Opioid Solutions Strategy Briefs
Upcoming Events
Related News
In 2022, NACo convened an advisory board of national experts and leading researchers to analyze Exhibit E of the national opioid settlement agreements. Exhibit E outlines a non-exhaustive list of over 130 approved uses of opioid settlement funds that qualify as “opioid remediation.” NACo’s Opioid Solutions Strategy Briefs document 15 high-impact opioid abatement strategies from this list that are under county authority. Each brief summarizes the available evidence, best practices for implementation, county examples and links to additional resources, including opportunities for specialized technical assistance.
Jump to Section
In 2022, NACo convened an advisory board of national experts and leading researchers to analyze Exhibit E of the national opioid settlement agreements. Exhibit E outlines a non-exhaustive list of over 130 approved uses of opioid settlement funds that qualify as “opioid remediation.” NACo’s Opioid Solutions Strategy Briefs document 15 high-impact opioid abatement strategies from this list that are under county authority. Each brief summarizes the available evidence, best practices for implementation, county examples and links to additional resources, including opportunities for specialized technical assistance.
Key Strategies
Several strategies are commonly regarded as pillars of response to opioid use disorder. These strategies span the substance use continuum of care – from prevention, to harm reduction, treatment and recovery.
County leaders who are new to the field of substance use or interested in investing in time-tested strategies may find the strategy briefs to the right helpful.
Youth-Focused Prevention: A NACo Opioid Solutions Strategy Brief
Youth-focused programs, including school-based programs, may help support young people and their families, strengthen community connections and mitigate the long-term negative impacts of adverse childhood experiences.
Naloxone to Reverse Opioid Overdose
Naloxone is a “rescue” drug that quickly and safely reverses opioid overdose. It is available as an injectable solution and as a nasal spray. Naloxone works by blocking the effects of opioids in the body. Virtually all opioid overdose deaths are preventable if naloxone is administered in time.
Syringe Services Programs: A NACo Opioid Solutions Strategy Brief
Syringe services programs (SSPs) provide low-barrier access to sterile supplies for safer substance use, naloxone and overdose prevention tools like fentanyl test strips and drug checking services. SSPs also provide a range of other services, such as options for safe syringe disposal, overdose recognition and response training and help accessing services for HIV, substance use disorders and more.
Medication-Assisted Treatment (“MAT”) for Opioid Use Disorder: A NACo Opioid Solutions Strategy Brief
The Food and Drug Administration (FDA) has approved three medications that safely and effectively treat opioid use disorder (OUD) to improve the health and wellbeing of people living with OUD. MAT is defined by on-going, long-term treatment with one of these three medications.
Improving Access Across Systems
Counties oversee a myriad of service systems – from public health to law enforcement, human services and emergency response – that serve communities affected by substance use disorder. From this unique position, county leaders play a pivotal role in fostering collaboration across systems and ensuring that individuals who are engaged in other systems will be aware of and connected with MOUD.
The strategies to the right outline ways by which county leaders can promote a more integrated service system for individuals affected by SUD and make systems change that increases access to care.
Linkage to Care Across County Systems: A NACo Opioid Solutions Strategy Brief
As the owners and operators of systems of service that regularly interface with people affected by substance use such as hospitals, jails, courts and community colleges, counties are well positioned to link community members with evidence-based options for care, especially medications for opioid use disorder (MOUD).
Comprehensive Services for People With Co-Occurring Disorders: A NACo Opioid Solutions Strategy Brief
Comprehensive services integrate multiple forms of substance use, mental health and case management services and may include: evidence-based treatments for SUD, integrated mental health treatment services, housing support, transportation support, employment and educational services, income support, social support, legal services and child care.
Increasing Access to Evidence-Based Treatment: A NACo Opioid Solutions Strategy Brief
Our health care system’s capacity to provide medications for opioid use disorder (MOUD) falls far below the current demand for care. Only 1 in 4 people who need MOUD are able to access them. A multi-pronged approach is needed to build up the treatment workforce, create effective pathways to care and save lives.
Warm Hand-Offs: A NACo Opioid Solutions Strategy Brief
A warm hand-off is a form of referral to treatment or other services. A typical referral gives someone information about how to reach the services they need but may leave them to contact those services on their own. In contrast, a warm hand-off is a transfer of care between service providers through face-to-face, phone or video interaction in the presence of the person being helped.
Post-Overdose Response Teams
Post-overdose response teams (also called quick response teams or post-overdose outreach programs) conduct outreach and offer services to people who have experienced an overdose within about 72 hours of the overdose event.
Improving Access for Specific Communities
Counties often have a strong role in human services and corrections. As a result, county leaders can have a considerable impact on the communities served by these systems – families and people with criminal legal system involvement – by dismantling the specific barriers and meeting their unique needs.
Families
Pregnant and parenting people affected by substance use disorder and infants affected by neonatal abstinence syndrome are at a crucial juncture for treatment. Increasing access to and removing the stigma around medications for opioid use disorder (MOUD) strengthens families and supports recovery.
The strategy briefs to the right address these best practices.
Treatment and Recovery for Pregnant and Parenting People: A NACo Opioid Solutions Strategy Brief
Effective treatment for pregnant and parenting people means expanding access to MOUD and adopting a family-centered approach that prioritizes keeping families together.
Treatment for Neonatal Abstinence Syndrome: A NACo Opioid Solutions Strategy Brief
Neonatal Abstinence Syndrome or NAS (also called Neonatal Opioid Withdrawal Syndrome or NOWS) is a condition that sometimes affects newborns of parents who have taken opioids during pregnancy. Because NAS does not cause long-term health consequences, treatment with MOUD – as opposed to withdrawal and abstinence – is safer for both parents and their infants.
People Impacted by the Criminal Legal System
Incarceration is a primary risk factor for overdose. Within the first two weeks of release, formerly incarcerated individuals are 40 times more likely to experience an overdose than the general population. Increasing access to MOUD in the criminal legal system can save lives, reduce recidivism and promote recovery.
The strategy briefs to the right address these targeted interventions across the criminal legal system – from pre-arrest to release from incarceration.
Pre-Arrest Diversion: A NACo Opioid Solutions Strategy Brief
Pre-arrest diversion strategies enable law enforcement officers to refer community members with unmet needs to trauma-informed case management and support services in lieu of arrest, prosecution and incarceration.
Pretrial Services for People with Opioid Use Disorder
Pretrial services typically consist of assessments and decisions concerning bail, release and community supervision in anticipation of future court appearances. These processes provide important opportunities to engage local health care and social services providers and link defendants and their families to the care that they need.
Effective Treatment for Opioid Use Disorder for Incarcerated Populations: A NACo Opioid Solutions Strategy Brief
Medication-assisted treatment (MAT) is considered the “gold standard” of care for opioid use disorder (OUD). Because incarceration is a known driver of opioid overdose, failure to provide this gold standard of care to incarcerated individuals may exacerbate health risks in your community.
Coordination of Care Upon Release From Incarceration: A NACo Opioid Solutions Strategy Brief
Coordination of care upon release is the deliberate organization and sharing of information between correctional and community-based service providers to ensure the most effective care for each person returning to the community.
Featured Initiative
Opioid Solutions Center
NACo's Opioid Solutions Center empowers local leaders to invest resources in effective treatment, recovery, prevention and harm reduction practices that save lives and address the underlying causes of substance use disorder.
New Law Brings Long-Sought Transparency to FEMA Disaster Reimbursements
A new federal law requires FEMA to publish a publicly accessible, interactive dashboard tracking all Public Assistance reimbursement requests, giving counties unprecedented visibility into disaster recovery funding.
LUCC members tackle housing affordability shortage
Urban county officials visited Washington, D.C. to explore data-driven approaches to expanding housing supply and affordability and relay their concerns to members of Congress.
Reflections on federalism at America 250
NACo CEO Matt Chase: "Counties are where federal and state policy stops being policy and starts being real. We are not a delivery mechanism for decisions made elsewhere. We are where American governance actually lives."
Museum expansion amplifies a rural county’s story
In a frontier Montana county, local history and culture will get a larger stage as a museum prepares for a major addition.
Counties eye potential Medicaid reimbursement remedies
Increasing the number of beds in mental health treatment facilities eligible for Medicaid reimbursement would empower counties to do more to help their residents.
Salute to county leaders: Larry Waters
Larry Waters has served 12 terms as mayor of Sevier County, Tenn., starting when he was a 25-year-old school principal.
2026 Western Interstate Region (WIR) Conference
The NACo Western Interstate Region (WIR) Conference brings together county officials from across the nation to focus on pressing issues facing Western counties and our residents.
County Strategies to Support Mental Health and Wellbeing Across the Lifespan
Join NACo and the Healthy Counties Innovation Council for a webinar exploring how counties are supporting mental health across the lifespan.
Navigating Workforce System Consolidation: Policy Guidance for Local Leaders
Attendees will gain clear, actionable insights to help their communities prepare for and navigate proposals to consolidate or redesignate workforce areas.
NACo Policy Insider Webinar Series: Understanding the Federal Landscape for Counties, May 7
Join NACo for a bi-weekly webinar offering an overview of the full federal policy landscape impacting counties.
2026 Elections: Local Government Roles and Responsibilities Webinar
Hosted by the Local Government Legal Center (LGLC), in partnership with the National League of Cities (NLC) and International Municipal Lawyers Association (IMLA) this webinar on May 11 from 1-2pm EST will host legal and election experts in a discussion regarding the regulatory and administrative responsibilities local elected and executive leaders, and election administrators should understand for the upcoming election cycle. This webinar will provide an overview of the new executive orders, and federal policies impacting the upcoming 2026 elections, as well as the legal parameters and the legislative proposals local governments should understand that may impact their roles and responsibilities for election administration.
Opportunity Zones 2.0: Economic Development and Community Revitalization
Tune in to hear directly from HUD leaders on how collaboration between housing and economic development can reshape communities.