How to End the Opioid Crisis — Page 3

Follow-up in the court system

The threat of jail time can persuade offenders to get clean.

In more than 4,000 drug courts nationwide, offenders can avoid a sentence and clear their record if they complete long-term drug treatment. In one survey, about 56 percent of drug court participants reported using drugs during the previous year, compared to 76 percent of a comparison group.

When people addicted to opioids land in jail or prison, they likely don’t get treatment. One strategy is to screen new arrivals for drug disorders. Many also suffer from mental illness.

Some big cities offer medication, but that’s the exception, especially in rural America. Franklin County in Massachusetts paved the way in 2016 when it offered buprenorphine, as well as naltrexone, in its corrections facilities. A neighboring rural county began offering buprenorphine in 2019.

The approach helped. A study concluded that the treatment cut the rate of probation violations, reincarcerations, and court charges by 32 percent.

In Los Angeles, people in county jails receive free Narcan, the overdose medication, and can get free Narcan to take with them when they leave.

Follow up with people who get emergency care   

Wilmington, N.C., has another strategy to convince users to accept help. When emergency responders treat people with naloxone, the opioid overdose remedy, the city sends a trained team to visit the patients within 72 hours, asking them to enter treatment. If a user refuses, the team comes back again.

A similar Ohio program has spread to most of its counties, helping many people addicted to methamphetamine and opioids. Some outreach teams respond within 72 hours. In other similar programs, a team might not arrive for weeks.

In general, people need better long-term follow-up care. The Centers for Disease Control and Prevention (CDC) reports that nearly 20 percent of opioid-related deaths occur among people who have previously been treated for substance abuse. About 10 percent of them overdosed before.

Follow up with people released from institutions

People released from prison are at high risk of drug overdoses, especially during the first two weeks. Public policies can make sure people who are leaving any institution — criminal justice facilities, inpatient rehabilitation programs, or psychiatric care — are evaluated and have medication for substance issues before they go. People released from such facilities account for about 10 percent of drug overdoses.

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