Washington, D.C. — Much of the day-to-day work of opioid prevention and response falls to local health departments. To better understand this critical role, the National Association of County and City Health Officials (NACCHO) staff conducted a survey and are releasing a new report, “Local Health Department Approaches to Opioid Use Prevention and Response: An Environmental Scan.”

The scan surveyed 198 local health departments in efforts to capture a foundational understanding of the roles local health departments play in opioid use prevention and response efforts in order to inform priorities at the local, state, and national levels. Topics covered in this report include opioid use prevention and response workforce, partnerships, programmatic and clinical services, policy, and data collection and evaluation.

Key Findings

Local health departments engage in a range of opioid use prevention and response activities. While 83% of respondents reported providing community education and outreach, only 50% engaged in naloxone distribution.

Fentanyl and other drug testing protocols were least likely to be available by local health departments at 11%.

Local health departments efforts are well connected in the community. More than 75% of respondents reported working with partner organizations to provide community education, outreach, and linkages to treatment.

Local health department clinical responses are mostly focused on addressing the infectious disease consequences of opioid use. A total of 71% of respondents provide HIV/STI testing. However, other clinical opioid-related services are more likely to be provided by a partner organization than the health department in most of these areas.

Syringe service programs were offered by 21% of local health department respondents. Syringe service policies were also the most reported as being under consideration by localities, which could lead to greater uptake of these programs. In addition, small local health departments have the highest rate of involvement in syringe services policies, compared to large- and medium-sized local health departments.

Local health departments often inform local policies to help address opioid use. More than 70% of respondents reported having the following policies in their jurisdictions: first responder naloxone distribution, increased access to naloxone, Good Samaritan immunity policies, or opioid prescribing guidelines. Syringe services was the policy most reporter as “under consideration,” followed by opioid abuse reporting requirements and syringe decriminalization.

Local health departments around the country provided brief stories from the field outlining their opioid use program successes; these are included in the report. They are:

COLORADO

Comprehensive Data Collection Plan

Tri-County Health Department

KENTUCKY

Cumberland Valley District Health Department, Kentucky

Discarded Needle Program

MAINE

Portland Health Department, Maine

Successful Inter-agency Partnerships

MARYLAND

Dorchester County Health Department, Maryland

Opioid Coordinator and Peer Navigator Program

MASSACHUSETTS

Medford Health Department, Massachusetts, part of the Mystic Valley Public Health Coalition

Comprehensive Stigma Prevention Campaigns

MINNESOTA

Hennepin County Health Department,

Minnesota Advocating for MAT Services in Jails and Correctional Facilities

MISSOURI

Ste. Genevieve County Health Department, Missouri

Innovative Communications Methods: Local Pastoral Alliance

NEVADA

Southern Nevada Health District, Nevada

Syringe Vending Machines

NEW HAMPSHIRE

Nashua Division of Public Health and Community Services, New Hampshire

Safe Stations and Syringe Service Program Evaluation

OHIO

Franklin County Health Department, Ohio

Improving Naloxone Access and Linkages to Care in Jails

Montgomery County Health Department, Ohio

Partnering to Learn from Experienced Coalitions

PENNSYLVANIA

Allegheny County Health Department, Pennsylvania

Developing a Cadre of Diverse Opioid Policies

TENNESSEE

Metro Public Health Department, Tennessee

Tracking Overdose Activity with ODMAP

Sevier County Health Department, Tennessee

Evaluating the Impact of Neonatal Abstinence Syndrome (NAS) Education

WISCONSIN

Real-time Public and Private Overdose Mapping

Public Health Madison and Dane County, Wisconsin

Wauwatosa Health Department, Wisconsin

Comprehensive Social Media Campaign