Resources to Support Opioid Programming

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Resources to Support Opioid Programming

The growing opioid crisis in the United States impacts our friends, families, and communities. AmeriCorps VISTA opioid programming addresses the crisis by placing VISTA members with nonprofit organizations, government entities, and tribal nations that are creating or expanding existing opioid projects targeting low-income communities. The programming treats opioid misuse, addiction, and recovery as a health issue and fits into the Corporation for National and Community Service’s Healthy Futures focus area. Other CNCS focus areas such as economic opportunity, education, and veterans may also be addressed by the opioid programming. CNCS’s opioid programming emphasizes prevention, intervention, and treatment.

The resources on this page include toolkits, documents, and websites designed to help you align your program activities with existing and emerging local, state, and national efforts to address the opioid crisis.

The Opioid Crisis: An Overview

Opioids Defined

Opioids are a class of drugs that range from prescription pain killers, such as fentanyl, to heroin. Prescription opioids are prescribed by doctors to treat moderate to severe pain and commonly include oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and methadone. Prescription opioids can be misused and abused. Fentanyl is a synthetic opioid pain reliever. It is many times more powerful than other opioids and is approved for treating severe pain, typically advanced cancer pain. Illegally made and distributed fentanyl has been on the rise in several states. Heroin, an illegal opioid, is often laced with chemicals, including other synthetic opioids like fentanyl, which make it cheaper to produce but far more dangerous and potentially lethal for users.

Recent History

According to the US Centers for Disease Control and Prevention (CDC), almost 100 people die from opioid overdoses in the United States each day. Opioid overdose rates have quadrupled in the United States since 1999. The death toll continues to rise, with a record high of 33,000 opioid related deaths reported in the US in 2015. In 2013, the United States Department of Health and Human Services called prescription overdose deaths an epidemic, and in August 2017 the President of the United States declared the opioid crisis a national emergency.

Opioids and Poverty

The United States is experiencing an opioid epidemic that cuts across all economic categories. Income or wealth do not determine a person’s likelihood of addiction. However, there are contributing factors – such as education, abuse and neglect, mental health, and parental substance abuse – that make low-income individuals more vulnerable to substance abuse.

  • Level of education is strongly linked to substance abuse tendencies. Individuals with higher education are less likely to be substance abusers. Low-income individuals are likely to have less formal education. In a survey regarding their parents’ drug use cessation, high school students whose parents did not attend high school showed a much lower decline in drug abuse than their peers whose parents did attend high school – 2.7 percent decrease versus a 13 percent decrease.
  • Most childhood abuse and neglect cases involve drug or alcohol abuse. Adult substance abusers are more likely to be abusive to their children. In a survey of state welfare offices, 85 percent claimed that parental drug and/or alcohol use and poverty were the top two problems in child protective cases.
  • Mental health plays a major role in substance abuse. Approximately 29 percent of all people diagnosed with a mental health disorder also abuse drugs or alcohol. The incidence of mental illness is higher among low-income individuals. Severe mental illness is most common – at 16.3 percent – among those with family income levels of less than $20,000.
  • Parental drug and alcohol abuse exposes children to an environment that can lead to a substance abuse problem for the children. Children of alcoholic parents have a fourfold increased risk of being dependent on alcohol later in life. Households in which one or both caretakers abuse drugs are more likely to be of lower economic status.

Research shows that heroin use is increasing most rapidly in households with annual incomes under $20,000, and that opioid overdose deaths and emergency room visits for opioid overdoses rise as unemployment rises in a state or county. In a paper published by the National Bureau of Economic Research finds that for every one percentage point increase in the unemployment rate in a given county, the opioid-death-rate rises by 3.6 percent, and emergency-room visits rise by 7 percent.

Key research findings indicate a link between substance abuse and welfare recipients; illicit drug use and dependence are more common among women receiving welfare than among women who do not. Drug use is a risk factor for welfare recipients, even after controlling for race, educational attainment, region, and other factors.

What's Being Done

Strategies to address the prescription drug crisis include physician education about safe prescribing and recognizing misuse; legislation to limit prescriptions; increased access to drug treatment; and monitoring by federal and state agencies. Prescription Drug Monitoring Programs (PDMPs) are one example of a current strategy to address the prescription drug crisis. PDMPs allow, or in some states require, that prescribers or dispensers check a patient’s history to make sure they aren’t receiving multiple opioid prescriptions from various sources.

In addition to these large-scale strategies, it’s crucial to recognize that the opioid crisis affects communities every day, and will only be turned back by people working together, one neighborhood, one block, one home, one family, one person at a time.

State and Community-Level Data

Use this information to conduct community assessments; develop programming matched to community needs; create awareness about how the opioid crisis is impacting your community; and advocate for the development of resources such as treatment centers and support groups for individuals and families.

Educational Resources and Toolkits

This information can be used to develop training materials to educate and raise awareness, develop materials about new programming, and provide context to support community partnerships and connections. Of special note are the pre-existing toolkits used by local and state governments.

Educational Resources

Comprehensive Toolkits

  • The Community Anti-Drug Coalition has compiled a Prevent Rx Abuse Toolkit with a guide to completing a community assessment, a media kit for outreach, stories of successful coalitions, and community change strategies.
  • The National League of Cities and the National Association of Counties created a joint report on the opioid crisis with recommendations for state and community leaders..

State Examples

  • Massachusetts developed an online tool for groups working to reduce prescription drug misuse and abuse based on the SAMHSA Strategic Prevention Framework (SPF). The resource includes tools and worksheets on messaging, media strategies, strategic plan development, action plan templates, and tips on using data to measure success.
  • The California Opioid Safety Coalitions Network, established by the California Health Care Foundation, provides a state overdose surveillance data dashboard broken down by state and counties and links site users to local coalitions.
  • Virginia developed VaAware, which contains information, resources and data for health care providers, law enforcement personnel, families, and community members.

Legal and Legislative Resources

This section highlights legislation addressing the opioid epidemic and provides an understanding of the legal rights of people recovering from opioid addiction. While AmeriCorps VISTA members are not permitted to lobby or advocate on behalf of legislation, these resources include important information about how legislators are addressing the opioid crisis in your state or community and can help VISTA members support the development or expansion of re-entry programs that reduce recidivism for individuals involved in the criminal justice system.

  • Legal Rights for Recovering People The Legal Action Center provides information about the rights of people with substance use disorders. Resources on this webpage include educational materials for opioid users seeking, or in, treatment and recovery, with sections on public benefits, employment and housing rights, confidentiality laws, access to treatment, and the intersection of addiction treatment and the criminal justice system.
  • Medically-Assisted Treatment (MAT) for Opioid Addiction: Myths and Facts The Legal Action Center created this four page fact sheet to provide an overview of the common myths and facts about MAT. This document is a useful education tool.
  • Opioid Overdose Reporters: Immunity and Good Samaritan Laws by State Good Samaritan laws protect overdose victims and bystanders from being prosecuted for drug use and possession, allowing victim and bystanders to stay on the scene instead of leaving an overdose victim because of fear of arrest.
  • Criminal Justice and Addiction This website focuses on expanding access to Substance Use Disorder services for individuals involved in the criminal justice system. It highlights grant programs that feature collaboration between criminal justice/law enforcement and Substance Use Disorder treatment.
  • What Are Drug Courts? This website describes how criminal justice and treatment providers partner to address the needs of individuals involved in the legal system by diverting nonviolent offenders from correctional facilities and engaging them in community treatment programs with legal supervision.
  • State Legislation Addressing Opioids This is a searchable database for state laws on opioid prevention and misuse legislation.
  • What are Prescription Drug Monitoring Programs? (PDMPs) This website describes PDMPs in detail and has a searchable database to help users learn how states have implemented these programs and what effect they have had on opioid prescribing.
Existing Prevention, Intervention, Treatment, and Recovery Programs

The resources in this section provide an overview of prevention, intervention, treatment approaches, and recovery support for individuals who are misusing opioids or have Opioid Use Disorders (OUDs). These resources can help with program development; designing training materials; creating outreach and media campaigns; and identifying potential partnerships with service agencies.

Prevention

Intervention

Treatment

Recovery Support and Advocacy

  • What is Recovery? What guiding principles are important to consider when working with individuals in recovery?
  • Using Person Centered Language Read Changing the Language of Addiction from the Office of National Drug Control Policy, which recommends terms to use and avoid when talking with and about individuals with opioid use disorders.
  • Narcotics Anonymous The 12-step mutual help support groups for addiction.
  • Families Anonymous The 12-step mutual help support group for family members.
  • Smart Recovery A support group that provides an alternative to traditional 12 step approaches.
Housing and Support Services for Persons in Recovery

This section provides housing resources for individuals in recovery, whether they are transitioning from residential treatment, incarceration, or just need a safe, supportive environment. Information here can help with program development and creating connections for individuals recovering from Opioid Use Disorders (OUDs) who need a safe place to stay.

  • National Association of Recovery Residences This website has a searchable database of accredited recovery residences and highlights the importance of providing safe, quality housing to individuals seeking recovery.
  • Oxford House Sober Living This website offers a searchable database of available homes and a guide to the organization’s philosophy of recovery.
National Organizations Leading Recovery Efforts

These organizations provide advocacy, recovery support services, training, and volunteer recruitment. They also partner with local communities to promote recovery awareness and activities. Information here can be used to help develop community partnerships, such as connections with local organizations that provide peer recovery support and direct help for recovering individuals and their families.

  • Faces and Voices of Recovery This comprehensive website provides advocacy resources, a community listening toolkit, a sample needs assessment, and community partnering resources, as well as information on planning, managing, and sustaining recovery for community organizations.
  • Youth Move This website focuses on a youth-based recovery movement and guides users on partnering with or establishing chapters in their communities.
  • Young People in Recovery This website provides guides to grassroots training and organizing for young people in recovery.
AmeriCorps VISTA Opioid Programming Examples

This section provides a brief overview of programming from four states in which AmeriCorps VISTA members have been placed to support ending the opioid epidemic. Last updated September 2017

Massachusetts:

United Way Pioneer Valley (UWPW) in Springfield, MA has an AmeriCorps VISTA member serving as Opioid Task Force Facilitation VISTA. The region recently formed the Hampden County Addiction Task Force, through which the VISTA member is analyzing data, assessing county-wide needs, developing standardized communications between addiction-related groups, and engaging the UWPW Youth Generate Initiative in programming relevant to addiction issues. Youth Generate, which partners with local schools, is a program that inspires young people to assess their communities and develop projects that meet a unique or specific community need.

West Virginia:

The AmeriCorps VISTA project at Marshall University in Huntington, WV collaborates with first responders to intervene after drug-related incidents to help addicts enter treatment programs. The VISTA member serves as a Community Opioid Addiction Organizer to build community capacity by recruiting, training, and organizing volunteer agencies to more effectively assist predominantly low-income addicted individuals. As a result of the VISTA member’s service, first responders and other volunteers will be trained to assist with recovery efforts and an organizational structure is being developed to manage the activities of these partners.

Arizona:

The Arizona Governor’s Commission on Service and Volunteerism in Phoenix, AZ has two AmeriCorps VISTA members hosted by the Governor’s Office of Youth, Faith and Family to support the Prescription Drug Misuse and Abuse Initiative in Arizona. The VISTA members train community stakeholders, community partners, government entities, and nonprofit organizations on the Prescription Drug Misuse and Abuse Initiative; expand and strengthen partnerships; provide technical assistance and training and prevention curriculum to community partners; and provide training materials to implement the Rx Initiative.

Through partnerships with law enforcement departments and different drug treatment centers, including opioid recovery centers, a VISTA member is developing standards for Arizona’s Angel Initiative. The Angel Initiative is a pilot program that allows citizens to walk into a police precinct, turn in their drugs, and request treatment without fear of arrest as long as there are no existing warrants for their arrest. Treatment services are provided free of charge.

Another VISTA member is collecting data on state-supported prescription drug use drop boxes that allow citizens to dispose of unused prescription medications. The member is also building the capacity of the program by streamlining the drop-off and collection methods and analyzing previous take-back events to gauge effectiveness and areas for potential growth and improvement.

Florida:

During the summer of 2017, forty-six AmeriCorps VISTA Summer Associates were placed at summer camp sites across Florida, in communities such as Miami-Dade, Leon County, and Gadsden, to support and assist in educating young people about opioid and substance abuse with the goal of prevention. Communities in Schools of Florida served as the VISTA intermediary for several Summer Associate locations serving in youth summer camps. The summer camps—many located in high-poverty communities and Title I school districts-- are primarily designed to prevent summer learning loss.