ES 5. Develop Policies and Plans that Support
Individual and Community Health Efforts

Core Function: Policy Development

Local health departments play an important role in developing policy and codes to protect the health of the public through health improvement plans that address the complexities of all substance-related issues, including opioids. To reduce substance misuse and its related consequences, health departments can use a public health systems approach by working with zoning boards and other municipal officials in a wide range of settings by supporting broad implementation of effective prevention and treatment interventions and recovery supports.

Strategic Approaches and Models

• Connecticut Opioid REsponse (CORE) Initiative is a strategic plan developed in October 2016 for Connecticut state agencies to combat opioid addiction and overdose in Connecticut. http://www.ct.gov/dmhas/lib/dmhas/publications/core_initiative10.6.16.pdf
• Preventing Opioid Misuse and Overdoses in the States and Territories: A Comprehensive Public Health Framework to Address the Opioid Crisis is a web-based tool developed by the Association of State and Territorial Health Officials that provides strategies and supporting evidence in (1) training and education, (2), monitoring and surveillance; (3) treatment, recovery and harm reduction; and (4) primary and overdose prevention. Additional resources are provided in a searchable database.  https://my.astho.org/opioids/home
• Strategy to Combat Opioid Abuse, Misuse and Overdose: A Framework Based on the Five Point Strategy is a report published by the US Department of Health and Human Services to address the opioid crisis. https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf
• Opioid Overdose Prevention Toolkit is a downloadable resource from the Substance Abuse and Mental Health Services Administration (SAMHSA) offering strategies to health care providers, communities, and local governments for developing practices and policies to help prevent opioid-related overdoses and deaths. Access reports for community members, prescribers, patients and families, and those recovering from opioid overdose from SAMHSA. https://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit/SMA18-4742
• Evidence-based Strategies for Preventing Opioid Overdose: What’s Working in the United States (2018) is a publication from the Centers for Disease Control and Prevention (CDC) that introduces public heath, law enforcement, local organizations, and others striving to serve their community with evidence-based practices they can adapt for their communities.  https://www.cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf

Opioid Use Disorder: City Actions and Opportunities to Address the Epidemic is a resource published by the National League of Cities with strategies for cities to address the opioid epidemic. The resource also includes short examples of efforts in cities across the country to combat the opioid epidemic, including state- and local-level strategies. https://www.nlc.org/sites/default/files/users/user75/NLC_OPIODS_bckgrndr_FINAL_032618_r2.pdf

Zoning Policy

Zoning policy has been used to limit the selling, advertising, or promotion of substances such as tobacco and alcohol, and more recently marijuana. See ES6 for more resources. 

• Vermont Department of Health has developed Sample Language for Town Plans: Preventing Substance Abuse, a resource to provide guidance on land use, transportation, facilities, and housing. https://www.healthvermont.gov/sites/default/files/documents/pdf/OLH_Burl%20ATOD%20sample%20language%20for%20town%20plans_5.30.17.pdf   

Syringe Service Programs

Syringe service programs (SSPs), also known as needle exchange programs, can reduce infection with HIV or hepatitis C, provide opportunities to gather surveillance data, and offer prevention education to individuals who use drugs. 

• CT Center for Harm Reduction offers harm reduction and drug user health services throughout Connecticut. The Center educates individuals, social service providers, and communities on techniques to reduce overdoses, sites to receive clean syringes and dispose of used ones, and practices that reduce the spread of HIV, Hepatitis C, and other transmissible infections. The Center is a division of AIDS Connecticut, Inc. http://www.harmreduction-ct.org/
• Connecticut Department of Public Health (CT DPH) may now, with local board of health approval, contract with eligible organizations to deliver needle exchange services in the context of comprehensive health promotion for individuals who inject drugsInformation on Syringe Services Programs in Connecticut may be found online.  https://www.211ct.org/search?term=syringe&page=1&location=ct&service_area=connecticut
• North American Syringe Exchange Network was formed in 1992 and distributes at-cost supplies of harm reduction materials to syringe exchange programs. https://nasen.org/  
• Reducing Harms from Injection Drug Use & Opioid Use Disorder with Syringe Services Programs is a fact sheet for the public that provides basic information and statistics on the comprehensive services and benefits provided by a syringe service program. https://www.naccho.org/uploads/downloadable-resources/HRR-reducing-harms-from-idu-oud-ssps-toolkit13.pdf   

Proper Disposal of Medications and Syringes

• Connecticut Department of Consumer Protection provides resources on safe use and disposal of medications, including a downloadable brochure and a search tool of prescription drug drop off boxes around the state for citizens to properly dispose of unused household medications. https://portal.ct.gov/-/media/DCP/drug_control/PMP/pdf/dropboxpdf.pdf?la=en and https://portal.ct.gov/DCP/Drug-Control-Division/Drug-Control/Local-Drug-Collection-Boxes
• Drug Free CT has information for the public on safe use, storage and disposal of prescription medications. https://www.drugfreect.org/medication-safety/
• Remove the Risk Outreach Toolkit, sponsored by the U.S. Food and Drug Administration, has a wide range of materials in English and Spanish to support safe disposal of medications. Use these free toolkit materials—public service announcements (PSAs), social media images and posts, fact sheets, and more—for sharing with others about safe opioid disposal. https://www.fda.gov/drugs/ensuring-safe-use-medicine/safe-opioid-disposal-remove-risk-outreach-toolkit?utm_source=other&utm_medium=content-text&utm_campaign=RemoveTheRisk#fact

Opioids in the Workplace

• Connecticut Department of Public Health’s Occupational Health Program supports a special emphasis program to encourage employers to recognize and support employees with an opioid or any type of substance abuse disorder to seek treatment and recovery. https://portal.ct.gov/DPH/Environmental-Health/Environmental-and-Occupational-Health-Assessment/Opioid-Use-in-the-Workplace  
• National Institute for Occupational Safety and Health (NIOSH) offers research, reports and resources related to occupational exposure risks among emergency responders and other groups of workers impacted by the opioid crisis. https://www.cdc.gov/niosh/topics/opioids/fieldinvestigations.html

Information Related to Related to Sober Housing

Sober Living Homes are alcohol and drug-free residences where unrelated adults who are recovering from a substance use disorder voluntarily choose to live together in a supportive environment during their recovery. No formal substance use disorder treatment services are provided at Sober Living Homes. 

• Department of Mental Health and Addiction Services (DMHAS) currently lists Connecticut-certified Sober Living Homes as required by law (see PA 18-171). Note: DMHAS does not monitor, certify, or oversee sober living homes.  https://www.ct.gov/dmhas/cwp/view.asp?a=2900&q=603942
• Connecticut Alliance of Recovery Residences (CTARR) supports recovery residences in Connecticut to practice national quality standards for recovery residences. CTARR inspects and certifies Connecticut recovery homes, provides training and maintains a forum for exchanging ideas, solving problems and providing guidance. http://ctrecoveryresidences.org