Those battling substance use disorders face challenge with getting medication

Across the country, hospitals are embracing intensive intervention programs to help victims of violence — including those who have criminal histories — after they have been brought in for treatment of injuries. Such programs can help prevent retaliation, reduce the chance a patient will be violently injured again, and put people on track for success.

In Colorado, four communities are piloting a program that offers low-level drug or prostitution offenders an alternative to prison. This program, known as Law Enforcement Assisted Diversion, matches the offender with a case manager who in turn connects them with treatment and training resources.

Across New Hampshire, youth are leading the fight against substance abuse. Programs like Dover’s Youth-to-Youth, Stand Up Sachems, Youth Leadership Through Adventure, and the Making it Happen Coalition, are all youth-led, adult-supported initiatives that are empowering young adults to create and disseminate substance abuse awareness and prevention campaigns. Fundamental to each of these efforts effective communication and creating a sense of community as key to prevention.

Based out of the city of Addis Ababa in Ethiopia, a live radio show is tackling the stigma around mental health care by combining their platform with those in the mental health care field. Not only does the radio show discuss psychological issues on air, but it also offers free and reduced-cost mental health services to those that serve as guests on the show.

More than 2,700 police departments in the U.S. have crisis intervention teams aimed at responding to mental health crises with fewer arrests and less violence, but the death of Daniel Prude in Rochester police custody offers clear lessons in the shortcomings and misuse of the CIT model. A lack of adequate mental health services across the country, coupled with superficial training of the police, too often means a police response to a crisis will not de-escalate the situation or lead to meaningful help for the person in crisis. A recent study found CITs have not shown they will lower violence.

Vermont's hub and spoke model of care has gained notoriety as being a system that has successfully played a positive role in creating better access to health care, especially as it relates to the opioid crisis. Now, officials in New Hampshire are looking to scale and adapt the program to work in their state.

Fifty years on, America's war on drugs has failed at its principal goals: to eradicate illicit drug use and sales, to repair communities damaged by the drug trade, and to prevent drug-related deaths. Despite massive amounts spent on law enforcement, which has created great social harms and fueled incarceration, drug use has rebounded to 40-year highs, drug overdose deaths are peaking, and supply of illegal drugs is abundant. Policy advocates say a combination of legalization and public-health approaches to the problems would accomplish more than the wasteful, ineffective "war" mentality used to date.

New Hampshire's Rockinham County gives some people with extensive drug and criminal histories an offramp from the criminal legal system, in the form of housing at Cross Roads House and a drug court to emphasize treatment over punishment. But, while other cities in the state meet such needs with multiple programs, the second-most populous county in the state has a severe shortage of supportive housing and services. Such services can make the difference between prison and success, and even between life and death in a place with high rates of overdose deaths.

Thunder Bay police formed IMPACT (Integrated Mobile Police Assessment Crisis Team), pairing crisis responders with mental health expertise with police officers to respond 24/7 to people experiencing mental health crises. Instead of defaulting to police responses, which risk the use of force and often land people in custody or a hospital, the teams often are able to get people connected to needed social and health services. So far the team has managed to divert about 40 percent of calls to helping services.

San Francisco considers the scaling of safe injection sites, which were successfully piloted in Vancouver, to become the first city in the United States to offer this service. However, the main challenge of starting such a service in San Francisco is helping the public get over the concern that safe injection sites encourage drug use for non-abusers. Community groups actively educated the public on the benefits of safe injection sites and politicians made trips to Vancouver to observe the success in action.