Opioids in Appalachia: The Role of Counties in Reversing a Regional Epidemic

Error message
In order to filter by the "in queue" property, you need to add the Entityqueue: Queue relationship.-
Reports & ToolkitsAcross the nation, communities are suffering from rampant opioid misuse and overdose rates, and the 420 counties in the Appalachian region of the eastern U.S. have been disproportionately impacted by this epidemic of addiction.Opioids in Appalachia: The Role of Counties in Reversing a Regional EpidemicMay 1, 2019May 1, 2019, 3:00 pm
-
Document
Opioids in Appalachia: The Role of Counties in Reversing a Regional Epidemic
Across the nation, communities are suffering from rampant opioid misuse and overdose rates, and the 420 counties in the Appalachian region of the eastern U.S. have been disproportionately impacted by this epidemic of addiction. At the turn of the millennium, the opioid overdose death rate for Appalachian counties was roughly equal to that of the rest of the country. By 2017, however, the death rate for opioid overdoses in Appalachian counties was 72 percent higher than that of non-Appalachian counties.
Source: NACo Analysis of Centers for Disease Control and Prevention, National Center for Health Statistics, Multiple Cause of Death 1999-2017 on CDC WONDER Online Database; NACo Analysis of Centers for Disease Control and Prevention analysis of data from IQVIA Xponent 2006–2017. Available at www.cdc.gov/drugoverdose/maps/rxrate-maps.html.
Note: Age-adjusted death rates were calculated by applying age-specific death rates to the 2000 U.S. standard population age distribution. Death rates are deaths per 100,000 population (age-adjusted).While the misuse of opioids is driven by unique and varying factors, the pronounced impact of the opioid epidemic in Appalachia may be related to socioeconomic indicators in which the region trails the rest of the country, including education, health, and income.
As leaders in their communities, Appalachian county officials are well-positioned to drive local efforts to overcome the opioid epidemic. They have authority and legitimacy from holding public office, coupled with empathy and trust from daily community involvement, and can leverage relationships with businesses, community organizations and other governments to enhance the community response to addiction. Given that Appalachian governments operated with 35% less per capita revenue than their non-Appalachian counterparts in 2012 ($1,184 vs. $1,831 respectively), the role of the region’s county leaders in crafting efficient and sustainable responses to the opioid epidemic is especially important. The recommendations and case studies contained in this report are designed to aid Appalachian county leaders in their efforts to formulate these responses.
Recommendations for Local Action
1. Exercise Strategic Local Leadership
Key Actions
- Set a tone of compassion in local conversations on opioids
- Convene diverse stakeholders and faith-based organizations to form Opioid Task Forces
- Foster regional and intergovernmental cooperation
Case Study: Ross County, Ohio
Case Study: Mercer County, W.Va.
2. Create and Strengthen Preventive and Educational Initiatives
Key Actions
- Increase public awareness and facilitate safe disposal sites for opioids
- Conduct community outreach to children and families, particularly within the education system
- Leverage data and technology to target services
Case Study: Allegany County, Md.
3. Expand Access to Addiction Treatments
Key Actions
- Increase the availability of and access to naloxone and medication-assisted treatments (MAT)
- Employ telemedicine solutions
- Encourage mental health treatment and counseling alongside addiction treatments
Case Study: Project Lazarus (Wilkes County, N.C.)
4. Implement a Criminal Justice Response to Illegal Opioid Sales and Provide Treatment and Services to Justice-Involved Individuals with Opioid Use Disorders
Key Actions
- Reduce the illicit supply of opioids
- Facilitate treatment and workforce training in jails and upon reentry to reduce recidivism
- Connect people in recovery, including those involved in the criminal justice system, to housing and employment opportunities
Case Study: A New Beginning (Campbell County, Tenn.)
5. Mitigate Local Economic Impacts and Consider New Economic Development Strategies
Key Actions
- Collaborate with high schools, educational institutions and businesses to align education and workforce training with shifting industry needs
- Leverage each county’s strengths to attract and retain high-quality businesses, and help them learn to work with individuals in recovery
- Reinforce safety net services and expand education and employment opportunities for families experiencing cyclical poverty
- Expand entrepreneurial opportunities for county governments to make opioid recovery initiatives sustainable
Case Study: Coalfield Development Corporation (Lincoln, McDowell, Mingo and Wayne Counties, W.Va.)
Case Study: Housing Development Alliance (Perry County, Ky.)
Full Report
To learn more, download the full Opioids in Appalachia: The Role of Counties in Reversing a Regional Epidemic report.
Full report Across the nation, communities are suffering from rampant opioid misuse and overdose rates, and the 420 counties in the Appalachian region of the eastern U.S. have been disproportionately impacted by this epidemic of addiction.2019-05-01Reports & Toolkits2023-04-11
Across the nation, communities are suffering from rampant opioid misuse and overdose rates, and the 420 counties in the Appalachian region of the eastern U.S. have been disproportionately impacted by this epidemic of addiction. At the turn of the millennium, the opioid overdose death rate for Appalachian counties was roughly equal to that of the rest of the country. By 2017, however, the death rate for opioid overdoses in Appalachian counties was 72 percent higher than that of non-Appalachian counties.
Source: NACo Analysis of Centers for Disease Control and Prevention, National Center for Health Statistics, Multiple Cause of Death 1999-2017 on CDC WONDER Online Database; NACo Analysis of Centers for Disease Control and Prevention analysis of data from IQVIA Xponent 2006–2017. Available at www.cdc.gov/drugoverdose/maps/rxrate-maps.html.
Note: Age-adjusted death rates were calculated by applying age-specific death rates to the 2000 U.S. standard population age distribution. Death rates are deaths per 100,000 population (age-adjusted).
While the misuse of opioids is driven by unique and varying factors, the pronounced impact of the opioid epidemic in Appalachia may be related to socioeconomic indicators in which the region trails the rest of the country, including education, health, and income.
As leaders in their communities, Appalachian county officials are well-positioned to drive local efforts to overcome the opioid epidemic. They have authority and legitimacy from holding public office, coupled with empathy and trust from daily community involvement, and can leverage relationships with businesses, community organizations and other governments to enhance the community response to addiction. Given that Appalachian governments operated with 35% less per capita revenue than their non-Appalachian counterparts in 2012 ($1,184 vs. $1,831 respectively), the role of the region’s county leaders in crafting efficient and sustainable responses to the opioid epidemic is especially important. The recommendations and case studies contained in this report are designed to aid Appalachian county leaders in their efforts to formulate these responses.
Recommendations for Local Action
1. Exercise Strategic Local Leadership
Key Actions
- Set a tone of compassion in local conversations on opioids
- Convene diverse stakeholders and faith-based organizations to form Opioid Task Forces
- Foster regional and intergovernmental cooperation
Case Study: Ross County, Ohio
Case Study: Mercer County, W.Va.
2. Create and Strengthen Preventive and Educational Initiatives
Key Actions
- Increase public awareness and facilitate safe disposal sites for opioids
- Conduct community outreach to children and families, particularly within the education system
- Leverage data and technology to target services
Case Study: Allegany County, Md.
3. Expand Access to Addiction Treatments
Key Actions
- Increase the availability of and access to naloxone and medication-assisted treatments (MAT)
- Employ telemedicine solutions
- Encourage mental health treatment and counseling alongside addiction treatments
Case Study: Project Lazarus (Wilkes County, N.C.)
4. Implement a Criminal Justice Response to Illegal Opioid Sales and Provide Treatment and Services to Justice-Involved Individuals with Opioid Use Disorders
Key Actions
- Reduce the illicit supply of opioids
- Facilitate treatment and workforce training in jails and upon reentry to reduce recidivism
- Connect people in recovery, including those involved in the criminal justice system, to housing and employment opportunities
Case Study: A New Beginning (Campbell County, Tenn.)
5. Mitigate Local Economic Impacts and Consider New Economic Development Strategies
Key Actions
- Collaborate with high schools, educational institutions and businesses to align education and workforce training with shifting industry needs
- Leverage each county’s strengths to attract and retain high-quality businesses, and help them learn to work with individuals in recovery
- Reinforce safety net services and expand education and employment opportunities for families experiencing cyclical poverty
- Expand entrepreneurial opportunities for county governments to make opioid recovery initiatives sustainable
Case Study: Coalfield Development Corporation (Lincoln, McDowell, Mingo and Wayne Counties, W.Va.)
Case Study: Housing Development Alliance (Perry County, Ky.)
Full ReportTo learn more, download the full Opioids in Appalachia: The Role of Counties in Reversing a Regional Epidemic report. |
Full report |
-
Blog
U.S. Surgeon General releases Advisory and National Strategy to Advance Social Connection
On May 2, U.S. Surgeon General Dr. Vivek Murthy released a Surgeon General’s Advisory entitled, “Our Epidemic of Loneliness and Isolation,” highlighting the growing number of individuals in the U.S. -
Blog
Changes enacted to federal immigration policies as Title 42 expires
On May 11, “Title 42”, a pandemic-era policy that allowed for the rapid expulsion of asylum seekers throughout the COVID-19 pandemic, ended. In anticipation of the end of Title 42, several changes to federal immigration processes have been made, which impact county governments. -
Press Release
National Association of Counties Releases Data on Mental Health Crisis
Commission on Mental Health and Wellbeing Advocates for Policy Solutions at White House, on Capitol Hill -
Webinar
Familiar Faces Initiative: Model Jurisdictions for Improving Outcomes through Coordinated Health and Justice Systems
May. 11, 2023 , 2:00 pm – 3:30 pmIn 2022, NACo relaunched the Familiar Faces Initiative during Mental Health Awareness Month to support counties and cities in better meeting the needs of their familiar faces—individuals with complex health and behavioral health conditions who frequently cycle through jails, homeless shelters, emergency departments and other crisis service -
Reports & Toolkits
Behavioral Health Conditions Reach Crisis Levels: Counties Urge Stronger Intergovernmental Partnership and Outcomes
Counties are facing an acute escalation of the mental and behavioral health crisis. In a recent NACo survey, 75 percent of counties reported an increase in the incidence of behavioral health conditions over the past year and 89 percent reported an increase compared to five years ago. -
Blog
How counties can extend the reach of drug disposal programs with at-home drug deactivation and disposal
This blog post is sponsored by NACo partner Deterra. Empower Your Community: Enhance Drug Disposal Programs with At-Home Deactivation & Disposal Solutions
-
Webinar
Prenatal-to-Three Peer Learning Network: How the Social Determinants of Health Impact Families and Children
June 13, 2023 , 2:00 pm – 3:00 pmEnsuring that parents and caregivers have access to what they need to raise healthy babies helps build a strong foundation for all future learning and development.06132:00 pm<p>Ensuring that parents and caregivers have access to what they need to raise healthy babies helps build a strong foundation for all future learning and development.
-
Webinar
Prenatal-to-Three Peer Learning Network: How the Social Determinants of Health Impact Families and Children
June 15, 2023 , 2:00 pm – 3:00 pmEnsuring that parents and caregivers have access to what they need to raise healthy babies helps build a strong foundation for all future learning and development.06152:00 pm<p>Ensuring that parents and caregivers have access to what they need to raise healthy babies helps build a strong foundation for all future learning and development.
-
Basic page
Mental Health First Aid
Mental Health First Aid, a skills-based training administered by the National Council for Mental Wellbeing, teaches people how to identify, understand and respond to signs and symptoms of mental health and substance use challenges in their peers, friends and colleaguepagepagepage<h3><strong>WHY MENTAL HEALTH FIRST AID?</strong></h3>
-
Basic page
Healthy Counties Initiative
Healthy Counties focuses on enhancing: public-private partnerships in local health delivery, access to, and coordination of, care for vulnerable populations in the community and community public health and behavioral health programs.pagepagepage<h3>Healthy Counties focuses on enhancing:</h3>
-
Basic page
Live Healthy U.S. Counties
The National Association of Counties (NACo) Live Healthy Prescription, Health & Dental Discount Program is a NO-COST program available to all member counties.pagepagepage<h1>With <a id="naco" name="naco">NACo</a>, Saving Feels Better</h1>
-
Basic page
Human Services & Education Steering Committee
All matters pertaining to children’s issues, foster care, public assistance and income support, services to senior citizens and individuals with disabilities, immigration policy, social services, and elementary, secondary and post-secondary education. Policy Platform & Resolutions 2022-2023 2022 NACo Legislative Prioritiespagepagepage<p>All matters pertaining to children’s issues, foster care, public assistance and income support, services to senior citizens and individuals with disabilities, immigration policy, social services, and elementary,
-
Reports & Toolkits
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.Reports & Toolkitsdocument10123:30 pmReports & Toolkits<p>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.
Related News
-
BlogU.S. Surgeon General releases Advisory and National Strategy to Advance Social ConnectionMay. 23, 2023
-
BlogHow counties can extend the reach of drug disposal programs with at-home drug deactivation and disposalMay. 9, 2023
-
BlogBipartisan legislation introduced in House and Senate to address Medicaid Inmate Exclusion PolicyMay. 9, 2023
Related Resources
-
Press ReleaseNational Association of Counties Releases Data on Mental Health CrisisMay. 11, 2023
-
Reports & ToolkitsBehavioral Health Conditions Reach Crisis Levels: Counties Urge Stronger Intergovernmental Partnership and OutcomesMay. 11, 2023
-
Press ReleaseCounties Recognize Mental Health Awareness MonthMay. 1, 2023
Related Resources
-
Blog
U.S. Surgeon General releases Advisory and National Strategy to Advance Social Connection
On May 2, U.S. Surgeon General Dr. Vivek Murthy released a Surgeon General’s Advisory entitled, “Our Epidemic of Loneliness and Isolation,” highlighting the growing number of individuals in the U.S. -
Blog
How counties can extend the reach of drug disposal programs with at-home drug deactivation and disposal
This blog post is sponsored by NACo partner Deterra. Empower Your Community: Enhance Drug Disposal Programs with At-Home Deactivation & Disposal Solutions -
Blog
Bipartisan legislation introduced in House and Senate to address Medicaid Inmate Exclusion Policy
Two bipartisan bills have recently been reintroduced in both the U.S. Senate and U.S. House of Representatives to address the Medicaid Inmate Exclusion Policy.
-
Press Release
National Association of Counties Releases Data on Mental Health Crisis
Commission on Mental Health and Wellbeing Advocates for Policy Solutions at White House, on Capitol Hill -
Reports & Toolkits
Behavioral Health Conditions Reach Crisis Levels: Counties Urge Stronger Intergovernmental Partnership and Outcomes
Counties are facing an acute escalation of the mental and behavioral health crisis. In a recent NACo survey, 75 percent of counties reported an increase in the incidence of behavioral health conditions over the past year and 89 percent reported an increase compared to five years ago. -
Reports & Toolkits
Myths & Facts: American Rescue Plan Coronavirus State & Local Fiscal Recovery Funds
The Coronavirus State and Local Fiscal Recovery Fund (SLFRF), part of the American Rescue Plan Act (ARPA), allocated $65.1 billion in direct, flexible aid for every county, parish and borough in America.
Related Events
-
13Jun2023Webinar
Prenatal-to-Three Peer Learning Network: How the Social Determinants of Health Impact Families and Children
Jun. 13, 2023 , 2:00 pm – 3:00 pm -
15Jun2023Webinar
Prenatal-to-Three Peer Learning Network: How the Social Determinants of Health Impact Families and Children
Jun. 15, 2023 , 2:00 pm – 3:00 pm
Upcoming Events
-
8Jun2023Webinar
Worried about inflation? Strategies for Increasing Non-Tax Revenues.
Jun. 8, 2023 , 1:00 pm – 2:00 pm -
8Jun2023Webinar
County Finance Transformation: Improve Efficiency, Productivity, and Compliance
Jun. 8, 2023 , 1:00 pm – 2:00 pm -
8Jun2023Webinar
NACo Briefing for Newly Elected Congressional Staff on Counties & the Federal Grant Process
Jun. 8, 2023 , 3:00 pm – 4:00 pm
More From
-
ARPA Impact Report: An Analysis of How Counties are Addressing National Issues With Local Investments
With American Rescue Plan funds, counties are strengthening America’s workforce, addressing the nation’s behavioral health crisis, expanding broadband access, improving housing affordability and building prosperous communities for the next generation.
Learn More