerous.  It is therefore important to research these organizations so local coalitions can verify that their goals and priorities are aligned with any national organization they choose to become involved with.  A few examples follow, but there are many more at the national and even regional level.

'''Fed Up! Coalition to End the Opioid Epidemic'''<br/> Platform:

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

<br/> '''Coalition to Optimize the Management of Pain Associated with Surgery ([http://compasfoundation.org/ COMPAS])'''<br/> Mission: To educated all those involved in pain management decisions about acute pain management strategies that minimize the need for opioids.<br/> COMPAS also will provide education on how to implement multimodal analgesic strategies and how to measure success for patients and hospitals alike.<br/> <br/> '''Community Anti-Drug Coalitions of America ([http://www.cadca.org/ CADCA])'''<br/> 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.

= Local Coalition Examples and Resources =

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 

== Dayton Ohio - Community Overdose Action Team (COAT) ==

Dayton provides an example of a highly structured coalition.  The chart below details this structure and summarizes the role of each component within the COAT.  Other local coalitions might not bas complex or highly structured, but this example helps to provide ideas of what could be considered. 

[https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png]

<br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

= <br/> Sources =
</div>
[[Category:Community Resources]]

Strengthening Your Community Coalition

2020-12-16T09:43:35Z

Pkalch:

 

 

= Summary =

The substance misuse and SUD epidemic is a complex problem requiring a highly coordinated and cooperative response from communities.  The increase in non-fatal and fatal overdoses in recent years has caused many communities to realize that individual organizations cannot afford to work in silos.  Without a unified strategy and a focus on common goals, communities addressing a crisis as large as the addiction epidemic will not be poised for success. There is a clear understanding that local government, community partners of all types, and the private sector must align and work together to develop and implement effective strategies to improve their collective response to the SUD epidemic across the continuum of care.  By bringing together and working with a broad range of stakeholders, communities large and small can develop solutions that work for all those touched by the opioid and addiction crisis.  

Creating a community coalition is one of the most effective ways to solve complex problems and it is at the core of creating a local movement.  A coalition is simply a group of individuals and organizations with a common interest, who agree to see the problem through each other’s eyes and work together toward a common goal.  A coalition concentrates a community’s focus on a particular problem, creates alliances among those who might not normally work together, and keeps the community’s approach consistent. 

This page provides an overview of what it takes to build and strengthen an effective coalition based on the experiences of communities across the country.

__TOC__

= Building Your Coalition =

Many local communities have assembled coalitions to improve response to the SUD epidemic.  There is no one-size-fits-all set of practices for creating an effective coalition.  The suggestions that follow are based on the experiences of many communities and are meant to serve as a guide for those looking to form a new coalition or expand and improve upon one that already exists.  One important aspect when looking to create a coalition is to realize that, historically, substance use disorder has been seen by many as a moral failing and not a disease.  

As Mayor Nan Whaley from Dayton, Ohio, puts it, "When we began our work in Dayton, there was no blueprint for treating a substance misuse epidemic because the United States has never treated addiction as it treats other chronic illnesses."  [http://ifi-wikis.com/IFI-OpioidCrisis/Strengthen_the_Coalition_to_Reduce_Substance_Use#cite_note-1 [1]]

Dayton and other communities who have found success have embraced the fact that SUD is a chronic health illness, not a choice.  This outlook, in turn, has informed a new set of strategies that includes compassion and meeting those suffering from SUD where they are at the moment.  

 

= Getting Started =

Who can start a coalition to address SUD?  Anyone can.  Coalitions and task forces are often started by local elected leaders, public health departments, public safety agencies, community organizations, or even passionate individuals engaged in the fight to save lives and reduce harm created by drug misuse and SUD.  Typically, coalitions are formed as a response to higher rates of overdose and overdose deaths.  Regardless of who takes the initiative, it is important to be inclusive and identify stakeholders whose ultimate goals align.  Get started by looking around the community and determining if there are similar existing efforts in which to get involved or add value.  It’s important not to duplicate efforts.  Is there a mechanism or coalition body already taking a comprehensive approach to addiction that can be leveraged?  

== Potential Partners and Their Roles ==
<div class="_">
There are many potential partners that can be invited to join the coalition and improve the community response to SUD.  The following list is not intended to be all inclusive and it is not a requirement to have all of these individuals at the table.  These are suggestions based on the types of partners that are most often brought together.  Highlighted categories contain links to what roles they might play within the coalition.  Keep in mind it’s important to establish a team of optimal size and with sufficient authority to plan and implement ideas and strategies effectively and efficiently.  Does the team include leaders with the authority to make decisions and drive the implementation of new strategies?
</div>
#Local Health Departments
#Hospitals
#Pharmacists
#Primary Care Physicians
#Pain Specialists or Pain Centers
#Nurses
#Health Plans and Insurance Companies
#Local Elected Officials
#Local Law Enforcement
#Corrections
#Treatment Providers
#Faith Based Communities
#Persons with lived experience, including those in recovery and still using substances
#Local Harm Reduction Organizations
#Education Leaders
#Business Leaders
#Recovery Support Organizations
#Family Support Groups and Recovery Allies
#Local Philanthropic Organizations

== Working with Partners  ==

=== Faith-Based Communities ===

See [[Coalition_Partner_-_Faith_Communities|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.  <span style="font-size:small;"><span style="font-family:Arial,Helvetica,sans-serif;"><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">[http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&103&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Opioid Epidemic Practical Toolkit: Helping Faith and][http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&104&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Community Leaders Bring Hope and Healing to Our Communities] may also be helpful.</span></span></span><br/> Programs like [http://www.onebodycollaboratives.org/ One Body Coll][http://www.onebodycollaboratives.org/ aboratives] and software like [https://meettheneed.org/ Meet the Need] can help engage and equip churches to participate in their communities.
<div class="_">
=== Public Health and Public Safety ===

<u>'''Principles for Building Better Relationships'''</u><br/> The Police Executive Research forum reports 5 principles for building better partnerships between law enforcement agencies, public health organizations, treatment providers, and other stakeholders from their April 2016 meeting. The five principles are:

#Find common ground and work toward shared goals.
#Respect and Learn from one another's positions and perspectives
#Involve people from all levels within an organization
#Be open to expanding your perspective and accepting new roles.
#Maintain a community focus.<sup>[1]</sup>

= Organization, Structure, and Meetings =

This is another area where each coalition will determine for itself what works best for them.  However, some guidelines based on experience may be helpful.  Questions of leadership, frequency of meetings, who else should be included, the need for some type of by-laws or governance document, and the roles of participants are just some of the questions that typically arise during planning.  Working through these and other issues requires patience and cooperation.

== Initial Outreach ==

Getting your desired partners to the table is not always easy.  Keep in mind that while there are a number of ways to contact these groups, in-person and direct contact is always best.  You may have to overcome resistance of several types.  Organizers of local coalitions to improve response to drug misuse and SUD have often found that some potential partners are suspicious or even defensive.  Some organizations are not naturally inclined to work with others.  For example, the harm reduction and law enforcement communities are not always natural allies.  However, we have found that where these two groups come together and see the problem through each other’s lenses, some very powerful work can be done.  Some organizations might not want to get involved because of their own perception of capacity (this is more work for me) or stigma (this is not my problem).  You may have to expend considerable effort to convince these groups that reversing the epidemic is in the entire community’s interest and that everyone has a contribution to make.

It is important to build trust from the outset.  Some common advice heard from those who have been through the process of bringing together a coalition include:

     - Honoring the Work that has Been Done.  Everyone fighting this epidemic is doing their best and should always be recognized for their efforts.

     - No Judgement.  The rise of the current epidemic has been created by a series of events outside of any local jurisdiction.  It is not the fault of local government and community leaders fighting the epidemic.

     - Common Goals.  As part of initial discussions, it is important to talk about what all partners typically have in common - the desire to save lives and reduce suffering.  While partners will vary in the approaches they use, and which they may feel are more effective, all involved want to see the same end result.  It is important to focus on what the partners share in terms of outcomes they want to see and discuss how greater collaboration will benefit the efforts of all involved. 

== Initial Actions ==

Hold your first meeting.  Don’t worry if you have as few as five community leaders or as many as 20.  The important thing is, you have found people who are willing to work together to thoughtfully and comprehensively address the particular problem in your community.  Although the topic that brings all of the stakeholders together is difficult, it is the coalition leader’s job to bring energy and optimism to the movement.  Because solutions might look different to each of your stakeholders, focus on defining the common problem you are looking to solve.  A goal of your first meeting should be to establish a meeting rhythm in which the coalition frequently gathers to review progress, update your plan, and share success stories.   

== Evaluate the State of Your Community ==

For your community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets within your community.  One way to evaluate perception and resources is through the SAFE Community Pulse Survey and SAFE Community Resources Exercise.  These tools are designed specifically to provide you with the insight your coalition needs to focus and prioritize your work.  These tools can be found in [[SAFE_Project’s|SAFE Project’s Community Playbook]] – a framework for communities to organization, evaluate, and create change in their community to impact the addiction epidemic.  

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise?  

= Lessons Learned and Related Questions =

As you consider who to reach out to in order to create or expand a coalition, we have provided below some lessons learned by communities that have gone through - and continue to go through - this process.  As you proceed you will likely find that the needs of the coalition, as expressed by the members, will change over time.  Most often, the composition of the coalition will change as well.  The lessons are followed by questions that should be asked when considering which potential partners to include.  As a coalition leader, it might also be helpful to track lessons learned over time to help maintain institutional knowledge as staffing changes over time.

== Data is a Critical Foundation to Action   ==
<div class="_">
The improved collection, distribution, and rapid 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 in order to know where more resources need to be deployed.  What data sources are currently available?  How are they being used?  Does the coalition have the partners to provide the necessary data?  How can the coalition expand the data set to help focus resources where they are most needed, and when they are most needed?  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?  Use local data disaggregated by population characteristics like race, ethnicity, immigration status, language, and household levels of income to identify disparities in outcomes and inform policies and practice for specific populations, neighborhoods, and zip codes.

== Prevention Efforts Reduce First Time Use and Support other Coalition Stakeholders ==

Prevention efferts that focus on educating the community - especially youth and young adults - about the risks of drug use are an important componant of an effective community coalition.  Prevention organizations have experience with messaging and building awareness campaigns that educate the community about the impacts of drug use on individuals and families.  This knowledge and experience is often helpful in developing strategies to reach specifc populations and the community at large.  Prevention reaches into many other areas along the continuum of care, and they often help provide information on linkages to care, treatment options, and recovery supports. 
</div>
== Harm Reduction Saves Lives and Should Provide a Linkage to Care   ==

The distribution and training of how to use naloxone continues to be an effective way to reverse opioid overdose and save lives.  Other programs, like needle/syringe exchanges, 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 training on naloxone administration is 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 to expand distribution of naloxone and add other harm reduction measures?  Are there ways to improve linkages to care?  What can the coalition do to reach more people, especially in areas with the highest rates of overdose, to expand harm reduction efforts?

== Agencies and Community Organizations May 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 the coalition include to create new or expanded partnerships in the region?  Ideally what role(s) would they take on?

== <br/> 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 coalition.  Many such groups help raise awareness, reduce stigma, educate and train on the use of naloxone, and advocate for needed policy changes.   Is there an effective family group in the area?  Would greater coordination and involvement with the coalition be beneficial?  

== The Contribution of Peer Support Networks  ==

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, Peer Support Specialists and Recovery 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, as well as 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, who is needed to help make that a reality?   

== Finding Ways to Serve Underserved Areas   ==

This is an issue of major concern in most communities, and often, multiple strategies are necessary.  Stronger data collection efforts can help to more effectively direct the appropriate services to targeted areas within the community where they are most needed.  This will also help community partners in better addressing the crisis in their neighborhoods.  How can the coalition better serve areas of the community that have been underserved?  What partnerships can help make this happen effectively?  

== SUD must be seen as a Disease, not a Crime or Moral Failing   ==

Although there is growing understanding that SUD is a disease, there is still a stigma present that often prevents individuals and families from seeking help.  Stigma can also impact the type and quality of care provided by clinicians.  Stigma can be reduced through public awareness campaigns and education efforts.  If these are taking place in the community - how can these be expanded?  What organizations in the community can help this effort as part of the coalition? 

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.

== The Criminal Justice System Plays a Key Role   ==

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 can lead to a life in recovery, as opposed to long-term incarceration.  Socially and economically, 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 state and local criminal justice systems in terms of additional or expanded programs to help those with SUD find treatment - either through diversion programs or treatment for those incarcerated?  Are key figures who are part of the system willing to participate in a coalition?

== 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?  What about area workforce development entities?  Who can help expand these efforts as part of the coalition?

= National Coalitions =

There are many national coalitions and organization that can provide useful information and resources for local coalitions.  These national groups are widely varied and numerous.  It is therefore important to research these organizations so local coalitions can verify that their goals and priorities are aligned with any national organization they choose to become involved with.  A few examples follow, but there are many more at the national and even regional level.

'''Fed Up! Coalition to End the Opioid Epidemic'''<br/> Platform:

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

<br/> '''Coalition to Optimize the Management of Pain Associated with Surgery ([http://compasfoundation.org/ COMPAS])'''<br/> Mission: To educated all those involved in pain management decisions about acute pain management strategies that minimize the need for opioids.<br/> COMPAS also will provide education on how to implement multimodal analgesic strategies and how to measure success for patients and hospitals alike.<br/> <br/> '''Community Anti-Drug Coalitions of America ([http://www.cadca.org/ CADCA])'''<br/> 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.

= Local Coalition Examples and Resources =

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 

== Dayton Ohio - Community Overdose Action Team (COAT) ==

Dayton provides an example of a highly structured coalition.  The chart below details this structure and summarizes the role of each component within the COAT.  Other local coalitions might not bas complex or highly structured, but this example helps to provide ideas of what could be considered. 

[https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png]

<br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

= <br/> Sources =
</div>
[[Category:Community Resources]]

Strengthening Your Community Coalition

2020-12-16T09:42:55Z

Pkalch:

 

 

= Summary =

The substance misuse and SUD epidemic is a complex problem requiring a highly coordinated and cooperative response from communities.  The increase in non-fatal and fatal overdoses in recent years has caused many communities to realize that individual organizations cannot afford to work in silos.  Without a unified strategy and a focus on common goals, communities addressing a crisis as large as the addiction epidemic will not be poised for success. There is a clear understanding that local government, community partners of all types, and the private sector must align and work together to develop and implement effective strategies to improve their collective response to the SUD epidemic across the continuum of care.  By bringing together and working with a broad range of stakeholders, communities large and small can develop solutions that work for all those touched by the opioid and addiction crisis.  

Creating a community coalition is one of the most effective ways to solve complex problems and it is at the core of creating a local movement.  A coalition is simply a group of individuals and organizations with a common interest, who agree to see the problem through each other’s eyes and work together toward a common goal.  A coalition concentrates a community’s focus on a particular problem, creates alliances among those who might not normally work together, and keeps the community’s approach consistent. 

This page provides an overview of what it takes to build and strengthen an effective coalition based on the experiences of communities across the country.

__TOC__

= Building Your Coalition =

Many local communities have assembled coalitions to improve response to the SUD epidemic.  There is no one-size-fits-all set of practices for creating an effective coalition.  The suggestions that follow are based on the experiences of many communities and are meant to serve as a guide for those looking to form a new coalition or expand and improve upon one that already exists.  One important aspect when looking to create a coalition is to realize that, historically, substance use disorder has been seen by many as a moral failing and not a disease.  

As Mayor Nan Whaley from Dayton, Ohio, puts it, "When we began our work in Dayton, there was no blueprint for treating a substance misuse epidemic because the United States has never treated addiction as it treats other chronic illnesses."  [http://ifi-wikis.com/IFI-OpioidCrisis/Strengthen_the_Coalition_to_Reduce_Substance_Use#cite_note-1 [1]]

Dayton and other communities who have found success have embraced the fact that SUD is a chronic health illness, not a choice.  This outlook, in turn, has informed a new set of strategies that includes compassion and meeting those suffering from SUD where they are at the moment.  

 

= Getting Started =

Who can start a coalition to address SUD?  Anyone can.  Coalitions and task forces are often started by local elected leaders, public health departments, public safety agencies, community organizations, or even passionate individuals engaged in the fight to save lives and reduce harm created by drug misuse and SUD.  Typically, coalitions are formed as a response to higher rates of overdose and overdose deaths.  Regardless of who takes the initiative, it is important to be inclusive and identify stakeholders whose ultimate goals align.  Get started by looking around the community and determining if there are similar existing efforts in which to get involved or add value.  It’s important not to duplicate efforts.  Is there a mechanism or coalition body already taking a comprehensive approach to addiction that can be leveraged?  

== Potential Partners and Their Roles ==
<div class="_">
There are many potential partners that can be invited to join the coalition and improve the community response to SUD.  The following list is not intended to be all inclusive and it is not a requirement to have all of these individuals at the table.  These are suggestions based on the types of partners that are most often brought together.  Highlighted categories contain links to what roles they might play within the coalition.  Keep in mind it’s important to establish a team of optimal size and with sufficient authority to plan and implement ideas and strategies effectively and efficiently.  Does the team include leaders with the authority to make decisions and drive the implementation of new strategies?
</div>
#Local Health Departments
#Hospitals
#Pharmacists
#Primary Care Physicians
#Pain Specialists or Pain Centers
#Nurses
#Health Plans and Insurance Companies
#Local Elected Officials
#Local Law Enforcement
#Corrections
#Treatment Providers
#Faith Based Communities
#Persons with lived experience, including those in recovery and still using substances
#Local Harm Reduction Organizations
#Education Leaders
#Business Leaders
#Recovery Support Organizations
#Family Support Groups and Recovery Allies
#Local Philanthropic Organization

== Working with Partners  ==

=== Faith-Based Communities ===

See [[Coalition_Partner_-_Faith_Communities|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.  <span style="font-size:small;"><span style="font-family:Arial,Helvetica,sans-serif;"><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">[http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&103&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Opioid Epidemic Practical Toolkit: Helping Faith and][http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&104&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Community Leaders Bring Hope and Healing to Our Communities] may also be helpful.</span></span></span><br/> Programs like [http://www.onebodycollaboratives.org/ One Body Coll][http://www.onebodycollaboratives.org/ aboratives] and software like [https://meettheneed.org/ Meet the Need] can help engage and equip churches to participate in their communities.
<div class="_">
=== Public Health and Public Safety ===

<u>'''Principles for Building Better Relationships'''</u><br/> The Police Executive Research forum reports 5 principles for building better partnerships between law enforcement agencies, public health organizations, treatment providers, and other stakeholders from their April 2016 meeting. The five principles are:

#Find common ground and work toward shared goals.
#Respect and Learn from one another's positions and perspectives
#Involve people from all levels within an organization
#Be open to expanding your perspective and accepting new roles.
#Maintain a community focus.<sup>[1]</sup>

= Organization, Structure, and Meetings =

This is another area where each coalition will determine for itself what works best for them.  However, some guidelines based on experience may be helpful.  Questions of leadership, frequency of meetings, who else should be included, the need for some type of by-laws or governance document, and the roles of participants are just some of the questions that typically arise during planning.  Working through these and other issues requires patience and cooperation.

== Initial Outreach ==

Getting your desired partners to the table is not always easy.  Keep in mind that while there are a number of ways to contact these groups, in-person and direct contact is always best.  You may have to overcome resistance of several types.  Organizers of local coalitions to improve response to drug misuse and SUD have often found that some potential partners are suspicious or even defensive.  Some organizations are not naturally inclined to work with others.  For example, the harm reduction and law enforcement communities are not always natural allies.  However, we have found that where these two groups come together and see the problem through each other’s lenses, some very powerful work can be done.  Some organizations might not want to get involved because of their own perception of capacity (this is more work for me) or stigma (this is not my problem).  You may have to expend considerable effort to convince these groups that reversing the epidemic is in the entire community’s interest and that everyone has a contribution to make.

It is important to build trust from the outset.  Some common advice heard from those who have been through the process of bringing together a coalition include:

     - Honoring the Work that has Been Done.  Everyone fighting this epidemic is doing their best and should always be recognized for their efforts.

     - No Judgement.  The rise of the current epidemic has been created by a series of events outside of any local jurisdiction.  It is not the fault of local government and community leaders fighting the epidemic.

     - Common Goals.  As part of initial discussions, it is important to talk about what all partners typically have in common - the desire to save lives and reduce suffering.  While partners will vary in the approaches they use, and which they may feel are more effective, all involved want to see the same end result.  It is important to focus on what the partners share in terms of outcomes they want to see and discuss how greater collaboration will benefit the efforts of all involved. 

== Initial Actions ==

Hold your first meeting.  Don’t worry if you have as few as five community leaders or as many as 20.  The important thing is, you have found people who are willing to work together to thoughtfully and comprehensively address the particular problem in your community.  Although the topic that brings all of the stakeholders together is difficult, it is the coalition leader’s job to bring energy and optimism to the movement.  Because solutions might look different to each of your stakeholders, focus on defining the common problem you are looking to solve.  A goal of your first meeting should be to establish a meeting rhythm in which the coalition frequently gathers to review progress, update your plan, and share success stories.   

== Evaluate the State of Your Community ==

For your community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets within your community.  One way to evaluate perception and resources is through the SAFE Community Pulse Survey and SAFE Community Resources Exercise.  These tools are designed specifically to provide you with the insight your coalition needs to focus and prioritize your work.  These tools can be found in [[SAFE_Project’s|SAFE Project’s Community Playbook]] – a framework for communities to organization, evaluate, and create change in their community to impact the addiction epidemic.  

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise?  

= Lessons Learned and Related Questions =

As you consider who to reach out to in order to create or expand a coalition, we have provided below some lessons learned by communities that have gone through - and continue to go through - this process.  As you proceed you will likely find that the needs of the coalition, as expressed by the members, will change over time.  Most often, the composition of the coalition will change as well.  The lessons are followed by questions that should be asked when considering which potential partners to include.  As a coalition leader, it might also be helpful to track lessons learned over time to help maintain institutional knowledge as staffing changes over time.

== Data is a Critical Foundation to Action   ==
<div class="_">
The improved collection, distribution, and rapid 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 in order to know where more resources need to be deployed.  What data sources are currently available?  How are they being used?  Does the coalition have the partners to provide the necessary data?  How can the coalition expand the data set to help focus resources where they are most needed, and when they are most needed?  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?  Use local data disaggregated by population characteristics like race, ethnicity, immigration status, language, and household levels of income to identify disparities in outcomes and inform policies and practice for specific populations, neighborhoods, and zip codes.

== Prevention Efforts Reduce First Time Use and Support other Coalition Stakeholders ==

Prevention efferts that focus on educating the community - especially youth and young adults - about the risks of drug use are an important componant of an effective community coalition.  Prevention organizations have experience with messaging and building awareness campaigns that educate the community about the impacts of drug use on individuals and families.  This knowledge and experience is often helpful in developing strategies to reach specifc populations and the community at large.  Prevention reaches into many other areas along the continuum of care, and they often help provide information on linkages to care, treatment options, and recovery supports. 
</div>
== Harm Reduction Saves Lives and Should Provide a Linkage to Care   ==

The distribution and training of how to use naloxone continues to be an effective way to reverse opioid overdose and save lives.  Other programs, like needle/syringe exchanges, 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 training on naloxone administration is 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 to expand distribution of naloxone and add other harm reduction measures?  Are there ways to improve linkages to care?  What can the coalition do to reach more people, especially in areas with the highest rates of overdose, to expand harm reduction efforts?

== Agencies and Community Organizations May 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 the coalition include to create new or expanded partnerships in the region?  Ideally what role(s) would they take on?

== <br/> 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 coalition.  Many such groups help raise awareness, reduce stigma, educate and train on the use of naloxone, and advocate for needed policy changes.   Is there an effective family group in the area?  Would greater coordination and involvement with the coalition be beneficial?  

== The Contribution of Peer Support Networks  ==

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, Peer Support Specialists and Recovery 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, as well as 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, who is needed to help make that a reality?   

== Finding Ways to Serve Underserved Areas   ==

This is an issue of major concern in most communities, and often, multiple strategies are necessary.  Stronger data collection efforts can help to more effectively direct the appropriate services to targeted areas within the community where they are most needed.  This will also help community partners in better addressing the crisis in their neighborhoods.  How can the coalition better serve areas of the community that have been underserved?  What partnerships can help make this happen effectively?  

== SUD must be seen as a Disease, not a Crime or Moral Failing   ==

Although there is growing understanding that SUD is a disease, there is still a stigma present that often prevents individuals and families from seeking help.  Stigma can also impact the type and quality of care provided by clinicians.  Stigma can be reduced through public awareness campaigns and education efforts.  If these are taking place in the community - how can these be expanded?  What organizations in the community can help this effort as part of the coalition? 

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.

== The Criminal Justice System Plays a Key Role   ==

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 can lead to a life in recovery, as opposed to long-term incarceration.  Socially and economically, 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 state and local criminal justice systems in terms of additional or expanded programs to help those with SUD find treatment - either through diversion programs or treatment for those incarcerated?  Are key figures who are part of the system willing to participate in a coalition?

== 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?  What about area workforce development entities?  Who can help expand these efforts as part of the coalition?

= National Coalitions =

There are many national coalitions and organization that can provide useful information and resources for local coalitions.  These national groups are widely varied and numerous.  It is therefore important to research these organizations so local coalitions can verify that their goals and priorities are aligned with any national organization they choose to become involved with.  A few examples follow, but there are many more at the national and even regional level.

'''Fed Up! Coalition to End the Opioid Epidemic'''<br/> Platform:

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

<br/> '''Coalition to Optimize the Management of Pain Associated with Surgery ([http://compasfoundation.org/ COMPAS])'''<br/> Mission: To educated all those involved in pain management decisions about acute pain management strategies that minimize the need for opioids.<br/> COMPAS also will provide education on how to implement multimodal analgesic strategies and how to measure success for patients and hospitals alike.<br/> <br/> '''Community Anti-Drug Coalitions of America ([http://www.cadca.org/ CADCA])'''<br/> 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.

= Local Coalition Examples and Resources =

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 

== Dayton Ohio - Community Overdose Action Team (COAT) ==

Dayton provides an example of a highly structured coalition.  The chart below details this structure and summarizes the role of each component within the COAT.  Other local coalitions might not bas complex or highly structured, but this example helps to provide ideas of what could be considered. 

[https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png]

<br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

= <br/> Sources =
</div>
[[Category:Community Resources]]

Strengthening Your Community Coalition

2020-12-16T09:40:50Z

Pkalch:

 

 

= Summary =

The substance misuse and SUD epidemic is a complex problem requiring a highly coordinated and cooperative response from communities.  The increase in non-fatal and fatal overdoses in recent years has caused many communities to realize that individual organizations cannot afford to work in silos.  Without a unified strategy and a focus on common goals, communities addressing a crisis as large as the addiction epidemic will not be poised for success. There is a clear understanding that local government, community partners of all types, and the private sector must align and work together to develop and implement effective strategies to improve their collective response to the SUD epidemic across the continuum of care.  By bringing together and working with a broad range of stakeholders, communities large and small can develop solutions that work for all those touched by the opioid and addiction crisis.  

Creating a community coalition is one of the most effective ways to solve complex problems and it is at the core of creating a local movement.  A coalition is simply a group of individuals and organizations with a common interest, who agree to see the problem through each other’s eyes and work together toward a common goal.  A coalition concentrates a community’s focus on a particular problem, creates alliances among those who might not normally work together, and keeps the community’s approach consistent. 

This page provides an overview of what it takes to build and strengthen an effective coalition based on the experiences of communities across the country.

__TOC__

= Building Your Coalition =

Many local communities have assembled coalitions to improve response to the SUD epidemic.  There is no one-size-fits-all set of practices for creating an effective coalition.  The suggestions that follow are based on the experiences of many communities and are meant to serve as a guide for those looking to form a new coalition or expand and improve upon one that already exists.  One important aspect when looking to create a coalition is to realize that, historically, substance use disorder has been seen by many as a moral failing and not a disease.  

As Mayor Nan Whaley from Dayton, Ohio, puts it, "When we began our work in Dayton, there was no blueprint for treating a substance misuse epidemic because the United States has never treated addiction as it treats other chronic illnesses."  [http://ifi-wikis.com/IFI-OpioidCrisis/Strengthen_the_Coalition_to_Reduce_Substance_Use#cite_note-1 [1]]

Dayton and other communities who have found success have embraced the fact that SUD is a chronic health illness, not a choice.  This outlook, in turn, has informed a new set of strategies that includes compassion and meeting those suffering from SUD where they are at the moment.  

 

= Getting Started =

Who can start a coalition to address SUD?  Anyone can.  Coalitions and task forces are often started by local elected leaders, public health departments, public safety agencies, community organizations, or even passionate individuals engaged in the fight to save lives and reduce harm created by drug misuse and SUD.  Typically, coalitions are formed as a response to higher rates of overdose and overdose deaths.  Regardless of who takes the initiative, it is important to be inclusive and identify stakeholders whose ultimate goals align.  Get started by looking around the community and determining if there are similar existing efforts in which to get involved or add value.  It’s important not to duplicate efforts.  Is there a mechanism or coalition body already taking a comprehensive approach to addiction that can be leveraged?  

 

 

== Potential Partners and Their Roles ==
<div class="_">
There are many potential partners that can be invited to join the coalition and improve the community response to SUD.  The following list is not intended to be all inclusive and it is not a requirement to have all of these individuals at the table.  These are suggestions based on the types of partners that are most often brought together.  Highlighted categories contain links to what roles they might play within the coalition.  Keep in mind it’s important to establish a team of optimal size and with sufficient authority to plan and implement ideas and strategies effectively and efficiently.  Does the team include leaders with the authority to make decisions and drive the implementation of new strategies?
</div>
#Local Health Departments
#Hospitals
#Pharmacists
#Primary Care Physicians
#Pain Specialists or Pain Centers
#Nurses
#Health Plans and Insurance Companies
#Local Elected Officials
#Local Law Enforcement
#Corrections
#Treatment Providers
#Faith Based Communities
#Persons with lived experience, including those in recovery and still using substances
#Local Harm Reduction Organizations
#Education Leaders
#Business Leaders
#Recovery Support Organizations
#Family Support Groups and Recovery Allies
#Local Philanthropic Organization
<div class="_"> </div>
== Working with Partners  ==

=== Faith-Based Communities ===

See [[Coalition_Partner_-_Faith_Communities|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.  <span style="font-size:small;"><span style="font-family:Arial,Helvetica,sans-serif;"><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">[http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&103&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Opioid Epidemic Practical Toolkit: Helping Faith and][http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&104&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Community Leaders Bring Hope and Healing to Our Communities] may also be helpful.</span></span></span><br/> Programs like [http://www.onebodycollaboratives.org/ One Body Coll][http://www.onebodycollaboratives.org/ aboratives] and software like [https://meettheneed.org/ Meet the Need] can help engage and equip churches to participate in their communities.
</div> <div class="_">
=== Public Health and Public Safety ===

<u>'''Principles for Building Better Relationships'''</u><br/> The Police Executive Research forum reports 5 principles for building better partnerships between law enforcement agencies, public health organizations, treatment providers, and other stakeholders from their April 2016 meeting. The five principles are:

#Find common ground and work toward shared goals.
#Respect and Learn from one another's positions and perspectives
#Involve people from all levels within an organization
#Be open to expanding your perspective and accepting new roles.
#Maintain a community focus.<sup>[1]</sup>

= Organization, Structure, and Meetings =

This is another area where each coalition will determine for itself what works best for them.  However, some guidelines based on experience may be helpful.  Questions of leadership, frequency of meetings, who else should be included, the need for some type of by-laws or governance document, and the roles of participants are just some of the questions that typically arise during planning.  Working through these and other issues requires patience and cooperation.

== Initial Outreach ==

Getting your desired partners to the table is not always easy.  Keep in mind that while there are a number of ways to contact these groups, in-person and direct contact is always best.  You may have to overcome resistance of several types.  Organizers of local coalitions to improve response to drug misuse and SUD have often found that some potential partners are suspicious or even defensive.  Some organizations are not naturally inclined to work with others.  For example, the harm reduction and law enforcement communities are not always natural allies.  However, we have found that where these two groups come together and see the problem through each other’s lenses, some very powerful work can be done.  Some organizations might not want to get involved because of their own perception of capacity (this is more work for me) or stigma (this is not my problem).  You may have to expend considerable effort to convince these groups that reversing the epidemic is in the entire community’s interest and that everyone has a contribution to make.

It is important to build trust from the outset.  Some common advice heard from those who have been through the process of bringing together a coalition include:

     - Honoring the Work that has Been Done.  Everyone fighting this epidemic is doing their best and should always be recognized for their efforts.

     - No Judgement.  The rise of the current epidemic has been created by a series of events outside of any local jurisdiction.  It is not the fault of local government and community leaders fighting the epidemic.

     - Common Goals.  As part of initial discussions, it is important to talk about what all partners typically have in common - the desire to save lives and reduce suffering.  While partners will vary in the approaches they use, and which they may feel are more effective, all involved want to see the same end result.  It is important to focus on what the partners share in terms of outcomes they want to see and discuss how greater collaboration will benefit the efforts of all involved. 

== Initial Actions ==

Hold your first meeting.  Don’t worry if you have as few as five community leaders or as many as 20.  The important thing is, you have found people who are willing to work together to thoughtfully and comprehensively address the particular problem in your community.  Although the topic that brings all of the stakeholders together is difficult, it is the coalition leader’s job to bring energy and optimism to the movement.  Because solutions might look different to each of your stakeholders, focus on defining the common problem you are looking to solve.  A goal of your first meeting should be to establish a meeting rhythm in which the coalition frequently gathers to review progress, update your plan, and share success stories.   

== Evaluate the State of Your Community ==

For your community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets within your community.  One way to evaluate perception and resources is through the SAFE Community Pulse Survey and SAFE Community Resources Exercise.  These tools are designed specifically to provide you with the insight your coalition needs to focus and prioritize your work.  These tools can be found in [[SAFE_Project’s_#NoShame_Pledge_–_This_virtual_campaign_helps_to_combat_negative_perception_and_offers_support_to_others_when_seeking_treatment_or_speaking_up_about_mental_health_and_substance_use_disorders.|SAFE Project’s Community Playbook]] – a framework for communities to organization, evaluate, and create change in their community to impact the addiction epidemic.  

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise?  

= Lessons Learned and Related Questions =

As you consider who to reach out to in order to create or expand a coalition, we have provided below some lessons learned by communities that have gone through - and continue to go through - this process.  As you proceed you will likely find that the needs of the coalition, as expressed by the members, will change over time.  Most often, the composition of the coalition will change as well.  The lessons are followed by questions that should be asked when considering which potential partners to include.  As a coalition leader, it might also be helpful to track lessons learned over time to help maintain institutional knowledge as staffing changes over time.

== Data is a Critical Foundation to Action   ==
<div class="_">
The improved collection, distribution, and rapid 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 in order to know where more resources need to be deployed.  What data sources are currently available?  How are they being used?  Does the coalition have the partners to provide the necessary data?  How can the coalition expand the data set to help focus resources where they are most needed, and when they are most needed?  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?  Use local data disaggregated by population characteristics like race, ethnicity, immigration status, language, and household levels of income to identify disparities in outcomes and inform policies and practice for specific populations, neighborhoods, and zip codes.

== Prevention Efforts Reduce First Time Use and Support other Coalition Stakeholders ==

Prevention efferts that focus on educating the community - especially youth and young adults - about the risks of drug use are an important componant of an effective community coalition.  Prevention organizations have experience with messaging and building awareness campaigns that educate the community about the impacts of drug use on individuals and families.  This knowledge and experience is often helpful in developing strategies to reach specifc populations and the community at large.  Prevention reaches into many other areas along the continuum of care, and they often help provide information on linkages to care, treatment options, and recovery supports. 
</div>
== Harm Reduction Saves Lives and Should Provide a Linkage to Care   ==

The distribution and training of how to use naloxone continues to be an effective way to reverse opioid overdose and save lives.  Other programs, like needle/syringe exchanges, 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 training on naloxone administration is 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 to expand distribution of naloxone and add other harm reduction measures?  Are there ways to improve linkages to care?  What can the coalition do to reach more people, especially in areas with the highest rates of overdose, to expand harm reduction efforts?

== Agencies and Community Organizations May 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 the coalition include to create new or expanded partnerships in the region?  Ideally what role(s) would they take on?

== <br/> 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 coalition.  Many such groups help raise awareness, reduce stigma, educate and train on the use of naloxone, and advocate for needed policy changes.   Is there an effective family group in the area?  Would greater coordination and involvement with the coalition be beneficial?  

== The Contribution of Peer Support Networks  ==

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, Peer Support Specialists and Recovery 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, as well as 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, who is needed to help make that a reality?   

== Finding Ways to Serve Underserved Areas   ==

This is an issue of major concern in most communities, and often, multiple strategies are necessary.  Stronger data collection efforts can help to more effectively direct the appropriate services to targeted areas within the community where they are most needed.  This will also help community partners in better addressing the crisis in their neighborhoods.  How can the coalition better serve areas of the community that have been underserved?  What partnerships can help make this happen effectively?  

== SUD must be seen as a Disease, not a Crime or Moral Failing   ==

Although there is growing understanding that SUD is a disease, there is still a stigma present that often prevents individuals and families from seeking help.  Stigma can also impact the type and quality of care provided by clinicians.  Stigma can be reduced through public awareness campaigns and education efforts.  If these are taking place in the community - how can these be expanded?  What organizations in the community can help this effort as part of the coalition? 

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.

== The Criminal Justice System Plays a Key Role   ==

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 can lead to a life in recovery, as opposed to long-term incarceration.  Socially and economically, 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 state and local criminal justice systems in terms of additional or expanded programs to help those with SUD find treatment - either through diversion programs or treatment for those incarcerated?  Are key figures who are part of the system willing to participate in a coalition?

== 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?  What about area workforce development entities?  Who can help expand these efforts as part of the coalition?

 

= National Coalitions =

There are many national coalitions and organization that can provide useful information and resources for local coalitions.  These national groups are widely varied and numerous.  It is therefore important to research these organizations so local coalitions can verify that their goals and priorities are aligned with any national organization they choose to become involved with.  A few examples follow, but there are many more at the national and even regional level.

'''Fed Up! Coalition to End the Opioid Epidemic'''<br/> Platform:

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

<br/> '''Coalition to Optimize the Management of Pain Associated with Surgery ([http://compasfoundation.org/ COMPAS])'''<br/> Mission: To educated all those involved in pain management decisions about acute pain management strategies that minimize the need for opioids.<br/> COMPAS also will provide education on how to implement multimodal analgesic strategies and how to measure success for patients and hospitals alike.<br/> <br/> '''Community Anti-Drug Coalitions of America ([http://www.cadca.org/ CADCA])'''<br/> 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.

= Local Coalition Examples and Resources =

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 

== Dayton Ohio - Community Overdose Action Team (COAT) ==

Dayton provides an example of a highly structured coalition.  The chart below details this structure and summarizes the role of each component within the COAT.  Other local coalitions might not bas complex or highly structured, but this example helps to provide ideas of what could be considered. 

[https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png]

 

 

= Tools & Resources =

[[TR_-_Strengthen_the_Coalition_to_Reduce_Opioid_Abuse|TR - Strengthen the Coalition to Reduce Opioid Abuse]]

<br/> <br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

= <br/> Sources =

[[Category:Community Resources]]

Activating Your Community

2020-12-16T09:36:27Z

Pkalch:

__NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]   
SWITCHING TO "Activating Your Community

== Contents ==

 

 

= Background =

There are many barriers that prevent and limit the efforts of communities addressing drug misuse and substance use disorder, but one particular challenge that many communities face is the ability to elevate their initiative above other local competing priorities.  Identifying champions who can publicly support the coalition’s mission can help to build and foster strategic partnerships, generate buy-in, and increase commitment to bolster supports. With a solid understanding of the current programmatic needs in your area, you can build power and mobilize the community by successfully bringing together advocates, policymakers, and professionals to take collective action.

Whether you are developing legislative or regulatory efforts, building and strengthening programs, or attempting to reach a diverse audience with a wide range of needs, communities of all sizes should consider the following principles when activating your community around this crisis:

*Put equity at the center for your efforts
*Engage individuals with lived experience or those directly impacted by substance use disorder in decision-making roles
*Create alliances and form strategic partnerships that build political will and support from a broad range of stakeholders
*Build relationships with federal, state, and locally elected leaders
*Understand your community’s most powerful levers for change 
*Allow data to drive your strategy development and decision-making
*Focus on measurable individual and community-based outcomes
*Empower citizens by increasing public awareness and community engagement opportunities
*'''Strengthen your system or infrastructure in order to achieve impact at scale'''

It’s important to note that any community organizing or political will building strategy should be implemented with regularity - it should not be a single event or effort.  For the greatest impact, communities should show the link or intersection of substance use disorder with other competing community priorities, consistently focus on drumming up new interest, and relay progress made over time back to community stakeholders using a message of hope in order to sustain engagement.

Drug misuse and SUD has consequences for all residents of local communities.  The current epidemic increases costs related to public health, public safety, criminal justice, treatment services, and many more.  Locally elected leaders are typically motivated by the economic impacts to improve local response, but a far greater price comes from the fatalities caused by the epidemic and related overdoses and the loved ones who must face the pain of those lost.  This is what motivates many others to create and join efforts to combat the epidemic within their communities.  Many of these leaders typically work in prevention, harm reduction, treatment, recovery support services, and other efforts that save lives and help those in need find recovery, but it may be necessary for communities to tailor messaging to suit a wide variety of audiences in a manner that speaks to the receiver’s particular interest.  When identifying champions or strategic alliances, communities should consider their most powerful levers for change.  Who or what in your community can unlock opportunity and accelerate change?  What is the backbone of your community?  Is it your local hospital system, community college, or a specific business or company?  Communities may find that some individuals or organizations may have conflicting viewpoints – try to approach them and open a door for conversation.  Sometimes non-traditional partners are only “non-traditional” because we label them as such.

= Key Community Members =

== Elected Officials and Local Health Leaders ==

Locally elected leaders and health officials can play a key role in leading efforts to improve the response to the SUD epidemic.  Mayors, County Executives, County Managers, Commissioners, and the local health leaders they appoint, can be powerful allies in raising public awareness about the extent of the problem, the availability of resources, and providing information on specific strategies, like harm reduction, that can help save lives.  In many instances, elected officials and local health officials might already be part of some type of community task force or other group charged with coordinating and improving local response to the epidemic; however, in the absence of such an effort, elected and health leaders can and should be engaged in raising awareness about the issue and solutions while also increasing support within the community.  

Elected leaders, and especially legislators, play an important role in the creation of budgets and ultimately decide on how local revenues are allocated to different programs, so it is critical they are aware of the scope of these issues in their communities and what is being done in response.  In most cases, they have political allies and are regularly invited to speak at community events or participate in meetings with diverse audiences where they can help to relay your message and share information about the response.

Although locally elected leaders are important champions, it’s also critical for a coalition to work alongside its state partners to help align efforts for maximum impact, inform policy, support funding, and make recommendations on scalability of programs that are working on-the-ground to avoid duplication or manage expectations that might not be feasible or sustainable at the local level.

=== Engagement Examples - Elected and Local Health Leaders ===

== Community Stakeholders and Infuencers ==

Anyone in your community can be a leader or a champion.  Drug misuse and substance use disorder affects a substantial number of residents in all communities.  Having a wide variety of stakeholders imbedded within the community can help to advance policies, programs, and systems that can work together and improve local response.  When appropriate, consider engaging other community partners to leverage efforts and boost support within the community.  These individuals in your community who could be key champions or partners along the way, but might not necessarily participate in the coalition.  Some examples might include:

*Health Professionals and Community Health Centers
*Hospital System Administration
*Faith Leaders
*Law Enforcement or other First Responders
*Public and Private School Systems
*Colleges, Universities, and Institutions of Higher Education
*Parent Groups
*Youth and Young Adults
*Local businesses, corporations, or the Chamber of Commerce
*Philanthropic Community

== Individuals with Lived Experience ==

Communities should also engage individuals with lived experience in decision-making roles - meaning those who have had first-hand involvement with substance use disorder and those who are friends or family members of those directly impacted.  Individuals with lived experience bring knowledge, understanding, and experience not learned through formal education.  To be most effective, it is imperative that communities honor and reflect the voices of those most impacted in their programs and systems. If possible, find ways to offer fair compensation for their time.  

= Improving Pubic Awareness And Engagement =

Public education and awareness is essential to activating a local community.  Residents need to know the unvarnished reality of what is taking place.  They need to know what the problem is, and what needs to be done to improve the local response and save lives.  In addition order to be educated, local residents also need to be involved in the process.  The people are the community, and many have first-hand experience with drug misuse and SUD.  Many others have lived experience with family and friends who are struggling with these issues, and their input and participation is needed to create a Comprehensive and effective Community

 

== Public Availability of Data ==

 

== Community Education Programs ==

 

== Building Strategic Partnerships ==

 

== Develop Outreach Strategies ==

 

= Overcoming Stigma =

== Anti--Stigma Campaigns: ==

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.  It was designed to include a toolkit for communities who want to replicate the campaign locally and use it a community mobilizing tool to drum up political will and raise awareness about local efforts underway to combat stigma.  By using the pledge as a catalyst, communities can identify new stakeholders who can be activated and drive social impact, as well as help to change behaviors at scale.

State of Massachusetts - Sate Without StigMA. <ref>https://www.mass.gov/state-without-stigma
</ref> The State of Massachusetts has developed a comprehensive anti-stigma campaign at the State level.  This resource provides information about what stigma is, how it contributes to the current epidemic, and personal stories of people who talk about their own experiences with stigma and how they overcame it to find help for themselves and others in a variety of settings.

 

 <br/> __TOC__

[[Category:Community Resources]]

Strengthening Your Community Coalition

2020-12-16T09:35:42Z

Pkalch:

 

 

= Summary =

The substance misuse and SUD epidemic is a complex problem requiring a highly coordinated and cooperative response from communities.  The increase in non-fatal and fatal overdoses in recent years has caused many communities to realize that individual organizations cannot afford to work in silos.  Without a unified strategy and a focus on common goals, communities addressing a crisis as large as the addiction epidemic will not be poised for success. There is a clear understanding that local government, community partners of all types, and the private sector must align and work together to develop and implement effective strategies to improve their collective response to the SUD epidemic across the continuum of care.  By bringing together and working with a broad range of stakeholders, communities large and small can develop solutions that work for all those touched by the opioid and addiction crisis.  

Creating a community coalition is one of the most effective ways to solve complex problems and it is at the core of creating a local movement.  A coalition is simply a group of individuals and organizations with a common interest, who agree to see the problem through each other’s eyes and work together toward a common goal.  A coalition concentrates a community’s focus on a particular problem, creates alliances among those who might not normally work together, and keeps the community’s approach consistent. 

This page provides an overview of what it takes to build and strengthen an effective coalition based on the experiences of communities across the country.

__TOC__

= Building Your Coalition =

Many local communities have assembled coalitions to improve response to the SUD epidemic.  There is no one-size-fits-all set of practices for creating an effective coalition.  The suggestions that follow are based on the experiences of many communities and are meant to serve as a guide for those looking to form a new coalition or expand and improve upon one that already exists.  One important aspect when looking to create a coalition is to realize that, historically, substance use disorder has been seen by many as a moral failing and not a disease.  

As Mayor Nan Whaley from Dayton, Ohio, puts it, "When we began our work in Dayton, there was no blueprint for treating a substance misuse epidemic because the United States has never treated addiction as it treats other chronic illnesses."  [http://ifi-wikis.com/IFI-OpioidCrisis/Strengthen_the_Coalition_to_Reduce_Substance_Use#cite_note-1 [1]]

Dayton and other communities who have found success have embraced the fact that SUD is a chronic health illness, not a choice.  This outlook, in turn, has informed a new set of strategies that includes compassion and meeting those suffering from SUD where they are at the moment.  

 

= Getting Started =

Who can start a coalition to address SUD?  Anyone can.  Coalitions and task forces are often started by local elected leaders, public health departments, public safety agencies, community organizations, or even passionate individuals engaged in the fight to save lives and reduce harm created by drug misuse and SUD.  Typically, coalitions are formed as a response to higher rates of overdose and overdose deaths.  Regardless of who takes the initiative, it is important to be inclusive and identify stakeholders whose ultimate goals align.  Get started by looking around the community and determining if there are similar existing efforts in which to get involved or add value.  It’s important not to duplicate efforts.  Is there a mechanism or coalition body already taking a comprehensive approach to addiction that can be leveraged?  

 

 

== Potential Partners and Their Roles ==
<div class="_">
There are many potential partners that can be invited to join the coalition and improve the community response to SUD.  The following list is not intended to be all inclusive and it is not a requirement to have all of these individuals at the table.  These are suggestions based on the types of partners that are most often brought together.  Highlighted categories contain links to what roles they might play within the coalition.  Keep in mind it’s important to establish a team of optimal size and with sufficient authority to plan and implement ideas and strategies effectively and efficiently.  Does the team include leaders with the authority to make decisions and drive the implementation of new strategies?
</div>
#Local Health Departments
#Hospitals
#Pharmacists
#Primary Care Physicians
#Pain Specialists or Pain Centers
#Nurses
#Health Plans and Insurance Companies
#Local Elected Officials
#Local Law Enforcement
#Corrections
#Treatment Providers
#Faith Based Communities
#Persons with lived experience, including those in recovery and still using substances
#Local Harm Reduction Organizations
#Education Leaders
#Business Leaders
#Recovery Support Organizations
#Family Support Groups and Recovery Allies
#Local Philanthropic Organization
<div class="_"> </div>
== Working with Partners  ==

=== Faith-Based Communities ===

See [[Coalition_Partner_-_Faith_Communities|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.  <span style="font-size:small;"><span style="font-family:Arial,Helvetica,sans-serif;"><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">[http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&103&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Opioid Epidemic Practical Toolkit: Helping Faith and][http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&104&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Community Leaders Bring Hope and Healing to Our Communities] may also be helpful.</span></span></span><br/> Programs like [http://www.onebodycollaboratives.org/ One Body Coll][http://www.onebodycollaboratives.org/ aboratives] and software like [https://meettheneed.org/ Meet the Need] can help engage and equip churches to participate in their communities.
</div> <div class="_">
=== Public Health and Public Safety ===

<u>'''Principles for Building Better Relationships'''</u><br/> The Police Executive Research forum reports 5 principles for building better partnerships between law enforcement agencies, public health organizations, treatment providers, and other stakeholders from their April 2016 meeting. The five principles are:

#Find common ground and work toward shared goals.
#Respect and Learn from one another's positions and perspectives
#Involve people from all levels within an organization
#Be open to expanding your perspective and accepting new roles.
#Maintain a community focus.<sup>[1]</sup>

= Organization, Structure, and Meetings =

This is another area where each coalition will determine for itself what works best for them.  However, some guidelines based on experience may be helpful.  Questions of leadership, frequency of meetings, who else should be included, the need for some type of by-laws or governance document, and the roles of participants are just some of the questions that typically arise during planning.  Working through these and other issues requires patience and cooperation.

== Initial Outreach ==

Getting your desired partners to the table is not always easy.  Keep in mind that while there are a number of ways to contact these groups, in-person and direct contact is always best.  You may have to overcome resistance of several types.  Organizers of local coalitions to improve response to drug misuse and SUD have often found that some potential partners are suspicious or even defensive.  Some organizations are not naturally inclined to work with others.  For example, the harm reduction and law enforcement communities are not always natural allies.  However, we have found that where these two groups come together and see the problem through each other’s lenses, some very powerful work can be done.  Some organizations might not want to get involved because of their own perception of capacity (this is more work for me) or stigma (this is not my problem).  You may have to expend considerable effort to convince these groups that reversing the epidemic is in the entire community’s interest and that everyone has a contribution to make.

It is important to build trust from the outset.  Some common advice heard from those who have been through the process of bringing together a coalition include:

     - Honoring the Work that has Been Done.  Everyone fighting this epidemic is doing their best and should always be recognized for their efforts.

     - No Judgement.  The rise of the current epidemic has been created by a series of events outside of any local jurisdiction.  It is not the fault of local government and community leaders fighting the epidemic.

     - Common Goals.  As part of initial discussions, it is important to talk about what all partners typically have in common - the desire to save lives and reduce suffering.  While partners will vary in the approaches they use, and which they may feel are more effective, all involved want to see the same end result.  It is important to focus on what the partners share in terms of outcomes they want to see and discuss how greater collaboration will benefit the efforts of all involved. 

== Initial Actions ==

Hold your first meeting.  Don’t worry if you have as few as five community leaders or as many as 20.  The important thing is, you have found people who are willing to work together to thoughtfully and comprehensively address the particular problem in your community.  Although the topic that brings all of the stakeholders together is difficult, it is the coalition leader’s job to bring energy and optimism to the movement.  Because solutions might look different to each of your stakeholders, focus on defining the common problem you are looking to solve.  A goal of your first meeting should be to establish a meeting rhythm in which the coalition frequently gathers to review progress, update your plan, and share success stories.   

== Evaluate the State of Your Community ==

For your community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets within your community.  One way to evaluate perception and resources is through the SAFE Community Pulse Survey and SAFE Community Resources Exercise.  These tools are designed specifically to provide you with the insight your coalition needs to focus and prioritize your work.  These tools can be found in SAFE Project’s Community Playbook – a framework for communities to organization, evaluate, and create change in their community to impact the addiction epidemic.  

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 
</div>
= Lessons Learned and Related Questions =

As you consider who to reach out to in order to create or expand a coalition, we have provided below some lessons learned by communities that have gone through - and continue to go through - this process.  As you proceed you will likely find that the needs of the coalition, as expressed by the members, will change over time.  Most often, the composition of the coalition will change as well.  The lessons are followed by questions that should be asked when considering which potential partners to include.  As a coalition leader, it might also be helpful to track lessons learned over time to help maintain institutional knowledge as staffing changes over time.

== Data is a Critical Foundation to Action   ==
<div class="_">
The improved collection, distribution, and rapid 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 in order to know where more resources need to be deployed.  What data sources are currently available?  How are they being used?  Does the coalition have the partners to provide the necessary data?  How can the coalition expand the data set to help focus resources where they are most needed, and when they are most needed?  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?  Use local data disaggregated by population characteristics like race, ethnicity, immigration status, language, and household levels of income to identify disparities in outcomes and inform policies and practice for specific populations, neighborhoods, and zip codes.

== Prevention Efforts Reduce First Time Use and Support other Coalition Stakeholders ==

Prevention efferts that focus on educating the community - especially youth and young adults - about the risks of drug use are an important componant of an effective community coalition.  Prevention organizations have experience with messaging and building awareness campaigns that educate the community about the impacts of drug use on individuals and families.  This knowledge and experience is often helpful in developing strategies to reach specifc populations and the community at large.  Prevention reaches into many other areas along the continuum of care, and they often help provide information on linkages to care, treatment options, and recovery supports. 
</div>
== Harm Reduction Saves Lives and Should Provide a Linkage to Care   ==

The distribution and training of how to use naloxone continues to be an effective way to reverse opioid overdose and save lives.  Other programs, like needle/syringe exchanges, 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 training on naloxone administration is 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 to expand distribution of naloxone and add other harm reduction measures?  Are there ways to improve linkages to care?  What can the coalition do to reach more people, especially in areas with the highest rates of overdose, to expand harm reduction efforts?

== Agencies and Community Organizations May 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 the coalition include to create new or expanded partnerships in the region?  Ideally what role(s) would they take on?

== <br/> 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 coalition.  Many such groups help raise awareness, reduce stigma, educate and train on the use of naloxone, and advocate for needed policy changes.   Is there an effective family group in the area?  Would greater coordination and involvement with the coalition be beneficial?  

== The Contribution of Peer Support Networks  ==

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, Peer Support Specialists and Recovery 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, as well as 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, who is needed to help make that a reality?   

== Finding Ways to Serve Underserved Areas   ==

This is an issue of major concern in most communities, and often, multiple strategies are necessary.  Stronger data collection efforts can help to more effectively direct the appropriate services to targeted areas within the community where they are most needed.  This will also help community partners in better addressing the crisis in their neighborhoods.  How can the coalition better serve areas of the community that have been underserved?  What partnerships can help make this happen effectively?  

== SUD must be seen as a Disease, not a Crime or Moral Failing   ==

Although there is growing understanding that SUD is a disease, there is still a stigma present that often prevents individuals and families from seeking help.  Stigma can also impact the type and quality of care provided by clinicians.  Stigma can be reduced through public awareness campaigns and education efforts.  If these are taking place in the community - how can these be expanded?  What organizations in the community can help this effort as part of the coalition? 

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.

== The Criminal Justice System Plays a Key Role   ==

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 can lead to a life in recovery, as opposed to long-term incarceration.  Socially and economically, 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 state and local criminal justice systems in terms of additional or expanded programs to help those with SUD find treatment - either through diversion programs or treatment for those incarcerated?  Are key figures who are part of the system willing to participate in a coalition?

== 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?  What about area workforce development entities?  Who can help expand these efforts as part of the coalition?

 

= National Coalitions =

There are many national coalitions and organization that can provide useful information and resources for local coalitions.  These national groups are widely varied and numerous.  It is therefore important to research these organizations so local coalitions can verify that their goals and priorities are aligned with any national organization they choose to become involved with.  A few examples follow, but there are many more at the national and even regional level.

'''Fed Up! Coalition to End the Opioid Epidemic'''<br/> Platform:

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

<br/> '''Coalition to Optimize the Management of Pain Associated with Surgery ([http://compasfoundation.org/ COMPAS])'''<br/> Mission: To educated all those involved in pain management decisions about acute pain management strategies that minimize the need for opioids.<br/> COMPAS also will provide education on how to implement multimodal analgesic strategies and how to measure success for patients and hospitals alike.<br/> <br/> '''Community Anti-Drug Coalitions of America ([http://www.cadca.org/ CADCA])'''<br/> 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.

= Local Coalition Examples and Resources =

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 

== Dayton Ohio - Community Overdose Action Team (COAT) ==

Dayton provides an example of a highly structured coalition.  The chart below details this structure and summarizes the role of each component within the COAT.  Other local coalitions might not bas complex or highly structured, but this example helps to provide ideas of what could be considered. 

[https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png]

 

 

= Tools & Resources =

[[TR_-_Strengthen_the_Coalition_to_Reduce_Opioid_Abuse|TR - Strengthen the Coalition to Reduce Opioid Abuse]]

<br/> <br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

= <br/> Sources =

[[Category:Community Resources]]

Strengthening Your Community Coalition

2020-12-16T09:31:21Z

Pkalch:

 

 

= Summary =

The substance misuse and SUD epidemic is a complex problem requiring a highly coordinated and cooperative response from communities.  The increase in non-fatal and fatal overdoses in recent years has caused many communities to realize that individual organizations cannot afford to work in silos.  Without a unified strategy and a focus on common goals, communities addressing a crisis as large as the addiction epidemic will not be poised for success. There is a clear understanding that local government, community partners of all types, and the private sector must align and work together to develop and implement effective strategies to improve their collective response to the SUD epidemic across the continuum of care.  By bringing together and working with a broad range of stakeholders, communities large and small can develop solutions that work for all those touched by the opioid and addiction crisis.  

Creating a community coalition is one of the most effective ways to solve complex problems and it is at the core of creating a local movement.  A coalition is simply a group of individuals and organizations with a common interest, who agree to see the problem through each other’s eyes and work together toward a common goal.  A coalition concentrates a community’s focus on a particular problem, creates alliances among those who might not normally work together, and keeps the community’s approach consistent. 

This page provides an overview of what it takes to build and strengthen an effective coalition based on the experiences of communities across the country.

__TOC__

= Building Your Coalition =

Many local communities have assembled coalitions to improve response to the SUD epidemic.  There is no one-size-fits-all set of practices for creating an effective coalition.  The suggestions that follow are based on the experiences of many communities and are meant to serve as a guide for those looking to form a new coalition or expand and improve upon one that already exists.  One important aspect when looking to create a coalition is to realize that, historically, substance use disorder has been seen by many as a moral failing and not a disease.  

As Mayor Nan Whaley from Dayton, Ohio, puts it, "When we began our work in Dayton, there was no blueprint for treating a substance misuse epidemic because the United States has never treated addiction as it treats other chronic illnesses."  [http://ifi-wikis.com/IFI-OpioidCrisis/Strengthen_the_Coalition_to_Reduce_Substance_Use#cite_note-1 [1]]

Dayton and other communities who have found success have embraced the fact that SUD is a chronic health illness, not a choice.  This outlook, in turn, has informed a new set of strategies that includes compassion and meeting those suffering from SUD where they are at the moment.  

 

= Getting Started =

Who can start a coalition to address SUD?  Anyone can.  Coalitions and task forces are often started by local elected leaders, public health departments, public safety agencies, community organizations, or even passionate individuals engaged in the fight to save lives and reduce harm created by drug misuse and SUD.  Typically, coalitions are formed as a response to higher rates of overdose and overdose deaths.  Regardless of who takes the initiative, it is important to be inclusive and identify stakeholders whose ultimate goals align.  Get started by looking around the community and determining if there are similar existing efforts in which to get involved or add value.  It’s important not to duplicate efforts.  Is there a mechanism or coalition body already taking a comprehensive approach to addiction that can be leveraged?  

 

 

== Potential Partners and Their Roles ==
<div class="_">
There are many potential partners that can be invited to join the coalition and improve the community response to SUD.  The following list is not intended to be all inclusive and it is not a requirement to have all of these individuals at the table.  These are suggestions based on the types of partners that are most often brought together.  Highlighted categories contain links to what roles they might play within the coalition.  Keep in mind it’s important to establish a team of optimal size and with sufficient authority to plan and implement ideas and strategies effectively and efficiently.  Does the team include leaders with the authority to make decisions and drive the implementation of new strategies?
</div>
#Local Health Departments
#Hospitals
#Pharmacists
#Primary Care Physicians
#Pain Specialists or Pain Centers
#Nurses
#Health Plans and Insurance Companies
#Local Elected Officials
#Local Law Enforcement
#Corrections
#Treatment Providers
#Faith Based Communities
#Persons with lived experience, including those in recovery and still using substances
#Local Harm Reduction Organizations
#Education Leaders
#Business Leaders
#Recovery Support Organizations
#Family Support Groups and Recovery Allies
#Local Philanthropic Organization
<div class="_"> </div>
== Working with Partners  ==

=== Faith-Based Communities ===

See [[Coalition_Partner_-_Faith_Communities|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.  <span style="font-size:small;"><span style="font-family:Arial,Helvetica,sans-serif;"><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">[http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&103&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Opioid Epidemic Practical Toolkit: Helping Faith and][http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&104&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Community Leaders Bring Hope and Healing to Our Communities] may also be helpful.</span></span></span><br/> Programs like [http://www.onebodycollaboratives.org/ One Body Coll][http://www.onebodycollaboratives.org/ aboratives] and software like [https://meettheneed.org/ Meet the Need] can help engage and equip churches to participate in their communities.
</div> <div class="_">
=== Public Health and Public Safety ===

<u>'''Principles for Building Better Relationships'''</u><br/> The Police Executive Research forum reports 5 principles for building better partnerships between law enforcement agencies, public health organizations, treatment providers, and other stakeholders from their April 2016 meeting. The five principles are:

#Find common ground and work toward shared goals.
#Respect and Learn from one another's positions and perspectives
#Involve people from all levels within an organization
#Be open to expanding your perspective and accepting new roles.
#Maintain a community focus.<sup>[1]</sup>

= Organization, Structure, and Meetings =

This is another area where each coalition will determine for itself what works best for them.  However, some guidelines based on experience may be helpful.  Questions of leadership, frequency of meetings, who else should be included, the need for some type of by-laws or governance document, and the roles of participants are just some of the questions that typically arise during planning.  Working through these and other issues requires patience and cooperation.

== Initial Outreach ==

Getting your desired partners to the table is not always easy.  Keep in mind that while there are a number of ways to contact these groups, in-person and direct contact is always best.  You may have to overcome resistance of several types.  Organizers of local coalitions to improve response to drug misuse and SUD have often found that some potential partners are suspicious or even defensive.  Some organizations are not naturally inclined to work with others.  For example, the harm reduction and law enforcement communities are not always natural allies.  However, we have found that where these two groups come together and see the problem through each other’s lenses, some very powerful work can be done.  Some organizations might not want to get involved because of their own perception of capacity (this is more work for me) or stigma (this is not my problem).  You may have to expend considerable effort to convince these groups that reversing the epidemic is in the entire community’s interest and that everyone has a contribution to make.

It is important to build trust from the outset.  Some common advice heard from those who have been through the process of bringing together a coalition include:

     - Honoring the Work that has Been Done.  Everyone fighting this epidemic is doing their best and should always be recognized for their efforts.

     - No Judgement.  The rise of the current epidemic has been created by a series of events outside of any local jurisdiction.  It is not the fault of local government and community leaders fighting the epidemic.

     - Common Goals.  As part of initial discussions, it is important to talk about what all partners typically have in common - the desire to save lives and reduce suffering.  While partners will vary in the approaches they use, and which they may feel are more effective, all involved want to see the same end result.  It is important to focus on what the partners share in terms of outcomes they want to see and discuss how greater collaboration will benefit the efforts of all involved. 

== Initial Actions ==

Hold your first meeting.  Don’t worry if you have as few as five community leaders or as many as 20.  The important thing is, you have found people who are willing to work together to thoughtfully and comprehensively address the particular problem in your community.  Although the topic that brings all of the stakeholders together is difficult, it is the coalition leader’s job to bring energy and optimism to the movement.  Because solutions might look different to each of your stakeholders, focus on defining the common problem you are looking to solve.  A goal of your first meeting should be to establish a meeting rhythm in which the coalition frequently gathers to review progress, update your plan, and share success stories.   

== Evaluate the State of Your Community ==

For your community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets within your community.  One way to evaluate perception and resources is through the SAFE Community Pulse Survey and SAFE Community Resources Exercise.  These tools are designed specifically to provide you with the insight your coalition needs to focus and prioritize your work.  These tools can be found in SAFE Project’s Community Playbook – a framework for communities to organization, evaluate, and create change in their community to impact the addiction epidemic.  

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 
</div>
= Lessons Learned and Related Questions =

As you consider who to reach out to in order to create or expand a coalition, we have provided below some lessons learned by communities that have gone through - and continue to go through - this process.  As you proceed you will likely find that the needs of the coalition, as expressed by the members, will change over time.  Most often, the composition of the coalition will change as well.  The lessons are followed by questions that should be asked when considering which potential partners to include.  As a coalition leader, it might also be helpful to track lessons learned over time to help maintain institutional knowledge as staffing changes over time.

== Data is a Critical Foundation to Action   ==
<div class="_">
The improved collection, distribution, and rapid 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 in order to know where more resources need to be deployed.  What data sources are currently available?  How are they being used?  Does the coalition have the partners to provide the necessary data?  How can the coalition expand the data set to help focus resources where they are most needed, and when they are most needed?  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?  Use local data disaggregated by population characteristics like race, ethnicity, immigration status, language, and household levels of income to identify disparities in outcomes and inform policies and practice for specific populations, neighborhoods, and zip codes.

== Prevention Efforts Reduce First Time Use and Support other Coalition Stakeholders ==

Prevention efferts that focus on educating the community - especially youth and young adults - about the risks of drug use are an important componant of an effective community coalition.  Prevention organizations have experience with messaging and building awareness campaigns that educate the community about the impacts of drug use on individuals and families.  This knowledge and experience is often helpful in developing strategies to reach specifc populations and the community at large.  Prevention reaches into many other areas along the continuum of care, and they often help provide information on linkages to care, treatment options, and recovery supports. 
</div>
== Harm Reduction Saves Lives and Should Provide a Linkage to Care   ==

The distribution and training of how to use naloxone continues to be an effective way to reverse opioid overdose and save lives.  Other programs, like needle/syringe exchanges, 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 training on naloxone administration is 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 to expand distribution of naloxone and add other harm reduction measures?  Are there ways to improve linkages to care?  What can the coalition do to reach more people, especially in areas with the highest rates of overdose, to expand harm reduction efforts?

== Agencies and Community Organizations May 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 the coalition include to create new or expanded partnerships in the region?  Ideally what role(s) would they take on?

== <br/> 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 coalition.  Many such groups help raise awareness, reduce stigma, educate and train on the use of naloxone, and advocate for needed policy changes.   Is there an effective family group in the area?  Would greater coordination and involvement with the coalition be beneficial?  

== The Contribution of Peer Support Networks  ==

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, Peer Support Specialists and Recovery 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, as well as 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, who is needed to help make that a reality?   

== Finding Ways to Serve Underserved Areas   ==

This is an issue of major concern in most communities, and often, multiple strategies are necessary.  Stronger data collection efforts can help to more effectively direct the appropriate services to targeted areas within the community where they are most needed.  This will also help community partners in better addressing the crisis in their neighborhoods.  How can the coalition better serve areas of the community that have been underserved?  What partnerships can help make this happen effectively?  

== SUD must be seen as a Disease, not a Crime or Moral Failing   ==

Although there is growing understanding that SUD is a disease, there is still a stigma present that often prevents individuals and families from seeking help.  Stigma can also impact the type and quality of care provided by clinicians.  Stigma can be reduced through public awareness campaigns and education efforts.  If these are taking place in the community - how can these be expanded?  What organizations in the community can help this effort as part of the coalition? 

== The Criminal Justice System Plays a Key Role   ==

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 can lead to a life in recovery, as opposed to long-term incarceration.  Socially and economically, 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 state and local criminal justice systems in terms of additional or expanded programs to help those with SUD find treatment - either through diversion programs or treatment for those incarcerated?  Are key figures who are part of the system willing to participate in a coalition?

== 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?  What about area workforce development entities?  Who can help expand these efforts as part of the coalition?

 

= National Coalitions =

There are many national coalitions and organization that can provide useful information and resources for local coalitions.  These national groups are widely varied and numerous.  It is therefore important to research these organizations so local coalitions can verify that their goals and priorities are aligned with any national organization they choose to become involved with.  A few examples follow, but there are many more at the national and even regional level.

'''Fed Up! Coalition to End the Opioid Epidemic'''<br/> Platform:

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

<br/> '''Coalition to Optimize the Management of Pain Associated with Surgery ([http://compasfoundation.org/ COMPAS])'''<br/> Mission: To educated all those involved in pain management decisions about acute pain management strategies that minimize the need for opioids.<br/> COMPAS also will provide education on how to implement multimodal analgesic strategies and how to measure success for patients and hospitals alike.<br/> <br/> '''Community Anti-Drug Coalitions of America ([http://www.cadca.org/ CADCA])'''<br/> 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.

= Local Coalition Examples and Resources =

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 

== Dayton Ohio - Community Overdose Action Team (COAT) ==

Dayton provides an example of a highly structured coalition.  The chart below details this structure and summarizes the role of each component within the COAT.  Other local coalitions might not bas complex or highly structured, but this example helps to provide ideas of what could be considered. 

[https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png]

 

 

= Tools & Resources =

[[TR_-_Strengthen_the_Coalition_to_Reduce_Opioid_Abuse|TR - Strengthen the Coalition to Reduce Opioid Abuse]]

<br/> <br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

= <br/> Sources =

[[Category:Community Resources]]

Strengthening Your Community Coalition

2020-12-16T09:15:39Z

Pkalch:

 

 

= Summary =

The substance misuse and SUD epidemic is a complex problem requiring a highly coordinated and cooperative response from communities.  The increase in non-fatal and fatal overdoses in recent years has caused many communities to realize that individual organizations cannot afford to work in silos.  Without a unified strategy and a focus on common goals, communities addressing a crisis as large as the addiction epidemic will not be poised for success. There is a clear understanding that local government, community partners of all types, and the private sector must align and work together to develop and implement effective strategies to improve their collective response to the SUD epidemic across the continuum of care.  By bringing together and working with a broad range of stakeholders, communities large and small can develop solutions that work for all those touched by the opioid and addiction crisis.  

Creating a community coalition is one of the most effective ways to solve complex problems and it is at the core of creating a local movement.  A coalition is simply a group of individuals and organizations with a common interest, who agree to see the problem through each other’s eyes and work together toward a common goal.  A coalition concentrates a community’s focus on a particular problem, creates alliances among those who might not normally work together, and keeps the community’s approach consistent. 

This page provides an overview of what it takes to build and strengthen an effective coalition based on the experiences of communities across the country.

__TOC__

= Building Your Coalition =

Many local communities have assembled coalitions to improve response to the SUD epidemic.  There is no one-size-fits-all set of practices for creating an effective coalition.  The suggestions that follow are based on the experiences of many communities and are meant to serve as a guide for those looking to form a new coalition or expand and improve upon one that already exists.  One important aspect when looking to create a coalition is to realize that, historically, substance use disorder has been seen by many as a moral failing and not a disease.  

As Mayor Nan Whaley from Dayton, Ohio, puts it, "When we began our work in Dayton, there was no blueprint for treating a substance misuse epidemic because the United States has never treated addiction as it treats other chronic illnesses."  [http://ifi-wikis.com/IFI-OpioidCrisis/Strengthen_the_Coalition_to_Reduce_Substance_Use#cite_note-1 [1]]

Dayton and other communities who have found success have embraced the fact that SUD is a chronic health illness, not a choice.  This outlook, in turn, has informed a new set of strategies that includes compassion and meeting those suffering from SUD where they are at the moment.  

 

= Getting Started =

Who can start a coalition to address SUD?  Anyone can.  Coalitions and task forces are often started by local elected leaders, public health departments, public safety agencies, community organizations, or even passionate individuals engaged in the fight to save lives and reduce harm created by drug misuse and SUD.  Typically, coalitions are formed as a response to higher rates of overdose and overdose deaths.  Regardless of who takes the initiative, it is important to be inclusive and identify stakeholders whose ultimate goals align.  Get started by looking around the community and determining if there are similar existing efforts in which to get involved or add value.  It’s important not to duplicate efforts.  Is there a mechanism or coalition body already taking a comprehensive approach to addiction that can be leveraged?  

 

== Potential Partners and Their Roles ==
<div class="_">
There are many potential partners that can be invited to join the coalition and improve the community response to SUD.  The following list is not intended to be all inclusive and it is not a requirement to have all of these individuals at the table.  These are suggestions based on the types of partners that are most often brought together.  Highlighted categories contain links to what roles they might play within the coalition.  Keep in mind it’s important to establish a team of optimal size and with sufficient authority to plan and implement ideas and strategies effectively and efficiently.  Does the team include leaders with the authority to make decisions and drive the implementation of new strategies?
</div>
#Local Health Departments
#Hospitals
#Pharmacists
#Primary Care Physicians
#Pain Specialists or Pain Centers
#Nurses
#Health Plans and Insurance Companies
#Local Elected Officials
#Local Law Enforcement
#Corrections
#Treatment Providers
#Faith Based Communities
#Persons with lived experience, including those in recovery and still using substances
#Local Harm Reduction Organizations
#Education Leaders
#Business Leaders
#Recovery Support Organizations
#Family Support Groups and Recovery Allies
#Local Philanthropic Organization
<div class="_"> </div>

== Working with Partners  ==

=== Faith-Based Communities ===

See [[Coalition_Partner_-_Faith_Communities|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.  <span style="font-size:small;"><span style="font-family:Arial,Helvetica,sans-serif;"><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">[http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&103&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Opioid Epidemic Practical Toolkit: Helping Faith and][http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwOTIxLjc4NDQ4OTExJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDkyMS43ODQ0ODkxMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3NDUxODE5JmVtYWlsaWQ9YmlsbC5iYXJiZXJnQGluc2lnaHRmb3JtYXRpb24uY29tJnVzZXJpZD1iaWxsLmJhcmJlcmdAaW5zaWdodGZvcm1hdGlvbi5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&104&&&https://www.hhs.gov/about/agencies/iea/partnerships/opioid-toolkit/index.html Community Leaders Bring Hope and Healing to Our Communities] may also be helpful.</span></span></span><br/> Programs like [http://www.onebodycollaboratives.org/ One Body Coll][http://www.onebodycollaboratives.org/ aboratives] and software like [https://meettheneed.org/ Meet the Need] can help engage and equip churches to participate in their communities.
</div> <div class="_">
=== Public Health and Public Safety ===

<u>'''Principles for Building Better Relationships'''</u><br/> The Police Executive Research forum reports 5 principles for building better partnerships between law enforcement agencies, public health organizations, treatment providers, and other stakeholders from their April 2016 meeting. The five principles are:

#Find common ground and work toward shared goals.
#Respect and Learn from one another's positions and perspectives
#Involve people from all levels within an organization
#Be open to expanding your perspective and accepting new roles.
#Maintain a community focus.<sup>[1]</sup>

= Organization, Structure, and Meetings =

This is another area where each coalition will determine for itself what works best for them.  However, some guidelines based on experience may be helpful.  Questions of leadership, frequency of meetings, who else should be included, the need for some type of by-laws or governance document, and the roles of participants are just some of the questions that typically arise during planning.  Working through these and other issues requires patience and cooperation.

== Initial Outreach ==

Getting your desired partners to the table is not always easy.  Keep in mind that while there are a number of ways to contact these groups, in-person and direct contact is always best.  You may have to overcome resistance of several types.  Organizers of local coalitions to improve response to drug misuse and SUD have often found that some potential partners are suspicious or even defensive.  Some organizations are not naturally inclined to work with others.  For example, the harm reduction and law enforcement communities are not always natural allies.  However, we have found that where these two groups come together and see the problem through each other’s lenses, some very powerful work can be done.  Some organizations might not want to get involved because of their own perception of capacity (this is more work for me) or stigma (this is not my problem).  You may have to expend considerable effort to convince these groups that reversing the epidemic is in the entire community’s interest and that everyone has a contribution to make.

It is important to build trust from the outset.  Some common advice heard from those who have been through the process of bringing together a coalition include:

     - Honoring the Work that has Been Done.  Everyone fighting this epidemic is doing their best and should always be recognized for their efforts.

     - No Judgement.  The rise of the current epidemic has been created by a series of events outside of any local jurisdiction.  It is not the fault of local government and community leaders fighting the epidemic.

     - Common Goals.  As part of initial discussions, it is important to talk about what all partners typically have in common - the desire to save lives and reduce suffering.  While partners will vary in the approaches they use, and which they may feel are more effective, all involved want to see the same end result.  It is important to focus on what the partners share in terms of outcomes they want to see and discuss how greater collaboration will benefit the efforts of all involved. 

== Initial Actions ==

Hold your first meeting.  Don’t worry if you have as few as five community leaders or as many as 20.  The important thing is, you have found people who are willing to work together to thoughtfully and comprehensively address the particular problem in your community.  Although the topic that brings all of the stakeholders together is difficult, it is the coalition leader’s job to bring energy and optimism to the movement.  Because solutions might look different to each of your stakeholders, focus on defining the common problem you are looking to solve.  A goal of your first meeting should be to establish a meeting rhythm in which the coalition frequently gathers to review progress, update your plan, and share success stories.   

== Evaluate the State of Your Community ==

For your community coalition to be successful, it will need to understand how the community perceives a number of elements of addiction, as well as what resources are already at work across the many stakeholder sets within your community.  One way to evaluate perception and resources is through the SAFE Community Pulse Survey and SAFE Community Resources Exercise.  These tools are designed specifically to provide you with the insight your coalition needs to focus and prioritize your work.  These tools can be found in SAFE Project’s Community Playbook – a framework for communities to organization, evaluate, and create change in their community to impact the addiction epidemic.  

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 
</div>
= Lessons Learned and Related Questions =

As you consider who to reach out to in order to create or expand a coalition, we have provided below some lessons learned by communities that have gone through - and continue to go through - this process.  As you proceed you will likely find that the needs of the coalition, as expressed by the members, will change over time.  Most often, the composition of the coalition will change as well.  The lessons are followed by questions that should be asked when considering which potential partners to include.  As a coalition leader, it might also be helpful to track lessons learned over time to help maintain institutional knowledge as staffing changes over time.

== Data is a Critical Foundation to Action   ==
<div class="_">
The improved collection, distribution, and rapid 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 in order to know where more resources need to be deployed.  What data sources are currently available?  How are they being used?  Does the coalition have the partners to provide the necessary data?  How can the coalition expand the data set to help focus resources where they are most needed, and when they are most needed?  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?  Use local data disaggregated by population characteristics like race, ethnicity, immigration status, language, and household levels of income to identify disparities in outcomes and inform policies and practice for specific populations, neighborhoods, and zip codes.
</div>
== Harm Reduction Saves Lives and Should Provide a Linkage to Care   ==

The distribution and training of how to use naloxone continues to be an effective way to reverse opioid overdose and save lives.  Other programs, like needle/syringe exchanges, 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 training on naloxone administration is 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 to expand distribution of naloxone and add other harm reduction measures?  Are there ways to improve linkages to care?  What can the coalition do to reach more people, especially in areas with the highest rates of overdose, to expand harm reduction efforts?

== Agencies and Community Organizations May 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 the coalition include to create new or expanded partnerships in the region?  Ideally what role(s) would they take on?

== <br/> 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 coalition.  Many such groups help raise awareness, reduce stigma, educate and train on the use of naloxone, and advocate for needed policy changes.   Is there an effective family group in the area?  Would greater coordination and involvement with the coalition be beneficial?  

== The Contribution of Peer Support Networks  ==

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, Peer Support Specialists and Recovery 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, as well as 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, who is needed to help make that a reality?   

== Finding Ways to Serve Underserved Areas   ==

This is an issue of major concern in most communities, and often, multiple strategies are necessary.  Stronger data collection efforts can help to more effectively direct the appropriate services to targeted areas within the community where they are most needed.  This will also help community partners in better addressing the crisis in their neighborhoods.  How can the coalition better serve areas of the community that have been underserved?  What partnerships can help make this happen effectively?  

== SUD must be seen as a Disease, not a Crime or Moral Failing   ==

Although there is growing understanding that SUD is a disease, there is still a stigma present that often prevents individuals and families from seeking help.  Stigma can also impact the type and quality of care provided by clinicians.  Stigma can be reduced through public awareness campaigns and education efforts.  If these are taking place in the community - how can these be expanded?  What organizations in the community can help this effort as part of the coalition? 

== The Criminal Justice System Plays a Key Role   ==

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 can lead to a life in recovery, as opposed to long-term incarceration.  Socially and economically, 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 state and local criminal justice systems in terms of additional or expanded programs to help those with SUD find treatment - either through diversion programs or treatment for those incarcerated?  Are key figures who are part of the system willing to participate in a coalition?

== 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?  What about area workforce development entities?  Who can help expand these efforts as part of the coalition?

 

= National Coalitions =

There are many national coalitions and organization that can provide useful information and resources for local coalitions.  These national groups are widely varied and numerous.  It is therefore important to research these organizations so local coalitions can verify that their goals and priorities are aligned with any national organization they choose to become involved with.  A few examples follow, but there are many more at the national and even regional level.

'''Fed Up! Coalition to End the Opioid Epidemic'''<br/> Platform:

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

<br/> '''Coalition to Optimize the Management of Pain Associated with Surgery ([http://compasfoundation.org/ COMPAS])'''<br/> Mission: To educated all those involved in pain management decisions about acute pain management strategies that minimize the need for opioids.<br/> COMPAS also will provide education on how to implement multimodal analgesic strategies and how to measure success for patients and hospitals alike.<br/> <br/> '''Community Anti-Drug Coalitions of America ([http://www.cadca.org/ CADCA])'''<br/> 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.

= Local Coalition Examples and Resources =

Once you have completed both evaluations, it’s time to take a step back and look at what the data and research are telling you.  Is there a correlation between what the community survey tells you and the gaps that you have identified in your resource exercise? 

== Dayton Ohio - Community Overdose Action Team (COAT) ==

Dayton provides an example of a highly structured coalition.  The chart below details this structure and summarizes the role of each component within the COAT.  Other local coalitions might not bas complex or highly structured, but this example helps to provide ideas of what could be considered. 

[https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png https://cdn.americanprogress.org/content/uploads/2019/01/10055812/DaytonOpioids-fig9-693.png]

 

 

= Tools & Resources =

[[TR_-_Strengthen_the_Coalition_to_Reduce_Opioid_Abuse|TR - Strengthen the Coalition to Reduce Opioid Abuse]]

<br/> <br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

= <br/> Sources =

[[Category:Community Resources]]

Supporting Key Legislative and Policy Changes

2020-12-16T09:08:35Z

Pkalch:

<div class="wiki" id="content_view" style="display: block">
Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map ]]<span style="font-size: 13px;">or the </span>[[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|Zoom Map - Expand Harm Reduction Practices Associated with Opioid Misuse]]

 

 

= Background =

Educating policymakers and the general public about the legislative or policy changes necessary to create change in your community is an important step to addressing substance misuse and SUD. Policies help states and local communities in several important ways:

1. By providing direct funding to communities for treatment and other services.

2. By improving access and/or affordability of care to individuals in need of assistance.

3. By removing barriers that prevent or limit the use of best practices across government agencies.

Policy changes can take place at all levels of government.  This page will provide information about how policy changes typically take place, as well as some examples of federal, state, and local laws that have helped local communities.  

 

= Policy Advocacy =

== Initial Steps ==

In order to bring about policy changes through laws or ordinances, any group of citizens must be able to become a "constituency of consequence" to those with the ability to create and change policy.  This can be accomplished with a number of different advocacy approaches, as highlighted below.  A few key principles to change policy at any level of government include:

1. Have clear policy objectives.  The more specific and narrow the objective the better.  If the policy goals are too broad or general, it is easy for legislators to object on that basis.

2. Support your position.  Have research and data to support why the policy change you are seeking would be beneficial.  For example, if seeking to improve harm reduction through the creation of a needle exchange program, provide data on expected lives that will be saved, reduced medical costs, improved linkages to care, and other benefits.

3. Build a coalition.  It is important to build a coalition to increase political clout.  Think about other groups within the state or local community whose goals align with yours that would support your policy objectives and who would be willing to take action in order to achieve it.  For example, if you were advocating for a needle exchange program, you might seek support from harm reduction organizations including hospitals, community health organizations and professionals, the recovery community, families in support of recovery, the treatment community, and potentially many others.  

4. Know your opposition.  If a policy change hasn't happened, it is likely opposition exists.  It is important to learn why policymakers may be hesitant to make a certain change, including what groups oppose the policy and why.  Learning about the other side is critical to developing an effective advocacy strategy.  Overcoming opposition may require education, effective counter-arguments, financial resources, and increased public awareness.

5. Identity champions.  The most successful efforts resulting in desired policy changes are led by individuals who are passionate about the issue.  Identifying and working with champions in the state or local government is a big key to success.  It is important to have people "on the inside" that can hold hearings, develop legislation, utilize input and information from stakeholders, and provide insight on the process.  Leaders within the coalition of groups seeking the policy change are also critical to identify.

6. Your voice matters.  Many times, individuals or groups with minimal advocacy experience can be intimidated by the process.  Remember that those "in power" are there because they were elected to serve.  Lawmakers across all levels of government represent the people of their states, districts, cities, towns, and so forth.  It is your constitutional right to petition the government and be heard.  Those representing the people need to hear the concerns of all those they represent.

 

== Into Action ==

After taking the initial steps to organize, conduct both supportive and opposition research, identify champions, and reach consensus on what the policy objective(s) should be, the next step is identify and implement a set of strategies that will grow public and political support for those policies.  While approaches and specific strategies and almost innumerable, taking action involves communication and messaging intended to educate and influence.  

=== Grassroots Advocacy ===

Grassroots Advocacy generally refers to engaging the public to actively educate and lobby on behalf of a desired policy objective.  Communication occurs through letters, emails, calls to legislators, rallies, social media campaigns, letters to the editor, and other forms of messaging campaigns designed to put political pressure on policymakers to enact desired changes.  A good overview of grassroots advocacy can be found [https://www.gih.org/files/usrdoc/Grassroots_Advocacy_Sunflower_Foundation_November_2010.pdf here].

=== Direct Lobbying ===

Direct lobbying refers to direct communication and meetings with policy makers, most often governors, mayors, county executives, and the legislative branch at all levels of government. This key activity provides the opportunity to meet with decision makers and their staffs to discuss the desired policy goals, the benefits and support, address any likely opposition, and gage the receptiveness of the policymakers.

Opportunities for direct lobbying often take place during the legislative session, which varies from jurisdiction to jurisdiction.  Some advocates and interest groups will organize a "lobby day" where members converge in Washington, state capitols, or with local legislative bodies to advocate for desired policy objectives.  When the legislative body is not in session, advocates can meet with their representatives at their local offices.  A good resources on the process of influencing policy can be found [https://ctb.ku.edu/en/influencing-policy-development here].

 

= Lobbying Rules and Restrictions =

Lobbying rules vary widely between levels of government and across all states.  It is, therefore, important to know how lobbying is defined and what the restrictions are in the jurisdiction you are involved with.  Some fundamentals include:

501(c)3 organizations (tax-exempt nonprofits) have some restrictions on lobbying in the government. [http://www.cadca.org/sites/default/files/resource/files/strat31.pdf This guide] explains federal laws on non-profit lobbying for policy changes. 

The IRS defines direct lobbying as: "A direct lobbying communication is any attempt to influence any legislation through communication with: Any member or employee of a legislative body; or Any government official or employee (other than a member or employee of a legislative body) who may participate in the formulation of the legislation, but only if the principal purpose of the communication is to influence legislation."<ref>Treas. Reg. Sections 56.4911-2(b)(1)</ref>

Direct Lobbying Communication is defined as: "Referring to specific legislation and reflects a view on such legislation."

The IRS defines grassroots lobbying as: "any attempt to influence any legislation through an attempt to affect the opinions of the general public or any segment thereof."

Grassroots Lobbying Communication is defined as: "Referring to specific legislation; reflecting a view on such legislation; and encouraging the recipient of the communication action with respect to such legislation." 

 

= The Legislative Process =

== Overview ==

The legislative process of course varies between different levels of governments and in jurisdictions across the country.  There are typically several steps in the process that provide opportunities to influence policymakers as when they are in session.  Some states and localities have relatively short time frames to consider and pass new laws or ordinances, while other states and the federal government are in session for the many more weeks throughout the year.  It is, therefore, important to know when the actual work of policy development and consideration takes place in the legislative body where you want the change to happen.

== Sponsors and Early Support ==

In any legislative body, a successful policy enactment starts with one or more members of the legislative body drafting legislation that would bring about the desired change.  Members can do this individually or as a group.  A member or group of members that introduce a legislative proposal are typically referred to as sponsors or "original" sponsors of the proposal.  Other members can then sign on in support of the bill as co-sponsors.

Effective advocacy can help build momentum for a bill during this process.  The more sponsors and cosponsors, the better.  It is also extremely beneficial to have early supporters from both political parties - especially at the state and federal level.  Bipartisan support, and support among a broad base of members at the local level, can show other members that the bill is likely not controversial.  It is also especially helpful for key committee leaders with jurisdiction to support the proposed legislation.

Advocates can provide their champions within the legislature with all of the supporting information and research to help their champions in the legislative body attract as many co-sponsors as possible and respond to questions or objections as they arise.

== Committee Process ==

Typically, legislative proposals are taken up by the committee (or committees) of jurisdiction.  Actual consideration of a proposal often takes place after one or more committee hearings on the proposal.  This often involves hearing from witnesses in support of, and potentially in opposition to, a given proposal.  Written testimony is also included in the public record to provide additional information to both the public and the legislators.  The hearing process provides another opportunity for advocates to testify as a witness and/or provide information to be included in the record.  Hearing can take place in front of the full committee or by a sub-committee which oversees the specific policy area impacted.

After the hearing process, the bill may be taken up by the full committee for consideration.  Although the bill can be altered by the manager of the bill at any time, consideration by the committee is the first time lawmakers have an opportunity to propose amendments to the proposal.  These amendments are voted and adopted, or not adopted, by a majority vote.  Following the amendment process the committee chair can call for a final vote on the legislation.  If passed, the bill can move to the full legislative body for consideration.

Advocacy efforts can move quickly during the committee process, as unexpected challenges may surface due to an unfriendly amendment that might weaken the bill and the policy impact desired.  It is important to work with allies to carefully track this process and respond to any negative developments.

== Consideration by the Full Body ==

At the local level, there is a single body that approves local legislative proposals.  This is typically a Board of Commissioners or other duly elected body.  At the state and federal levels, there are two legislative chambers, with delegates and senators at the state level, and the House and Senate at the federal level.

The process is usually relatively simple at the local level.  Legislation (or ordinance) proposals are taken up at regularly scheduled meetings where a debate occurs, amendments are offered, and the proposals are voted on.  Often, the chief executive at the local level has a vote along with the other members.

At the state and federal level, the process is more complex.  A bill has to pass both chambers before it can be reconciled, voted on again by both bodies, and sent to the Governor or President for signature.  While on the floor, members can again offer amendments that can be voted on individually or en bloc.  Typically, more controversial amendments will be voted on by individual basis.  Assuming the bill passes, it is sent to the other body for consideration.  A similar or identical bill may be in process in that other chamber already, or it may be that no companion legislation exists.  In the latter case the chamber that did not originate the bill will take up the version that was passed in the other chamber.

When a bill does pass both chambers, there are almost always differences that must be worked out.  The committee chairs will select a reconciliation committee with a bi-partisan group of legislators from both chambers to accomplish this.  Assuring any differences can be worked out, the bill then goes back to the floor of each chamber for a final vote.  If passed, the bill is finally referred to the Governor or President.

As with the Committee process, advocacy must continue throughout the time in which a bill is considered by the full legislative body.  At the state and federal levels, this can be a challenge with many steps involved and a larger number of legislators to contend with - some of whom my not be supportive.  Again, it is critical to stay in constant contact with supporters within the legislative body to keep track of potential harmful amendments and keep count of likely supporters within the full body.  At times advocacy efforts need to be focused on a handful of legislators who have reservations or are undecided.

== Potential Veto and Override ==

Although rare, Governors and the President may veto a bill passed by the state and federal legislators.  If the vote on final passage were close, it is unlikely that the bill will be taken up again, as a two-thirds majority is needed to override a veto.  If the original vote was approached the two-thirds number, there is a better chance to find the supporters needed for a successful override. 

== Continued Funding (Budget and Appropriations) ==

Even when a law or ordinance is passed and signed by the chief executive, advocacy efforts often do not end.  This is due to the fact that legislation containing funding to implement programs is authorized (usually for a period of years), but there is still a budget and appropriations process that must be monitored over the authorization period.  Typically, the executive branch of government produces an annual budget that reflects their policy and spending priorities.  The budget may or may not be approved by the legislative body.  After this point the legislative body will take up annual appropriations bills, which set spending levels for all agencies and their programs.  These bills often work through the regular order of other legislation, but sometimes will have a different, often expedited process.  

It is important for community coalitions and advocates to understand that funding for the agencies and programs they support can change through each step of the budget and appropriations process.  There is a need to stay vigilant and ensure full funding is achieved.  Advocates must stay in touch with their champions in the executive branch and legislature to keep informed of any changes and be ready to advocate just as vigorously as when it is done with new initiatives in order to restore any proposed cuts in funding.

== Example of Advocacy Strategies within the Legislative Process ==

The following illustrates some of the partnerships and strategies used to pass an important piece of legislation in the state of Illinois:

'''[[Illinois_SB2928|Illinois]]''' '''[[Illinois_SB2928|SB2928]]''' is a current law with the common name '''"'''Lake County Prescription Drug Disposal Pilot Program" which had been adopted in 2014 and is currently still functioning, losing its Pilot portion of title in 2015. <sup class="reference">[17]</sup><sup class="reference">[18]</sup> It has been shown to be a model by which many organizations and local governments can partner with one another to improve outcomes in drug recovery and disposal efforts. <sup class="reference">[19]</sup> The lead Project Coordinator Bill Gentes has as a result been awarded CADCA's Advocate of the Year.<sup class="reference">[20]</sup> The following steps were used in the creation, adoption and advocacy for this bill that allowed successful passing of it within the 98th general assembly:

#Investigation of Previous Regulation and Legislation - As is shown in the Securing Public-Private Partnerships section, it is required that one review current legal standings to determine if advocacy for amendment is required to allow for a more proactive approach to drug prevention to exist.
#Partnering with Local Law Enforcement - As stated by Gentes at an interview "“''circling back to law enforcement and telling them, ‘look, you guys dropped off 500 pounds and I want to tell you want that means,” makes it easy for those police departments to then get their mayors, and their village boards invested in the process''."<sup class="reference">[21]</sup> In many jurisdictions, it is regulated that only police forces may collect excess pharmaceutical products, which increases the need to partner with Local Law Enforcement even more. <sup class="reference">[22]</sup>
#Gaining support of Local and Community Leaders - Primarily through the method discussed in Partnering with Local Law Enforcement and through advocacy and education efforts, to have a bill passed one must show support at the local level as well as demonstrable results of local programs to garner such support. As Stated in the Route 50 Article: "Another goal for Gentes was to uncover and take advantage of the data coming out of the collection boxes. When scheduled substances are found within the boxes, the contents and amount is noted. This isn’t merely a measure to satisfy curiosity. Rather, Gentes uses the data collected as a tool to recruit new police departments to the program, and to remind participating police departments that their efforts are making a difference...''.'look, you guys dropped off 500 pounds and I want to tell you want that means,” makes it easy for those police departments to then get their mayors, and their village boards invested in the process.'''"<sup class="reference">[23]</sup>
#Securing Public-Private Partnerships - Walgreens has been approached by Gentes and worked to create Prescription Drop Off and Secure Sites with partnership with local police forces and legislature. Currently expanding their drop off points to several states, there appears to be issue with a need to review current laws regarding drug disposal. <sup class="reference">[24]</sup> This has as a result increased the capacity of the project and accompanying police force in collection efforts.
#Advocating for Adoption from State Officials - Through previous methods listed, especially community advocacy efforts, the proposal was adopted as a bill partly through the efforts of sponsor Senator Terry Link, and went on to receive unanimous support. <sup class="reference">[25]</sup>
#Securing Funding For A Statewide Program - In the Example of SB2928, funding would be secured in law through the Illinois EPA with the rationale that disposal of such materials would prevent drugs from tainting local water supplies, though it should be noted that labor and supplies were primarily used from local Law Enforcement Departments. <sup class="reference">[26]</sup><sup class="reference">[27]</sup>

= Examples of Federal, State, and Local Initiatives by Topic =

States and localities vary widely on what types of laws are implemented across multiple policy areas. Below are a few examples that can provide your community coalition with some ideas on what has been passed in other states and localities.

== Prevention and Reduced Access to Prescription Medications ==

New Jersey - [http://www.nj.gov/lps/ca2/pmp/ New Jersey's Prescription Monitoring Program]

California (Alameda County) - Local ordinances that require drug manufacturers to establish and fund a drug disposal program.<sup class="reference">[8]</sup>

Connecticut - [https://www.cga.ct.gov/2016/ACT/pa/2016PA-00043-R00HB-05053-PA.htm Statute] enacted May 2016: Seven-day limit for new opioid prescriptions for adults and all opioid prescriptions for kids. Exceptions for chronic and cancer pain, palliative care, and clinical judgement.<sup class="reference">[9] </sup>

Illinois - [http://www.ilga.gov/legislation/publicacts/99/PDF/099-0480.pdf Statue] enacted September 2015: Schedule II prescriptions limited to a 30-day supply (with exceptions). Allows multiple prescriptions up to a 90-day supply if the prescriber meets specified conditions.<sup class="reference">[10]</sup>

 

== Harm Reduction ==

Syringe Access Locations - [https://opioid.amfar.org/indicator/num_SSPs [1]]

National Harm Reduction Coalition - [https://harmreduction.org/issues/syringe-access/landscape-report/ Resources for Syringe Access and Policy]

Rhode Island - [https://preventoverdoseri.org/fentanyl-test-strips/ Fentanyl Testing Strip Program]

 

== Access to Treatment and Protecting Treatment Services ==

'''Federal Government - Affordable Care Act (2010)''' - More than 20 million people received support to get mental health and substance abuse treatment through the 2010 ACA.<sup class="reference">[15]</sup> If it is repealed and its replacement does not offer the same coverage many people will be unable to get to access treatment for addiction. The New York Time's Editorial Board states that "repealing the health care law is likely to exacerbate the crisis."<sup class="reference">[16</sup>

California legislation has a process for reducing treatment fraud and waste: [https://www.behavioral.net/news-item/policy/calif-bill-targets-profiteering-addiction-treatment-dialysis-industries [1]]

 

== Criminal Justice Reform and Decriminalization. ==

<u>Good Samaritan Laws</u> provide immunity from criminal prosecution for drug crimes to those who use drugs and those who act in good faith and call emergency services during an overdose.<sup class="reference">[6]</sup> The Policy Surveillance Program provides an [http://lawatlas.org/query?dataset=good-samaritan-overdose-laws interactive database] of current Good Samaritan Laws in the U.S. As of July 2016, 35 states and Washington D.C. had Good Samaritan Laws in place.<sup class="reference">[7]</sup>

Oregon - Recent State Initiative to Decriminalize almost all narcotics:  Measure 110, passed by a majority of statewide voters in November 2020, decriminalizes the possession of marijuana and small amounts of "harder" drugs including cocaine and methamphetamine and reduces criminal penalties for larger amounts.  A good summary of the measure can be found [https://apnews.com/article/oregon-first-decriminalizing-hard-drugs-01edca37c776c9ea8bfd4afdd7a7a33e here].

Washington State - [http://leadkingcounty.org/about/ Law Enforcement Assisted Diversion]

 

== Recovery Support Services ==

Federal SUPPORT Act: Sec. 7151. Building Communities of Recovery This section amends the Building Communities of Recovery (BCOR) program that was first authorized in the Comprehensive Addiction and Recovery Act (CARA) of 2016 by redefining “recovery community organization” as an organization that mobilizes resources within and outside of the recovery community, including through a peer support network. This section authorizes $5 million for each of FY 2019-2023.  

Federal Support Act: Section 7031. National Recovery Housing Best Practices This section amends part D of title V of the Public Health Service Act to authorize the Sec. of HHS to identify or facilitate the development of best practices for operating recovery housing. The Secretary is directed to bring together a wide variety of stakeholders to develop best practices for Recovery Housing.

= Federal and State Policy Plans to Address the Opioid Epidemic =

Governments at all levels will frequently create their own set of policy goals to address a particular issue.  This has been true for several public health issues including the current opioid epidemic.  This process typically involves bringing numerous stakeholders together to provide education and input in coordination with government representatives who initiate the process and finalize the set of policy objectives.

 

== Recommendations from the 2017 President's Commission on Combating Drug Addiction and the Opioid Crisis ==

*Establish and fund a federal incentive to enhance access to Medication-Assisted Treatment (MAT)
*Mandate Prescriber Education
*Require that all modes of MAT are offered at every licensed MAT facility and that those decisions are based on what is best for the patient.
*Partner with the National Institutes of Health (NIH) and the industry to facilitate testing and development of new MAT treatments.
*Provide model legislation for states to allow naloxone dispensing via standing orders, as well as requiring the prescribing of naloxone with high-risk opioid prescriptions; we must equip all law enforcement in the United States with naloxone to save lives
*Develop and disseminate Fentanyl detection sensors
*Support and fund interstate sharing of PDMP data
*Better align, through regulation, patient privacy laws specific to addiction with the Health Insurance Portability and Accountability Act (HIPAA) to ensure that information about SUDs be made available to medical professionals treating and prescribing medication to a patient. This could be done through the bipartisan Overdose Prevention and Patient Safety Act/Jessie’s Law
*Enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) with a standardized parity compliance tool to ensure health plans cannot impose less favorable benefits for mental health and substance use diagnoses verses physical health diagnoses

== Rhode Island ==

*[http://www.health.ri.gov/news/temp/RhodeIslandsStrategicPlanOnAddictionAndOverdose.pdf Rhode Island's Strategic Plan on Addiction and Overdose]

== Massachusetts ==

*[http://www.mass.gov/eohhs/docs/dph/stop-addiction/recommendations-of-the-governors-opioid-working-group.pdf Recommendations of the Governor's Opioid Working Group]

 

= National Advocacy Groups =

Below are some examples of national advocacy groups:

[https://feduprally.org/ FedUp!]

*A grassroots coalition formed in 2012 that seeks action from the federal government to end the public health epidemic created by opioids
*FedUp accepts no money from pharmaceutical corporations and 100% of the donations they receive are directly applied to managing the costs of hosting their FedUp! rallies

[https://www.thenationalcouncil.org/policy-agenda/ National Council For Behavioral Health] - National Organization the advocates for mental health and substance use policies.

[https://harmreduction.org/ National Harm Reduction Coalition].  Advocates for numerous harm reduction approaches.

<br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

 

 

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Sources

#[http://www.cnn.com/2016/04/28/opinions/massachusetts-opioid-treatment-prince-vox/?iid=ob_article_organicsidebar_expansion [4]]
#[http://www.modernhealthcare.com/article/20160615/NEWS/160619941?utm_source=modernhealthcare&utm_medium=email&utm_content=20160615-NEWS-160619941&utm_campaign=am [5]]
#[http://www.ucirvinehealth.org/health-library/content/?contentTypeID=6&contentID=712214 [6]]
#[http://content.healthaffairs.org/content/35/10/1876.abstract [7]]
#[https://www.justice.gov/file/822231/download [8]]
#[http://www.countyhealthrankings.org/policies/good-samaritan-drug-overdose-laws [9]]
#[http://lawatlas.org/query?dataset=good-samaritan-overdose-laws [10]]
#Hazelden Betty Ford Foundation. Heroin and Prescription Painkillers: A Toolkit for Community Action. 2016
#[https://www.nga.org/files/live/sites/NGA/files/pdf/2016/1607NGAOpioidRoadMap.pdf [11]]
#[https://www.nga.org/files/live/sites/NGA/files/pdf/2016/1607NGAOpioidRoadMap.pdf [12]]
#[https://www.nga.org/files/live/sites/NGA/files/pdf/2016/1607NGAOpioidRoadMap.pdf [13]]
#[https://www.nga.org/files/live/sites/NGA/files/pdf/2016/1607NGAOpioidRoadMap.pdf [14]]
#[https://www.nga.org/files/live/sites/NGA/files/pdf/2016/1607NGAOpioidRoadMap.pdf 16]]
#[https://www.nytimes.com/2017/01/16/opinion/young-victims-of-the-opioid-epidemic.html [17]]
#[https://www.nytimes.com/2017/01/16/opinion/young-victims-of-the-opioid-epidemic.html [18]]
#[http://www.routefifty.com/2016/04/illinois-county-provides-model-get-pill-disposal-program-and-running/127855/ [19]]
#[http://www.ilga.gov/legislation/98/SB/09800SB2928.htm [20]]
#[http://police.mundelein.org/content/pill-disposal-program [21]]
#[http://www.cadca.org/resources/coalitions-action-how-bill-helped-pass-law [22]]
#[http://www.routefifty.com/2016/04/illinois-county-provides-model-get-pill-disposal-program-and-running/127855/ [23]]
#[http://www.routefifty.com/2016/04/illinois-county-provides-model-get-pill-disposal-program-and-running/127855/ [24]]
#[http://www.routefifty.com/2016/04/illinois-county-provides-model-get-pill-disposal-program-and-running/127855/ [25]]
#[http://police.mundelein.org/content/pill-disposal-program [26]]
#[http://www.ilga.gov/legislation/98/SB/09800SB2928.htm [27]]
#[http://police.mundelein.org/content/pill-disposal-program [28]]
#[http://www.routefifty.com/2016/04/illinois-county-provides-model-get-pill-disposal-program-and-running/127855/ [29]]
#[http://www.cadca.org/sites/default/files/resource/files/strat31.pdf [30]]
</div>
[[Category:Pages with broken file links]]

Effective Action Planning and Implementation

2020-12-16T08:39:21Z

Pkalch:

Return to [[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]] or [[ZOOM_MAP_-_Improve_Alignment_&_Teamwork_Among_Existing_Programs_and_Opioid-Related_Coalitions|Zoom Map - Improve Alignment & Teamwork Among Existing Programs & Opioid-Related Coalitions]] or [[ZOOM_MAP_-_Improve_Treatment_&_Enable_Recovery_for_People_with_SUDs|Zoom Map - Improve Treatment & Enable Recovery for People with SUD's]] <div class="wiki" id="content_view" style="display: block">
----

 

 

 

= Background =
<div class="_">
After bringing stakeholders together, gathering and analyzing data, and identifying needs and priorities in terms of services and programs, the next step is for the coalition to collectively develop an action plan that addresses those identified needs, and then, support its implementation.  Working together in close coordination during this process is as important as ever, so that all stakeholders have buy-in and are accountable.  While the experience of communities varies, there are some common principles that consistently appear. 
</div>
= Key Components to an Effective Action Plan =

Substance misuse and substance use disorder is a complex problem whose solutions are numerous across the continuum of care.  What specific solutions are put into an action plan will vary widely, as will the approach different communities take.  Some communities, like Dayton, Ohio, have a complex organizational structure to their Community Overdose Action Team, which includes a planning section charged with development and revision of an action plan.  This section works closely with the data unit to provide status reports to the larger group and evaluate different initiatives within the plan.  Most community coalitions have less structure where specific tasks, like creating an action plan, are done by the entire coalition or where all or most members provide input.  Whatever the scope of the effort, there are some key components needed to develop an effective action plan.  Communities should also note that action plans are living documents and they will need to be constantly reviewed and revised to address new realities and lessons learned along the way.  

== Setting Clear Strategies ==

When gaps and additional service needs are identified, the community coalition can begin to map out a set of actions and strategies to achieve desired outcomes.  These outcomes first need to be agreed upon by the community coalition.  From there, a set of action items can be added to achieve each intended outcome. Many community coalitions - especially those with a large number of members - will break into working groups or committees around each strategy or objective.  Naturally those members who are subject matter experts and work in specific fields can take the lead in developing a plan and outlining the details for that specific strategy.

When formulating these plans, it is important that expectations are realistic and that the actions identified can be achieved.  Even when action plans are revised due to changing data and lessons learned, achieving progress is important to keeping participants energized and motivated so communities may consider planning for small and early wins first.

== Identifying Members to Lead Implementation of Strategies ==

It is important for all participants to know what part of the action plan they are responsible for leading the implementing.  This lays the groundwork of expectations between members and trust that each participant will carry out their portion of the plan.  These responsibilities should be clearly spelled out in writing so there is no confusion or misunderstanding.   Although a coalition member may be helping to coordinate the activities of members, it is the responsibility of each member to be accountable and help achieve progress. 

 

== Developing Short- and Long-Term Goals with Timelines ==

Once the group as a whole or sub-group agrees to an action plan, it is important to create timelines to complete each activity.  As steps are taken to address both short- and longer-term goals, trust is built between the members working toward a common outcome.  As with the actions themselves, the timelines need to be reasonable and achievable.  Having a range of timelines helps keep members engaged and have a sense of accomplishment.  Some coalitions will have short-term goals that can be achieved in 30 or 60 days, mid-term goals that are several months out, and long-term goals that can be expected to take a year or more.

== Identifying Resources ==

Part of creating an achievable action plan is identifying and securing any financial and other resources that are necessary.  There are a variety of funding sources that support planning and programs.  Sources of funding include:

Local or state government.  (grants or direct funding)

Federal grants.

Philanthropic Organizations

Support from the business/corporate community.

Grassroots and direct fundraising campaigns and events.

What is important is that the action plan take these needs into account and develop steps to secure any needed resources.  Without needed funding community groups will be unable to meet their goals and objectives.

== Plan Implementation ==

As work begins on implementing the plan, a process begins whereby actions are taken, effectiveness is assessed, and modifications to the plan are made.  The constant evaluation of progress is an ongoing effort.  Often goals are added and changed, as well as changes made in those responsible for implementing parts of the plan.  It is important to have the expectation from the start that almost nothing goes exactly as planned.

== Tracking of Progress and Outcomes ==

Within an effective action plan, communities should identify and outline a series of performance indicators that align with their goal(s) and track progress.  Shared accountability ensures that progress is being made towards achieving desired outcomes.  The data can be used to report back to key stakeholders in the community on the progress that is being made, but it also can be used to revise any details related to the action plans as needed if strategies aren’t going as intended, so that all involved can collectively improve the desired outcomes.

=== Data Use to Implement Performance Management ===

Accountability and monitoring of progress is an ongoing process.  As is the case with many aspects of community response, strategies and actions are constantly adjusted.  Generally, the performance management process has four components: 

<u>Identify Appropriate Performance Indicators</u> - Determine agreed upon markers of achieving success.

<u>Conduct Performance Measurement</u> - Leverage available data; collect new data to measure short-term and longer-term outcomes.

<u>Monitor and Report Performance Measurement Results</u> - Share cross-sector performance management data, insights, challenges, and successes.

<u>Quality Improvement</u> - Celebrate even small wins together, share what is working, and build on positive momentum to achieve continued progress.  Use evidence of limited results or setbacks as learning opportunities that can be used to improve strategies and action plans.

 

 

= Building a Culturally Competent Plan =

Addressing the drug misuse and substance use disorder epidemic is a complex problem requiring a complex and coordinated set of solutions.  Another critical factor to examine and plan for involves how to best serve diverse populations within a given community.  Due to differences in language, culture, and experiences communities addressing any public health issue must develop action plans that can achieve desired outcomes for all people within the community.  [https://www.samhsa.gov/section-223/cultural-competency/resources SAMHSA] has developed a list of resources to help imporve cultural competence.

 

== Cultural Competence Defined ==

Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients.<ref name="https://hpi.georgetown.edu/cultural/" />

A culturally competent healthcare organization seeks to understand the culture of the population served, recognizes the impact of cultural differences, fosters internal learning opportunities to improve cultural knowledge among care teams, and modifies patient care to meet the patient’s unique needs. 

=== Cultural Competence in Addressing Substance Abuse and Mental Health ===

There are many resources that discuss how to improve cultural competence in the areas of substance use and mental health.  [https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4849.pdf The Substance Abuse and Mental Health Services Administration] has examined this issue in great detail in improving treatment.

Improving Cultural Competence

There are many good resources on how healthcare interests can improve cultural competence.  Many of these strategies apply to community groups looking to improve their response to substance misuse and SUD:

*Collect race, ethnicity and language preference (REAL) data.
*Identify and report disparities.
*Provide culturally and linguistically competent care.
*Develop culturally competent management programs.
*Increase diversity and minority participation.
*Involve the community.
*Make cultural competency an priority

Typically it will take a combination of several strategies to improve cultural competence.  It is therefore important that there be as much input as possible when considering what needs to be done in a given community.  An report with greater detail of specific strategies can be found [https://www.aha.org/system/files/hpoe/Reports-HPOE/becoming-culturally-competent-health-care-organization.PDF here].

 

 

<br/> <br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

{| class="wiki_table"
|-
| '''Reviewer'''
| '''Date'''
| '''Comments'''
|-
|  
|  
|  
|}

 

= <span style="background-color: #ffffff">Sources</span> =

----

#[http://www.cadca.org/ [11]]
#[http://www.modernhealthcare.com/assets/pdf/CH115670524.PDF [12]]
#[http://www.modernhealthcare.com/article/20180524/SPONSORED/180529949 [13]]
#[http://www.modernhealthcare.com/article/20180524/SPONSORED/180529949 [14]]
</div> </div> </div> </div> </div> </div> </div></div></div></div>
[[Category:Community Resources]] [[Category:SAFE Communities]]

Effective Action Planning and Implementation

2020-12-16T08:27:10Z

Pkalch:

Return to [[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]] or [[ZOOM_MAP_-_Improve_Alignment_&_Teamwork_Among_Existing_Programs_and_Opioid-Related_Coalitions|Zoom Map - Improve Alignment & Teamwork Among Existing Programs & Opioid-Related Coalitions]] or [[ZOOM_MAP_-_Improve_Treatment_&_Enable_Recovery_for_People_with_SUDs|Zoom Map - Improve Treatment & Enable Recovery for People with SUD's]] <div class="wiki" id="content_view" style="display: block">
----

 

 

 

= Background =
<div class="_">
After bringing stakeholders together, gathering and analyzing data, and identifying needs and priorities in terms of services and programs, the next step is for the coalition to collectively develop an action plan that addresses those identified needs, and then, support its implementation.  Working together in close coordination during this process is as important as ever, so that all stakeholders have buy-in and are accountable.  While the experience of communities varies, there are some common principles that consistently appear. 
</div>
= Key Components to an Effective Action Plan =

Substance misuse and substance use disorder is a complex problem whose solutions are numerous across the continuum of care.  What specific solutions are put into an action plan will vary widely, as will the approach different communities take.  Some communities, like Dayton, Ohio, have a complex organizational structure to their Community Overdose Action Team, which includes a planning section charged with development and revision of an action plan.  This section works closely with the data unit to provide status reports to the larger group and evaluate different initiatives within the plan.  Most community coalitions have less structure where specific tasks, like creating an action plan, are done by the entire coalition or where all or most members provide input.  Whatever the scope of the effort, there are some key components needed to develop an effective action plan.  Communities should also note that action plans are living documents and they will need to be constantly reviewed and revised to address new realities and lessons learned along the way.  

== Setting Clear Strategies ==

When gaps and additional service needs are identified, the community coalition can begin to map out a set of actions and strategies to achieve desired outcomes.  These outcomes first need to be agreed upon by the community coalition.  From there, a set of action items can be added to achieve each intended outcome. Many community coalitions - especially those with a large number of members - will break into working groups or committees around each strategy or objective.  Naturally those members who are subject matter experts and work in specific fields can take the lead in developing a plan and outlining the details for that specific strategy.

When formulating these plans, it is important that expectations are realistic and that the actions identified can be achieved.  Even when action plans are revised due to changing data and lessons learned, achieving progress is important to keeping participants energized and motivated so communities may consider planning for small and early wins first.

== Identifying Members to Lead Implementation of Strategies ==

It is important for all participants to know what part of the action plan they are responsible for leading the implementing.  This lays the groundwork of expectations between members and trust that each participant will carry out their portion of the plan.  These responsibilities should be clearly spelled out in writing so there is no confusion or misunderstanding.   Although a coalition member may be helping to coordinate the activities of members, it is the responsibility of each member to be accountable and help achieve progress. 

== Developing Short- and Long-Term Goals with Timelines ==

Once the group as a whole or sub-group agrees to an action plan, it is important to create timelines to complete each activity.  As steps are taken to address both short- and longer-term goals, trust is built between the members working toward a common outcome.  As with the actions themselves, the timelines need to be reasonable and achievable.  Having a range of timelines helps keep members engaged and have a sense of accomplishment.  Some coalitions will have short-term goals that can be achieved in 30 or 60 days, mid-term goals that are several months out, and long-term goals that can be expected to take a year or more.

== Identifying Resources ==

Part of creating an achievable action plan is identifying and securing any financial and other resources that are necessary.  There are a variety of funding sources that support planning and programs.  Sources of funding include:

Local or state government.  (grants or direct funding)

Federal grants.

Philanthropic Organizations

Support from the business/corporate community.

Grassroots and direct fundraising campaigns and events.

What is important is that the action plan take these needs into account and develop steps to secure any needed resources.  Without needed funding community groups will be unable to meet their goals and objectives.

== Tracking of Progress and Outcomes ==

Within an effective action plan, communities should identify and outline a series of performance indicators that align with their goal(s) and track progress.  Shared accountability ensures that progress is being made towards achieving desired outcomes.  The data can be used to report back to key stakeholders in the community on the progress that is being made, but it also can be used to revise any details related to the action plans as needed if strategies aren’t going as intended, so that all involved can collectively improve the desired outcomes.

=== Data Use to Implement Performance Management ===

Accountability and monitoring of progress is an ongoing process.  As is the case with many aspects of community response, strategies and actions are constantly adjusted.  Generally, the performance management process has four components: 

<u>Identify Appropriate Performance Indicators</u> - Determine agreed upon markers of achieving success.

<u>Conduct Performance Measurement</u> - Leverage available data; collect new data to measure short-term and longer-term outcomes.

<u>Monitor and Report Performance Measurement Results</u> - Share cross-sector performance management data, insights, challenges, and successes.

<u>Quality Improvement</u> - Celebrate even small wins together, share what is working, and build on positive momentum to achieve continued progress.  Use evidence of limited results or setbacks as learning opportunities that can be used to improve strategies and action plans.

 

= Building a Culturally Competent Plan =

Addressing the drug misuse and substance use disorder epidemic is a complex problem requiring a complex and coordinated set of solutions.  Another critical factor to examine and plan for involves how to best serve diverse populations within a given community.  Due to differences in language, culture, and experiences communities addressing any public health issue must develop action plans that can achieve desired outcomes for all people within the community.  [https://www.samhsa.gov/section-223/cultural-competency/resources SAMHSA] has developed a list of resources to help imporve cultural competence.

 

== Cultural Competence Defined ==

Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients.<ref name="https://hpi.georgetown.edu/cultural/" />

A culturally competent healthcare organization seeks to understand the culture of the population served, recognizes the impact of cultural differences, fosters internal learning opportunities to improve cultural knowledge among care teams, and modifies patient care to meet the patient’s unique needs. 

=== Cultural Competence in Addressing Substance Abuse and Mental Health ===

There are many resources that discuss how to improve cultural competence in the areas of substance use and mental health.  [https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4849.pdf The Substance Abuse and Mental Health Services Administration] has examined this issue in great detail in improving treatment.

Improving Cultural Competence

There are many good resources on how healthcare interests can improve cultural competence.  Many of these strategies apply to community groups looking to improve their response to substance misuse and SUD:

*Collect race, ethnicity and language preference (REAL) data.
*Identify and report disparities.
*Provide culturally and linguistically competent care.
*Develop culturally competent management programs.
*Increase diversity and minority participation.
*Involve the community.
*Make cultural competency an priority

Typically it will take a combination of several strategies to improve cultural competence.  It is therefore important that there be as much input as possible when considering what needs to be done in a given community.  An report with greater detail of specific strategies can be found [https://www.aha.org/system/files/hpoe/Reports-HPOE/becoming-culturally-competent-health-care-organization.PDF here].

 

 

<br/> <br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

{| class="wiki_table"
|-
| '''Reviewer'''
| '''Date'''
| '''Comments'''
|-
|  
|  
|  
|}

 

= <span style="background-color: #ffffff">Sources</span> =

----

#[http://www.cadca.org/ [11]]
#[http://www.modernhealthcare.com/assets/pdf/CH115670524.PDF [12]]
#[http://www.modernhealthcare.com/article/20180524/SPONSORED/180529949 [13]]
#[http://www.modernhealthcare.com/article/20180524/SPONSORED/180529949 [14]]
</div> </div> </div> </div> </div> </div> </div></div></div></div>
[[Category:Community Resources]] [[Category:SAFE Communities]]

Effective Action Planning and Implementation

2020-12-16T08:18:49Z

Pkalch:

Return to [[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]] or [[ZOOM_MAP_-_Improve_Alignment_&_Teamwork_Among_Existing_Programs_and_Opioid-Related_Coalitions|Zoom Map - Improve Alignment & Teamwork Among Existing Programs & Opioid-Related Coalitions]] or [[ZOOM_MAP_-_Improve_Treatment_&_Enable_Recovery_for_People_with_SUDs|Zoom Map - Improve Treatment & Enable Recovery for People with SUD's]] <div class="wiki" id="content_view" style="display: block">
----

 

 

 

= Background =
<div class="_">
After bringing stakeholders together, gathering and analyzing data, and identifying needs and priorities in terms of services and programs, the next step is for the coalition to collectively develop an action plan that addresses those identified needs, and then, support its implementation.  Working together in close coordination during this process is as important as ever, so that all stakeholders have buy-in and are accountable.  While the experience of communities varies, there are some common principles that consistently appear. 
</div>
= Key Components to an Effective Action Plan =

Substance misuse and substance use disorder is a complex problem whose solutions are numerous across the continuum of care.  What specific solutions are put into an action plan will vary widely, as will the approach different communities take.  Some communities, like Dayton, Ohio, have a complex organizational structure to their Community Overdose Action Team, which includes a planning section charged with development and revision of an action plan.  This section works closely with the data unit to provide status reports to the larger group and evaluate different initiatives within the plan.  Most community coalitions have less structure where specific tasks, like creating an action plan, are done by the entire coalition or where all or most members provide input.  Whatever the scope of the effort, there are some key components needed to develop an effective action plan.  Communities should also note that action plans are living documents and they will need to be constantly reviewed and revised to address new realities and lessons learned along the way.  

== Setting Clear Strategies ==

When gaps and additional service needs are identified, the community coalition can begin to map out a set of actions and strategies to achieve desired outcomes.  These outcomes first need to be agreed upon by the community coalition.  From there, a set of action items can be added to achieve each intended outcome. Many community coalitions - especially those with a large number of members - will break into working groups or committees around each strategy or objective.  Naturally those members who are subject matter experts and work in specific fields can take the lead in developing a plan and outlining the details for that specific strategy.

When formulating these plans, it is important that expectations are realistic and that the actions identified can be achieved.  Even when action plans are revised due to changing data and lessons learned, achieving progress is important to keeping participants energized and motivated so communities may consider planning for small and early wins first.

== Identifying Members to Lead Implementation of Strategies ==

It is important for all participants to know what part of the action plan they are responsible for leading the implementing.  This lays the groundwork of expectations between members and trust that each participant will carry out their portion of the plan.  These responsibilities should be clearly spelled out in writing so there is no confusion or misunderstanding.   Although a coalition member may be helping to coordinate the activities of members, it is the responsibility of each member to be accountable and help achieve progress. 

== Developing Short- and Long-Term Goals with Timelines ==

Once the group as a whole or sub-group agrees to an action plan, it is important to create timelines to complete each activity.  As steps are taken to address both short- and longer-term goals, trust is built between the members working toward a common outcome.  As with the actions themselves, the timelines need to be reasonable and achievable.  Having a range of timelines helps keep members engaged and have a sense of accomplishment.  Some coalitions will have short-term goals that can be achieved in 30 or 60 days, mid-term goals that are several months out, and long-term goals that can be expected to take a year or more.

== Identifying Resources ==

Part of creating an achievable action plan is identifying and securing any financial and other resources that are necessary.  There are a variety of funding sources that support planning and programs.  Sources of funding include:

Local or state government.  (grants or direct funding)

Federal grants.

Philanthropic Organizations

Support from the business/corporate community.

Grassroots and direct fundraising campaigns and events.

What is important is that the action plan take these needs into account and develop steps to secure any needed resources.  Without needed funding community groups will be unable to meet their goals and objectives.

== Tracking of Progress and Outcomes ==

Within an effective action plan, communities should identify and outline a series of performance indicators that align with their goal(s) and track progress.  Shared accountability ensures that progress is being made towards achieving desired outcomes.  The data can be used to report back to key stakeholders in the community on the progress that is being made, but it also can be used to revise any details related to the action plans as needed if strategies aren’t going as intended, so that all involved can collectively improve the desired outcomes.

=== Data Use to Implement Performance Management ===

Accountability and monitoring of progress is an ongoing process.  As is the case with many aspects of community response, strategies and actions are constantly adjusted.  Generally, the performance management process has four components: 

<u>Identify Appropriate Performance Indicators</u> - Determine agreed upon markers of achieving success.

<u>Conduct Performance Measurement</u> - Leverage available data; collect new data to measure short-term and longer-term outcomes.

<u>Monitor and Report Performance Measurement Results</u> - Share cross-sector performance management data, insights, challenges, and successes.

<u>Quality Improvement</u> - Celebrate even small wins together, share what is working, and build on positive momentum to achieve continued progress.  Use evidence of limited results or setbacks as learning opportunities that can be used to improve strategies and action plans.

 

= Building a Culturally Competent Plan =

Addressing the drug misuse and substance use disorder epidemic is a complex problem requiring a complex and coordinated set of solutions.  Another critical factor to examine and plan for involves how to best serve diverse populations within a given community.  Due to differences in language, culture, and experiences communities addressing any public health issue must develop action plans that can achieve desired outcomes for all people within the community.

== Cultural Competence Defined ==

Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients.<ref name="https://hpi.georgetown.edu/cultural/" />

A culturally competent healthcare organization seeks to understand the culture of the population served, recognizes the impact of cultural differences, fosters internal learning opportunities to improve cultural knowledge among care teams, and modifies patient care to meet the patient’s unique needs. 

=== Cultural Competence in Addressing Substance Abuse and Mental Health ===

There are many resources that discuss how to improve cultural competence in the areas of substance use and mental health.  [https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4849.pdf The Substance Abuse and Mental Health Services Administration] has examined this issue in great detail in improving treatment.

Improving Cultural Competence

There are many good resources on how healthcare interests can improve cultural competence.  Many of these strategies apply to community groups looking to improve their response to substance misuse and SUD:

*Collect race, ethnicity and language preference (REAL) data.
*Identify and report disparities.
*Provide culturally and linguistically competent care.
*Develop culturally competent management programs.
*Increase diversity and minority participation.
*Involve the community.
*Make cultural competency an priority

Typically it will take a combination of several strategies to improve cultural competence.  It is therefore important that there be as much input as possible when considering what needs to be done in a given community.  An report with greater detail of specific strategies can be found [https://www.aha.org/system/files/hpoe/Reports-HPOE/becoming-culturally-competent-health-care-organization.PDF here].

 

 

<br/> <br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

{| class="wiki_table"
|-
| '''Reviewer'''
| '''Date'''
| '''Comments'''
|-
|  
|  
|  
|}

 

= <span style="background-color: #ffffff">Sources</span> =

----

#[http://www.cadca.org/ [11]]
#[http://www.modernhealthcare.com/assets/pdf/CH115670524.PDF [12]]
#[http://www.modernhealthcare.com/article/20180524/SPONSORED/180529949 [13]]
#[http://www.modernhealthcare.com/article/20180524/SPONSORED/180529949 [14]]
</div> </div> </div> </div> </div> </div> </div></div></div></div>
[[Category:Community Resources]] [[Category:SAFE Communities]]

Effective Action Planning and Implementation

2020-12-16T08:13:31Z

Pkalch:

Return to [[Opioid_Top-Level_Strategy_Map|Opioid_Top-Level_Strategy_Map]] or [[ZOOM_MAP_-_Improve_Alignment_&_Teamwork_Among_Existing_Programs_and_Opioid-Related_Coalitions|Zoom Map - Improve Alignment & Teamwork Among Existing Programs & Opioid-Related Coalitions]] or [[ZOOM_MAP_-_Improve_Treatment_&_Enable_Recovery_for_People_with_SUDs|Zoom Map - Improve Treatment & Enable Recovery for People with SUD's]] <div class="wiki" id="content_view" style="display: block">
----

 

 

 

= Background =
<div class="_">
After bringing stakeholders together, gathering and analyzing data, and identifying needs and priorities in terms of services and programs, the next step is for the coalition to collectively develop an action plan that addresses those identified needs, and then, support its implementation.  Working together in close coordination during this process is as important as ever, so that all stakeholders have buy-in and are accountable.  While the experience of communities varies, there are some common principles that consistently appear. 
</div>
= Key Components to an Effective Action Plan =

Substance misuse and substance use disorder is a complex problem whose solutions are numerous across the continuum of care.  What specific solutions are put into an action plan will vary widely, as will the approach different communities take.  Some communities, like Dayton, Ohio, have a complex organizational structure to their Community Overdose Action Team, which includes a planning section charged with development and revision of an action plan.  This section works closely with the data unit to provide status reports to the larger group and evaluate different initiatives within the plan.  Most community coalitions have less structure where specific tasks, like creating an action plan, are done by the entire coalition or where all or most members provide input.  Whatever the scope of the effort, there are some key components needed to develop an effective action plan.  Communities should also note that action plans are living documents and they will need to be constantly reviewed and revised to address new realities and lessons learned along the way.  

== Setting Clear Strategies ==

When gaps and additional service needs are identified, the community coalition can begin to map out a set of actions and strategies to achieve desired outcomes.  These outcomes first need to be agreed upon by the community coalition.  From there, a set of action items can be added to achieve each intended outcome. Many community coalitions - especially those with a large number of members - will break into working groups or committees around each strategy or objective.  Naturally those members who are subject matter experts and work in specific fields can take the lead in developing a plan and outlining the details for that specific strategy.

When formulating these plans, it is important that expectations are realistic and that the actions identified can be achieved.  Even when action plans are revised due to changing data and lessons learned, achieving progress is important to keeping participants energized and motivated so communities may consider planning for small and early wins first.

== Identifying Members to Lead Implementation of Strategies ==

It is important for all participants to know what part of the action plan they are responsible for leading the implementing.  This lays the groundwork of expectations between members and trust that each participant will carry out their portion of the plan.  These responsibilities should be clearly spelled out in writing so there is no confusion or misunderstanding.   Although a coalition member may be helping to coordinate the activities of members, it is the responsibility of each member to be accountable and help achieve progress. 

== Developing Short- and Long-Term Goals with Timelines ==

Once the group as a whole or sub-group agrees to an action plan, it is important to create timelines to complete each activity.  As steps are taken to address both short- and longer-term goals, trust is built between the members working toward a common outcome.  As with the actions themselves, the timelines need to be reasonable and achievable.

== Identifying Resources ==

Part of creating an achievable action plan is identifying and securing any financial and other resources that are necessary.  There are a variety of funding sources that support planning and programs.  Sources of funding include:

Local or state government.  (grants or direct funding)

Federal grants.

Philanthropic Organizations

Support from the business/corporate community.

Grassroots and direct fundraising campaigns and events.

What is important is that the action plan take these needs into account and develop steps to secure any needed resources.  Without needed funding community groups will be unable to meet their goals and objectives.

== Tracking of Progress and Outcomes ==

Within an effective action plan, communities should identify and outline a series of performance indicators that align with their goal(s) and track progress.  Shared accountability ensures that progress is being made towards achieving desired outcomes.  The data can be used to report back to key stakeholders in the community on the progress that is being made, but it also can be used to revise any details related to the action plans as needed if strategies aren’t going as intended, so that all involved can collectively improve the desired outcomes.

=== Data Use to Implement Performance Management ===

Accountability and monitoring of progress is an ongoing process.  As is the case with many aspects of community response, strategies and actions are constantly adjusted.  Generally, the performance management process has four components: 

<u>Identify Appropriate Performance Indicators</u> - Determine agreed upon markers of achieving success.

<u>Conduct Performance Measurement</u> - Leverage available data; collect new data to measure short-term and longer-term outcomes.

<u>Monitor and Report Performance Measurement Results</u> - Share cross-sector performance management data, insights, challenges, and successes.

<u>Quality Improvement</u> - Celebrate even small wins together, share what is working, and build on positive momentum to achieve continued progress.  Use evidence of limited results or setbacks as learning opportunities that can be used to improve strategies and action plans.

 

= Building a Culturally Competent Plan =

Addressing the drug misuse and substance use disorder epidemic is a complex problem requiring a complex and coordinated set of solutions.  Another critical factor to examine and plan for involves how to best serve diverse populations within a given community.  Due to differences in language, culture, and experiences communities addressing any public health issue must develop action plans that can achieve desired outcomes for all people within the community.

== Cultural Competence Defined ==

Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients.<ref name="https://hpi.georgetown.edu/cultural/" />

A culturally competent healthcare organization seeks to understand the culture of the population served, recognizes the impact of cultural differences, fosters internal learning opportunities to improve cultural knowledge among care teams, and modifies patient care to meet the patient’s unique needs. 

=== Cultural Competence in Addressing Substance Abuse and Mental Health ===

There are many resources that discuss how to improve cultural competence in the areas of substance use and mental health.  [https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4849.pdf The Substance Abuse and Mental Health Services Administration] has examined this issue in great detail in improving treatment.

Improving Cultural Competence

There are many good resources on how healthcare interests can improve cultural competence.  Many of these strategies apply to community groups looking to improve their response to substance misuse and SUD:

*Collect race, ethnicity and language preference (REAL) data.
*Identify and report disparities.
*Provide culturally and linguistically competent care.
*Develop culturally competent management programs.
*Increase diversity and minority participation.
*Involve the community.
*Make cultural competency an priority

Typically it will take a combination of several strategies to improve cultural competence.  It is therefore important that there be as much input as possible when considering what needs to be done in a given community.  An report with greater detail of specific strategies can be found [https://www.aha.org/system/files/hpoe/Reports-HPOE/becoming-culturally-competent-health-care-organization.PDF here].

 

 

<br/> <br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

{| class="wiki_table"
|-
| '''Reviewer'''
| '''Date'''
| '''Comments'''
|-
|  
|  
|  
|}

 

= <span style="background-color: #ffffff">Sources</span> =

----

#[http://www.cadca.org/ [11]]
#[http://www.modernhealthcare.com/assets/pdf/CH115670524.PDF [12]]
#[http://www.modernhealthcare.com/article/20180524/SPONSORED/180529949 [13]]
#[http://www.modernhealthcare.com/article/20180524/SPONSORED/180529949 [14]]
</div> </div> </div> </div> </div> </div> </div></div></div></div>
[[Category:Community Resources]] [[Category:SAFE Communities]]

Activating Your Community

2020-12-15T19:24:43Z

Pkalch:

Activating Your Community

2020-12-15T19:22:42Z

Pkalch:

__NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]   
SWITCHING TO "Activating Your Community

== Contents ==

 

 

= Background =

There are many barriers that prevent and limit the efforts of communities addressing drug misuse and substance use disorder, but one particular challenge that many communities face is the ability to elevate their initiative above other local competing priorities.  Identifying champions who can publicly support the coalition’s mission can help to build and foster strategic partnerships, generate buy-in, and increase commitment to bolster supports. With a solid understanding of the current programmatic needs in your area, you can build power and mobilize the community by successfully bringing together advocates, policymakers, and professionals to take collective action.

Whether you are developing legislative or regulatory efforts, building and strengthening programs, or attempting to reach a diverse audience with a wide range of needs, communities of all sizes should consider the following principles when activating your community around this crisis:

*Put equity at the center for your efforts
*Engage individuals with lived experience or those directly impacted by substance use disorder in decision-making roles
*Create alliances and form strategic partnerships that build political will and support from a broad range of stakeholders
*Build relationships with federal, state, and locally elected leaders
*Understand your community’s most powerful levers for change 
*Allow data to drive your strategy development and decision-making
*Focus on measurable individual and community-based outcomes
*Empower citizens by increasing public awareness and community engagement opportunities
*'''Strengthen your system or infrastructure in order to achieve impact at scale'''

It’s important to note that any community organizing or political will building strategy should be implemented with regularity - it should not be a single event or effort.  For the greatest impact, communities should show the link or intersection of substance use disorder with other competing community priorities, consistently focus on drumming up new interest, and relay progress made over time back to community stakeholders using a message of hope in order to sustain engagement.

Drug misuse and SUD has consequences for all residents of local communities.  The current epidemic increases costs related to public health, public safety, criminal justice, treatment services, and many more.  Locally elected leaders are typically motivated by the economic impacts to improve local response, but a far greater price comes from the fatalities caused by the epidemic and related overdoses and the loved ones who must face the pain of those lost.  This is what motivates many others to create and join efforts to combat the epidemic within their communities.  Many of these leaders typically work in prevention, harm reduction, treatment, recovery support services, and other efforts that save lives and help those in need find recovery, but it may be necessary for communities to tailor messaging to suit a wide variety of audiences in a manner that speaks to the receiver’s particular interest.  When identifying champions or strategic alliances, communities should consider their most powerful levers for change.  Who or what in your community can unlock opportunity and accelerate change?  What is the backbone of your community?  Is it your local hospital system, community college, or a specific business or company?  Communities may find that some individuals or organizations may have conflicting viewpoints – try to approach them and open a door for conversation.  Sometimes non-traditional partners are only “non-traditional” because we label them as such.

= Key Community Members =

== Elected Officials and Local Health Leaders ==

Locally elected leaders and health officials can play a key role in leading efforts to improve the response to the SUD epidemic.  Mayors, County Executives, County Managers, Commissioners, and the local health leaders they appoint, can be powerful allies in raising public awareness about the extent of the problem, the availability of resources, and providing information on specific strategies, like harm reduction, that can help save lives.  In many instances, elected officials and local health officials might already be part of some type of community task force or other group charged with coordinating and improving local response to the epidemic; however, in the absence of such an effort, elected and health leaders can and should be engaged in raising awareness about the issue and solutions while also increasing support within the community.  

Elected leaders, and especially legislators, play an important role in the creation of budgets and ultimately decide on how local revenues are allocated to different programs, so it is critical they are aware of the scope of these issues in their communities and what is being done in response.  In most cases, they have political allies and are regularly invited to speak at community events or participate in meetings with diverse audiences where they can help to relay your message and share information about the response.

Although locally elected leaders are important champions, it’s also critical for a coalition to work alongside its state partners to help align efforts for maximum impact, inform policy, support funding, and make recommendations on scalability of programs that are working on-the-ground to avoid duplication or manage expectations that might not be feasible or sustainable at the local level.

=== Engagement Examples - Elected and Local Health Leaders ===

== Community Stakeholders and Infuencers ==

Anyone in your community can be a leader or a champion.  Drug misuse and substance use disorder affects a substantial number of residents in all communities.  Having a wide variety of stakeholders imbedded within the community can help to advance policies, programs, and systems that can work together and improve local response.  When appropriate, consider engaging other community partners to leverage efforts and boost support within the community.  These individuals in your community who could be key champions or partners along the way, but might not necessarily participate in the coalition.  Some examples might include:

*Health Professionals and Community Health Centers
*Hospital System Administration
*Faith Leaders
*Law Enforcement or other First Responders
*Public and Private School Systems
*Colleges, Universities, and Institutions of Higher Education
*Parent Groups
*Youth and Young Adults
*Local businesses, corporations, or the Chamber of Commerce
*Philanthropic Community

== Individuals with Lived Experience ==

Communities should also engage individuals with lived experience in decision-making roles - meaning those who have had first-hand involvement with substance use disorder and those who are friends or family members of those directly impacted.  Individuals with lived experience bring knowledge, understanding, and experience not learned through formal education.  To be most effective, it is imperative that communities honor and reflect the voices of those most impacted in their programs and systems. If possible, find ways to offer fair compensation for their time.  

= Improving Pubic Awareness And Engagement =

Public education and awareness is essential to activating a local community.  Residents need to know the unvarnished reality of what is taking place.  They need to know what the problem is, and what needs to be done to improve the local response and save lives.  In addition order to be educated, local residents also need to be involved in the process.  The people are the community, and many have first-hand experience with drug misuse and SUD.  Many others have lived experience with family and friends who are struggling with these issues, and their input and participation is needed to create a Comprehensive and effective Community

 

== Public Availability of Data ==

 

== Community Education Programs ==

 

== Building Strategic Partnerships ==

 

== Develop Outreach Strategies ==

 

= Overcoming Stigma =

== Anti--Stigma Campaigns: ==

[http://www.safeproject.us/noshame SAFE Project’s #NoShame Pledge] – This virtual campaign helps to combat negative perception and offers support to others when seeking treatment or speaking up about mental health and substance use disorders.  It was designed to include a toolkit for communities who want to replicate the campaign locally and use it a community mobilizing tool to drum up political will and raise awareness about local efforts underway to combat stigma.  By using the pledge as a catalyst, communities can identify new stakeholders who can be activated and drive social impact, as well as help to change behaviors at scale.

State of Massachusetts - Sate Without StigMA. <ref>https://www.mass.gov/state-without-stigma
</ref> The State of Massachusetts has developed a comprehensive anti-stigma campaign at the State level.  This resource provides information about what stigma is, how it contributes to the current epidemic, and personal stories of people who talk about their own experiences with stigma and how they overcame it to find help for themselves and others in a variety of settings.

= Promising Practices and Case Studies =

 <br/> __TOC__

[[Category:Community Resources]]

Activating Your Community

2020-12-15T19:16:47Z

Pkalch:

__NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]   
SWITCHING TO "Activating Your Community

== Contents ==

 

 

= Background =

There are many barriers that prevent and limit the efforts of communities addressing drug misuse and substance use disorder, but one particular challenge that many communities face is the ability to elevate their initiative above other local competing priorities.  Identifying champions who can publicly support the coalition’s mission can help to build and foster strategic partnerships, generate buy-in, and increase commitment to bolster supports. With a solid understanding of the current programmatic needs in your area, you can build power and mobilize the community by successfully bringing together advocates, policymakers, and professionals to take collective action.

Whether you are developing legislative or regulatory efforts, building and strengthening programs, or attempting to reach a diverse audience with a wide range of needs, communities of all sizes should consider the following principles when activating your community around this crisis:

*Put equity at the center for your efforts
*Engage individuals with lived experience or those directly impacted by substance use disorder in decision-making roles
*Create alliances and form strategic partnerships that build political will and support from a broad range of stakeholders
*Build relationships with federal, state, and locally elected leaders
*Understand your community’s most powerful levers for change 
*Allow data to drive your strategy development and decision-making
*Focus on measurable individual and community-based outcomes
*Empower citizens by increasing public awareness and community engagement opportunities
*'''Strengthen your system or infrastructure in order to achieve impact at scale'''

It’s important to note that any community organizing or political will building strategy should be implemented with regularity - it should not be a single event or effort.  For the greatest impact, communities should show the link or intersection of substance use disorder with other competing community priorities, consistently focus on drumming up new interest, and relay progress made over time back to community stakeholders using a message of hope in order to sustain engagement.

Drug misuse and SUD has consequences for all residents of local communities.  The current epidemic increases costs related to public health, public safety, criminal justice, treatment services, and many more.  Locally elected leaders are typically motivated by the economic impacts to improve local response, but a far greater price comes from the fatalities caused by the epidemic and related overdoses and the loved ones who must face the pain of those lost.  This is what motivates many others to create and join efforts to combat the epidemic within their communities.  Many of these leaders typically work in prevention, harm reduction, treatment, recovery support services, and other efforts that save lives and help those in need find recovery, but it may be necessary for communities to tailor messaging to suit a wide variety of audiences in a manner that speaks to the receiver’s particular interest.  When identifying champions or strategic alliances, communities should consider their most powerful levers for change.  Who or what in your community can unlock opportunity and accelerate change?  What is the backbone of your community?  Is it your local hospital system, community college, or a specific business or company?  Communities may find that some individuals or organizations may have conflicting viewpoints – try to approach them and open a door for conversation.  Sometimes non-traditional partners are only “non-traditional” because we label them as such.

= Key Community Members =

== Elected Officials and Local Health Leaders ==

Locally elected leaders and health officials can play a key role in leading efforts to improve the response to the SUD epidemic.  Mayors, County Executives, County Managers, Commissioners, and the local health leaders they appoint, can be powerful allies in raising public awareness about the extent of the problem, the availability of resources, and providing information on specific strategies, like harm reduction, that can help save lives.  In many instances, elected officials and local health officials might already be part of some type of community task force or other group charged with coordinating and improving local response to the epidemic; however, in the absence of such an effort, elected and health leaders can and should be engaged in raising awareness about the issue and solutions while also increasing support within the community.  

Elected leaders, and especially legislators, play an important role in the creation of budgets and ultimately decide on how local revenues are allocated to different programs, so it is critical they are aware of the scope of these issues in their communities and what is being done in response.  In most cases, they have political allies and are regularly invited to speak at community events or participate in meetings with diverse audiences where they can help to relay your message and share information about the response.

Although locally elected leaders are important champions, it’s also critical for a coalition to work alongside its state partners to help align efforts for maximum impact, inform policy, support funding, and make recommendations on scalability of programs that are working on-the-ground to avoid duplication or manage expectations that might not be feasible or sustainable at the local level.

=== Engagement Examples - Elected and Local Health Leaders ===

== Community Stakeholders and Infuencers ==

Anyone in your community can be a leader or a champion.  Drug misuse and substance use disorder affects a substantial number of residents in all communities.  Having a wide variety of stakeholders imbedded within the community can help to advance policies, programs, and systems that can work together and improve local response.  When appropriate, consider engaging other community partners to leverage efforts and boost support within the community.  These individuals in your community who could be key champions or partners along the way, but might not necessarily participate in the coalition.  Some examples might include:

*Health Professionals and Community Health Centers
*Hospital System Administration
*Faith Leaders
*Law Enforcement or other First Responders
*Public and Private School Systems
*Colleges, Universities, and Institutions of Higher Education
*Parent Groups
*Youth and Young Adults
*Local businesses, corporations, or the Chamber of Commerce
*Philanthropic Community

== Individuals with Lived Experience ==

Communities should also engage individuals with lived experience in decision-making roles - meaning those who have had first-hand involvement with substance use disorder and those who are friends or family members of those directly impacted.  Individuals with lived experience bring knowledge, understanding, and experience not learned through formal education.  To be most effective, it is imperative that communities honor and reflect the voices of those most impacted in their programs and systems. If possible, find ways to offer fair compensation for their time.  

= Improving Pubic Awareness And Engagement =

Public education and awareness is essential to activating a local community.  Residents need to know the unvarnished reality of what is taking place.  They need to know what the problem is, and what needs to be done to improve the local response and save lives.  In addition order to be educated, local residents also need to be involved in the process.  The people are the community, and many have first-hand experience with drug misuse and SUD.  Many others have lived experience with family and friends who are struggling with these issues, and their input and participation is needed to create a Comprehensive and effective Community

 

== Public Availability of Data ==

 

== Community Education Programs ==

 

== Building Strategic Partnerships ==

 

== Develop Outreach Strategies ==

 

= Overcoming Stigma =

== Anti--Stigma Campaigns: ==

State of Massachusetts - Sate Without StigMA. <ref>https://www.mass.gov/state-without-stigma
</ref> The State of Massachusetts has developed a comprehensive anti-stigma campaign at the State level.  This resource provides information about what stigma is, how it contributes to the current epidemic, and personal stories of people who talk about their own experiences with stigma and how they overcame it to find help for themselves and others in a variety of settings.

 

[[TR_-_Educate_Communities_to_Prevent_First-Time_Use_and_Misuse|Solutions and Tools focused on this objective.]]

= Promising Practices and Case Studies =

 <br/> __TOC__

[[Category:Community Resources]]

Activating Your Community

2020-12-15T19:15:25Z

Pkalch:

__NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]   
SWITCHING TO "Activating Your Community

== Contents ==

 

 

= Background =

There are many barriers that prevent and limit the efforts of communities addressing drug misuse and substance use disorder, but one particular challenge that many communities face is the ability to elevate their initiative above other local competing priorities.  Identifying champions who can publicly support the coalition’s mission can help to build and foster strategic partnerships, generate buy-in, and increase commitment to bolster supports. With a solid understanding of the current programmatic needs in your area, you can build power and mobilize the community by successfully bringing together advocates, policymakers, and professionals to take collective action.

Whether you are developing legislative or regulatory efforts, building and strengthening programs, or attempting to reach a diverse audience with a wide range of needs, communities of all sizes should consider the following principles when activating your community around this crisis:

*Put equity at the center for your efforts
*Engage individuals with lived experience or those directly impacted by substance use disorder in decision-making roles
*Create alliances and form strategic partnerships that build political will and support from a broad range of stakeholders
*Build relationships with federal, state, and locally elected leaders
*Understand your community’s most powerful levers for change 
*Allow data to drive your strategy development and decision-making
*Focus on measurable individual and community-based outcomes
*Empower citizens by increasing public awareness and community engagement opportunities
*'''Strengthen your system or infrastructure in order to achieve impact at scale'''

It’s important to note that any community organizing or political will building strategy should be implemented with regularity - it should not be a single event or effort.  For the greatest impact, communities should show the link or intersection of substance use disorder with other competing community priorities, consistently focus on drumming up new interest, and relay progress made over time back to community stakeholders using a message of hope in order to sustain engagement.

Drug misuse and SUD has consequences for all residents of local communities.  The current epidemic increases costs related to public health, public safety, criminal justice, treatment services, and many more.  Locally elected leaders are typically motivated by the economic impacts to improve local response, but a far greater price comes from the fatalities caused by the epidemic and related overdoses and the loved ones who must face the pain of those lost.  This is what motivates many others to create and join efforts to combat the epidemic within their communities.  Many of these leaders typically work in prevention, harm reduction, treatment, recovery support services, and other efforts that save lives and help those in need find recovery, but it may be necessary for communities to tailor messaging to suit a wide variety of audiences in a manner that speaks to the receiver’s particular interest.  When identifying champions or strategic alliances, communities should consider their most powerful levers for change.  Who or what in your community can unlock opportunity and accelerate change?  What is the backbone of your community?  Is it your local hospital system, community college, or a specific business or company?  Communities may find that some individuals or organizations may have conflicting viewpoints – try to approach them and open a door for conversation.  Sometimes non-traditional partners are only “non-traditional” because we label them as such.

= Key Engagements =

== Elected Officials and Local Health Leaders ==

Locally elected leaders and health officials can play a key role in leading efforts to improve the response to the SUD epidemic.  Mayors, County Executives, County Managers, Commissioners, and the local health leaders they appoint, can be powerful allies in raising public awareness about the extent of the problem, the availability of resources, and providing information on specific strategies, like harm reduction, that can help save lives.  In many instances, elected officials and local health officials might already be part of some type of community task force or other group charged with coordinating and improving local response to the epidemic; however, in the absence of such an effort, elected and health leaders can and should be engaged in raising awareness about the issue and solutions while also increasing support within the community.  

Elected leaders, and especially legislators, play an important role in the creation of budgets and ultimately decide on how local revenues are allocated to different programs, so it is critical they are aware of the scope of these issues in their communities and what is being done in response.  In most cases, they have political allies and are regularly invited to speak at community events or participate in meetings with diverse audiences where they can help to relay your message and share information about the response.

Although locally elected leaders are important champions, it’s also critical for a coalition to work alongside its state partners to help align efforts for maximum impact, inform policy, support funding, and make recommendations on scalability of programs that are working on-the-ground to avoid duplication or manage expectations that might not be feasible or sustainable at the local level.

=== Engagement Examples - Elected and Local Health Leaders ===

== Community Stakeholders and Infuencers ==

Anyone in your community can be a leader or a champion.  Drug misuse and substance use disorder affects a substantial number of residents in all communities.  Having a wide variety of stakeholders imbedded within the community can help to advance policies, programs, and systems that can work together and improve local response.  When appropriate, consider engaging other community partners to leverage efforts and boost support within the community.  These individuals in your community who could be key champions or partners along the way, but might not necessarily participate in the coalition.  Some examples might include:

*Health Professionals and Community Health Centers
*Hospital System Administration
*Faith Leaders
*Law Enforcement or other First Responders
*Public and Private School Systems
*Colleges, Universities, and Institutions of Higher Education
*Parent Groups
*Youth and Young Adults
*Local businesses, corporations, or the Chamber of Commerce
*Philanthropic Community

== Individuals with Lived Experience ==

Communities should also engage individuals with lived experience in decision-making roles - meaning those who have had first-hand involvement with substance use disorder and those who are friends or family members of those directly impacted.  Individuals with lived experience bring knowledge, understanding, and experience not learned through formal education.  To be most effective, it is imperative that communities honor and reflect the voices of those most impacted in their programs and systems. If possible, find ways to offer fair compensation for their time.  

= Improving Pubic Awareness And Engagement =

Public education and awareness is essential to activating a local community.  Residents need to know the unvarnished reality of what is taking place.  They need to know what the problem is, and what needs to be done to improve the local response and save lives.  In addition order to be educated, local residents also need to be involved in the process.  The people are the community, and many have first-hand experience with drug misuse and SUD.  Many others have lived experience with family and friends who are struggling with these issues, and their input and participation is needed to create a Comprehensive and effective Community

 

== Public Availability of Data ==

 

== Community Education Programs ==

 

== Building Strategic Partnerships ==

 

== Develop Outreach Strategies ==

 

= Overcoming Stigma =

== Anti--Stigma Campaigns: ==

State of Massachusetts - Sate Without StigMA. <ref>https://www.mass.gov/state-without-stigma
</ref> The State of Massachusetts has developed a comprehensive anti-stigma campaign at the State level.  This resource provides information about what stigma is, how it contributes to the current epidemic, and personal stories of people who talk about their own experiences with stigma and how they overcame it to find help for themselves and others in a variety of settings.

 

[[TR_-_Educate_Communities_to_Prevent_First-Time_Use_and_Misuse|Solutions and Tools focused on this objective.]]

= Promising Practices and Case Studies =

 <br/> __TOC__

[[Category:Community Resources]]

Activating Your Community

2020-12-15T19:14:18Z

Pkalch:

__NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]   
SWITCHING TO "Activating Your Community

== Contents ==

 

 

= Background =

There are many barriers that prevent and limit the efforts of communities addressing drug misuse and substance use disorder, but one particular challenge that many communities face is the ability to elevate their initiative above other local competing priorities.  Identifying champions who can publicly support the coalition’s mission can help to build and foster strategic partnerships, generate buy-in, and increase commitment to bolster supports. With a solid understanding of the current programmatic needs in your area, you can build power and mobilize the community by successfully bringing together advocates, policymakers, and professionals to take collective action.

Whether you are developing legislative or regulatory efforts, building and strengthening programs, or attempting to reach a diverse audience with a wide range of needs, communities of all sizes should consider the following principles when activating your community around this crisis:

*Put equity at the center for your efforts
*Engage individuals with lived experience or those directly impacted by substance use disorder in decision-making roles
*Create alliances and form strategic partnerships that build political will and support from a broad range of stakeholders
*Build relationships with federal, state, and locally elected leaders
*Understand your community’s most powerful levers for change 
*Allow data to drive your strategy development and decision-making
*Focus on measurable individual and community-based outcomes
*Empower citizens by increasing public awareness and community engagement opportunities
*'''Strengthen your system or infrastructure in order to achieve impact at scale'''

It’s important to note that any community organizing or political will building strategy should be implemented with regularity - it should not be a single event or effort.  For the greatest impact, communities should show the link or intersection of substance use disorder with other competing community priorities, consistently focus on drumming up new interest, and relay progress made over time back to community stakeholders using a message of hope in order to sustain engagement.

Drug misuse and SUD has consequences for all residents of local communities.  The current epidemic increases costs related to public health, public safety, criminal justice, treatment services, and many more.  Locally elected leaders are typically motivated by the economic impacts to improve local response, but a far greater price comes from the fatalities caused by the epidemic and related overdoses and the loved ones who must face the pain of those lost.  This is what motivates many others to create and join efforts to combat the epidemic within their communities.  Many of these leaders typically work in prevention, harm reduction, treatment, recovery support services, and other efforts that save lives and help those in need find recovery, but it may be necessary for communities to tailor messaging to suit a wide variety of audiences in a manner that speaks to the receiver’s particular interest.  When identifying champions or strategic alliances, communities should consider their most powerful levers for change.  Who or what in your community can unlock opportunity and accelerate change?  What is the backbone of your community?  Is it your local hospital system, community college, or a specific business or company?  Communities may find that some individuals or organizations may have conflicting viewpoints – try to approach them and open a door for conversation.  Sometimes non-traditional partners are only “non-traditional” because we label them as such.

= Key Engagements =

== Elected Officials and Local Health Leaders ==

Locally elected leaders and health officials can play a key role in leading efforts to improve the response to the SUD epidemic.  Mayors, County Executives, County Managers, Commissioners, and the local health leaders they appoint, can be powerful allies in raising public awareness about the extent of the problem, the availability of resources, and providing information on specific strategies, like harm reduction, that can help save lives.  In many instances, elected officials and local health officials might already be part of some type of community task force or other group charged with coordinating and improving local response to the epidemic; however, in the absence of such an effort, elected and health leaders can and should be engaged in raising awareness about the issue and solutions while also increasing support within the community.  

Elected leaders, and especially legislators, play an important role in the creation of budgets and ultimately decide on how local revenues are allocated to different programs, so it is critical they are aware of the scope of these issues in their communities and what is being done in response.  In most cases, they have political allies and are regularly invited to speak at community events or participate in meetings with diverse audiences where they can help to relay your message and share information about the response.

Although locally elected leaders are important champions, it’s also critical for a coalition to work alongside its state partners to help align efforts for maximum impact, inform policy, support funding, and make recommendations on scalability of programs that are working on-the-ground to avoid duplication or manage expectations that might not be feasible or sustainable at the local level.

=== Engagement Examples - Elected and Local Health Leaders ===

== Community Stakeholders and Infuencers ==

Anyone in your community can be a leader or a champion.  Drug misuse and substance use disorder affects a substantial number of residents in all communities.  Having a wide variety of stakeholders imbedded within the community can help to advance policies, programs, and systems that can work together and improve local response.  When appropriate, consider engaging other community partners to leverage efforts and boost support within the community.  These individuals in your community who could be key champions or partners along the way, but might not necessarily participate in the coalition.  Some examples might include:

*
Health Professionals and Community Health Centers

*
Hospital System Administration

*
Faith Leaders

*
Law Enforcement or other First Responders

*
Public and Private School Systems

*
Colleges, Universities, and Institutions of Higher Education

*
Parent Groups

*
Youth and Young Adults

*
Local businesses, corporations, or the Chamber of Commerce

*
Philanthropic Community

== Individuals with Lived Experience ==

Communities should also engage individuals with lived experience in decision-making roles - meaning those who have had first-hand involvement with substance use disorder and those who are friends or family members of those directly impacted.  Individuals with lived experience bring knowledge, understanding, and experience not learned through formal education.  To be most effective, it is imperative that communities honor and reflect the voices of those most impacted in their programs and systems. If possible, find ways to offer fair compensation for their time.  

= Improving Pubic Awareness And Engagement =

Public education and awareness is essential to activating a local community.  Residents need to know the unvarnished reality of what is taking place.  They need to know what the problem is, and what needs to be done to improve the local response and save lives.  In addition order to be educated, local residents also need to be involved in the process.  The people are the community, and many have first-hand experience with drug misuse and SUD.  Many others have lived experience with family and friends who are struggling with these issues, and their input and participation is needed to create a Comprehensive and effective Community

 

== Public Availability of Data ==

 

== Community Education Programs ==

 

== Building Strategic Partnerships ==

 

== Develop Outreach Strategies ==

 

= Overcoming Stigma =

== Anti--Stigma Campaigns: ==

State of Massachusetts - Sate Without StigMA. <ref>https://www.mass.gov/state-without-stigma
</ref> The State of Massachusetts has developed a comprehensive anti-stigma campaign at the State level.  This resource provides information about what stigma is, how it contributes to the current epidemic, and personal stories of people who talk about their own experiences with stigma and how they overcame it to find help for themselves and others in a variety of settings.

 

[[TR_-_Educate_Communities_to_Prevent_First-Time_Use_and_Misuse|Solutions and Tools focused on this objective.]]

= Promising Practices and Case Studies =

 <br/> __TOC__

[[Category:Community Resources]]

Activating Your Community

2020-12-15T17:21:20Z

Pkalch:

__NOTOC__ Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]]   
SWITCHING TO "Activating Your Community

== Contents ==

 

 

= Background =

There are many barriers that prevent and limit the efforts of communities addressing drug misuse and substance use disorder, but one particular challenge that many communities face is the ability to elevate their initiative above other local competing priorities.  Identifying champions who can publicly support the coalition’s mission can help to build and foster strategic partnerships, generate buy-in, and increase commitment to bolster supports. With a solid understanding of the current programmatic needs in your area, you can build power and mobilize the community by successfully bringing together advocates, policymakers, and professionals to take collective action.

Whether you are developing legislative or regulatory efforts, building and strengthening programs, or attempting to reach a diverse audience with a wide range of needs, communities of all sizes should consider the following principles when activating your community around this crisis:

*Put equity at the center for your efforts
*Engage individuals with lived experience or those directly impacted by substance use disorder in decision-making roles
*Create alliances and form strategic partnerships that build political will and support from a broad range of stakeholders
*Build relationships with federal, state, and locally elected leaders
*Understand your community’s most powerful levers for change 
*Allow data to drive your strategy development and decision-making
*Focus on measurable individual and community-based outcomes
*Empower citizens by increasing public awareness and community engagement opportunities
*'''Strengthen your system or infrastructure in order to achieve impact at scale'''

It’s important to note that any community organizing or political will building strategy should be implemented with regularity - it should not be a single event or effort.  For the greatest impact, communities should show the link or intersection of substance use disorder with other competing community priorities, consistently focus on drumming up new interest, and relay progress made over time back to community stakeholders using a message of hope in order to sustain engagement.

Drug misuse and SUD has consequences for all residents of local communities.  The current epidemic increases costs related to public health, public safety, criminal justice, treatment services, and many more.  Locally elected leaders are typically motivated by the economic impacts to improve local response, but a far greater price comes from the fatalities caused by the epidemic and related overdoses and the loved ones who must face the pain of those lost.  This is what motivates many others to create and join efforts to combat the epidemic within their communities.  Many of these leaders typically work in prevention, harm reduction, treatment, recovery support services, and other efforts that save lives and help those in need find recovery, but it may be necessary for communities to tailor messaging to suit a wide variety of audiences in a manner that speaks to the receiver’s particular interest.  When identifying champions or strategic alliances, communities should consider their most powerful levers for change.  Who or what in your community can unlock opportunity and accelerate change?  What is the backbone of your community?  Is it your local hospital system, community college, or a specific business or company?  Communities may find that some individuals or organizations may have conflicting viewpoints – try to approach them and open a door for conversation.  Sometimes non-traditional partners are only “non-traditional” because we label them as such.

 

= Elected Officials and Local Health Leaders =

Locally elected leaders and health officials can play a key role in leading efforts to improve the response to the SUD epidemic.  Mayors, County Executives, County Managers, Commissioners, and the local health leaders they appoint, can be powerful allies in raising public awareness about the extent of the problem, the availability of resources, and providing information on specific strategies, like harm reduction, that can help save lives.  In many instances, elected officials and local health officials might already be part of some type of community task force or other group charged with coordinating and improving local response to the epidemic; however, in the absence of such an effort, elected and health leaders can and should be engaged in raising awareness about the issue and solutions while also increasing support within the community.  

Elected leaders, and especially legislators, play an important role in the creation of budgets and ultimately decide on how local revenues are allocated to different programs, so it is critical they are aware of the scope of these issues in their communities and what is being done in response.  In most cases, they have political allies and are regularly invited to speak at community events or participate in meetings with diverse audiences where they can help to relay your message and share information about the response.

Although locally elected leaders are important champions, it’s also critical for a coalition to work alongside its state partners to help align efforts for maximum impact, inform policy, support funding, and make recommendations on scalability of programs that are working on-the-ground to avoid duplication or manage expectations that might not be feasible or sustainable at the local level.

 

=== Engagement Examples - Elected and Local Health Leaders ===

 

== Community Stakeholders and Infuencers ==

Drug Misuse and Substance Use Disorder affects a substantial number of residents in all communities.  A wide variety of stakeholders within each community has an important role to play in advancing polices, programs and systems that can work together and improve local response.  Consider engaging additional community partners to leverage exisiting efforts and boost support within the community.  Some examples include:

- Health Professionals     - Hospitals    - Community Health Centers    - Faith Leaders     - Law Enforcement     - Public and Private Schools     - Colleges and Universities

- Parents Groups     - Treatment Community     - Recovery Community   - Local business and corporations    - Philanthropic Community

 

 

= Improving Pubic Awareness And Engagement =

 

== Public Availability of Data ==

 

== Community Education Programs ==

 

== Building Strategic Partnerships ==

 

== Develop Outreach Strategies ==

 

= Overcoming Stigma =

== Anti--Stigma Campaigns: ==

State of Massachusetts - Sate Without StigMA. <ref>https://www.mass.gov/state-without-stigma
</ref> The State of Massachusetts has developed a comprehensive anti-stigma campaign at the State level.  This resource provides information about what stigma is, how it contributes to the current epidemic, and personal stories of people who talk about their own experiences with stigma and how they overcame it to find help for themselves and others in a variety of settings.

 

[[TR_-_Educate_Communities_to_Prevent_First-Time_Use_and_Misuse|Solutions and Tools focused on this objective.]]

= Promising Practices and Case Studies =

 <br/> __TOC__

[[Category:Community Resources]]

Activating Your Community

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Prevent First Time Use and Misuse through Education

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= Overview =

 

 

 

= Key Topics and Strategies =

 

 

= References and Related Articles =

 

 

==   ==

= Sources =

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== Contents ==

 [[[hide]]] 

*[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Background 1Background]
*[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Engaging_Local_Leaders 2Engaging Local Leaders]
**[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Elected_and_Local_Health_Leaders 2.1Elected and Local Health Leaders]
***[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Engagement_Examples_-_Elected_and_Local_Health_Leaders 2.1.1Engagement Examples - Elected and Local Health Leaders]
**[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Community_Stakeholders_and_Infuencers 2.2Community Stakeholders and Infuencers]
*[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Improving_Pubic_Awareness_And_Engagement 3Improving Pubic Awareness And Engagement]
**[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Public_Availability_of_Data 3.1Public Availability of Data]
**[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Community_Education_Programs 3.2Community Education Programs]
**[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Building_Strategic_Partnerships 3.3Building Strategic Partnerships]
**[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Develop_Outreach_Strategies 3.4Develop Outreach Strategies]
*[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Overcoming_Stigma 4Overcoming Stigma]
**[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Anti--Stigma_Campaigns: 4.1Anti--Stigma Campaigns:]
*[http://ifi-wikis.com/IFI-OpioidCrisis/Improve_Referral_Mechanisms#Promising_Practices_and_Case_Studies 5Promising Practices and Case Studies]

= Background =

There are many barriers that prevent and limit the efforts of communities to address drug misuse and substance use disorder.  The topic is uncomfortable for many, and stigma exists at the community, family, and individual level.  Often there is a lack of leadership and champions who are willing to make improving local response a top priority.  Leadership is needed among multiple leaders - from elected and health officials, public safety entities, and community leaders already working along the continuum of care.  In addition, these leaders need to effectively coordinate their efforts.

Public education and awareness is also essential to activating a local community.  Residents need to know the unvarnished reality of what is taking place.  They need to what the problem is, and what needs to be done to improve the local response and save lives.  In addition to be educated, local residents also need to be involved in the the process.  The people are the community, and many have first-hand experience with drug misuse and SUD.  Many others have lived experience with family and friends who are struggling with these issues, and their input and participation is needed to create a Comprehensive and effective Community

 

 

= Engaging Local Leaders =

Drug Misuse and SUD has consequesces for all residents of local communities.  The current epidemic increases costs related to public health, public safety, criminal justice, treatment services, and many more.  Locally elected leaders should be motivated just by the economic impacts to improve local response.  A far greater price comes from the fatalities caused by the epidemic and related overdoses and the loved ones who must face the pain of those lost.  This is what motivates many others to create and join efforts to combat the epidemic within their communities.  These leaders work in prevention, harm reduction, treatment, recovery support services, and other efforts to save lives and help those in need find recovery.

 

== Elected and Local Health Leaders ==

Locally elected leaders and health officials can play an important role in leading efforts to improve the response to the SUD epidemic.  Mayors, County Executives, Commissioners, and the local health leaders they appoint can be powerful allies in raising public awareness about the extent of the problem, available resources available to local residents, and specific strategies like harm reduction that can help save lives.

In many instances elected officials and local health officials are part of some type of community task force or other group charged with coordinating and improving local response to the epidemic.  However in the absence of such an effort elected and health leaders can and should be engaged in raising awareness about the issue and solutions while also increasing support within the community.  Elected leaders and especially legislators also play an important role in the creation of budgets and ultimately decide on how local revenues are allocated to different programs, and it is critical they are aware of the scope of these issues in their communities.

=== Engagement Examples - Elected and Local Health Leaders ===

 

== Community Stakeholders and Infuencers ==

Drug Misuse and Substance Use Disorder affects a substantial number of residents in all communities.  A wide variety of stakeholders within each community has an important role to play in advancing polices, programs and systems that can work together and improve local response.  Consider engaging additional community partners to leverage exisiting efforts and boost support within the community.  Some examples include:

- Health Professionals     - Hospitals    - Community Health Centers    - Faith Leaders     - Law Enforcement     - Public and Private Schools     - Colleges and Universities

- Parents Groups     - Treatment Community     - Recovery Community   - Local business and corporations    - Philanthropic Community

 

 

= Improving Pubic Awareness And Engagement =

 

== Public Availability of Data ==

 

== Community Education Programs ==

 

== Building Strategic Partnerships ==

 

== Develop Outreach Strategies ==

 

= Overcoming Stigma =

== Anti--Stigma Campaigns: ==

State of Massachusetts - Sate Without StigMA. <ref>https://www.mass.gov/state-without-stigma
</ref> The State of Massachusetts has developed a comprehensive anti-stigma campaign at the State level.  This resource provides information about what stigma is, how it contributes to the current epidemic, and personal stories of people who talk about their own experiences with stigma and how they overcame it to find help for themselves and others in a variety of settings.

 

[[TR_-_Educate_Communities_to_Prevent_First-Time_Use_and_Misuse|Solutions and Tools focused on this objective.]]

= Promising Practices and Case Studies =

 <br/> __TOC__

[[Category:Community Resources]]