Community Partnerships As Mechanisms for Responses to Opioid Overdoses

Background/Purpose:

Community partnerships are recognized as critical mechanisms for addressing complex social issues that cross traditionally siloed service systems. As opioid overdoses continue to rise across the country, some funders have sought responses that pair community organizations with local law-enforcement departments to deliver responses that focus on treatment and support. Literature on partnership effectiveness point to factors including: agreement on the purpose of the partnership; engagement and commitment; environments with favorable financial climates; and adequate leadership and management. Successful partnerships can result in favorable outcomes, equitable distribution of services, and improvements in service quality. This study reports the results of a pilot project that required the development of partnerships between community organizations and local law enforcement to implement opioid response teams to address overdose issues in a state which experienced 14,626 naloxone administrations and 2,564 suspected overdose deaths in 2023.

Methods:

The study site is a state in the Northeast which piloted a state-wide initiative to develop peer response teams to connect individuals experiencing an overdose with support and treatment services in the hours after an overdose. All sites were required by the funder to develop partnerships between community organizations and local law-enforcement. The aim was to focus responses on connections to treatment and harm reduction services, rather than arrest. Five municipalities were selected based on overdose incidences as defined by a drug harm index. Sites included two large metropolitan areas, three mid-size municipalities, and one small town. As part of a project evaluation team, the authors monitored the implementation of the program at every stage (initial planning, convening potential partners, attending stakeholder meetings, documenting partnership structures), and conducted in-person interviews with key stakeholders from each site in the final year of the program to assess strengths and limitations of the partnership development process. Quantitative data were also collected on overdose numbers and subsequent treatment referrals for each site, but those data are not reported in this presentation. Responses to open-ended questions were analyzed using thematic analysis.

Results: Three of the five partnerships effectively implemented program goals and were sustained (and expanded) past the pilot grant period. These were characterized by partnership leaders with a commitment to the project mission, strong communication skills, clear and actionable project objectives, and a capacity for continued grant-getting; and partners with strong organizational infrastructure, and prior experience in opioid response treatment and supports. One project that failed to thrive was characterized by the reverse (weak leadership commitment and infrastructure, etc.). One site experienced delays due to multiple leadership turnovers and was rebuilding. Key mechanisms were thus strong leadership and organizational infrastructure.

Conclusion/implications: Community partnerships are context bound. An evidence base generated from research on partnership formation and sustenance is critical to identify elements – such as leadership and organizational capacity - that may transcend and be transferrable across projects and sites, and that can inform decision making with regard to strengthening this mechanism for issue response and service delivery.