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8 TFAH • WBT • PaininTheNation.org Community Partnerships Prevention efforts are most effective when all sectors in a community—healthcare systems, schools, law enforcement, government agencies, businesses, community organizations and faith-based groups—work together to invest in upstream prevention and identify at-risk community members to ensure they receive the support and services they need. The Institute for Healthcare Improvement has identified a community-wide, system-level approach as a meaningful strategy to combat the opioid epidemic. 48,49 Healthcare systems have an important role in spearheading and participating in such community-wide efforts. Many healthcare systems are participating in and providing support for community coalitions to prevent substance misuse, prevent suicide and improve mental health. Hospitals can be key leaders in such community coalitions. Healthcare systems can also work to educate their communities about pain, anxiety, addiction and trauma, including the potential dangers of opioids and viability of alternative pain management methods. For example, hospitals are providing training for first responders, law enforcement officers and other community workers about overdoses and use of the drug naloxone. 50 And another way healthcare systems are partnering with the community is through take back programs and expanding availability and use of naloxone, a medication that rapidly reverses opioid overdose. A recent advisory from the Surgeon General calls on physicians and other prescribers, substance use disorder treatment providers and pharmacists to prescribe or dispense naloxone to those at elevated risk for opioid overdose and to their friends and family. 51 One example of this type of successful community effort was spearheaded by the Massachusetts General Hospital (MGH) Center for Community Health Improvement. The Center created four coalitions focused on preventing substance use disorders, including take back programs, naloxone distribution, emphasizing connections to treatment through recover y coaches, and screening all patients for substance misuse. 52 Specifically, the MGH Coalition in the Charlestown neighborhood partnered with community residents who teach science at elementary and middle schools, utilized a community health worker model, and worked with the Charlestown Drug Court to help individuals on probation who are suffering from chronic substance use disorders. The Charlestown Coalition, formed in 2004, has had some notable successes: l Emergency Medical Services responses for heroin overdoses decreased 62 percent from 2003 to 2010; l Drug-related deaths decreased 78 percent between 2003 and 2008; and l A preliminary evaluation suggests youth are more likely to think through the consequences before deciding about substance use and more likely to say no to tobacco, alcohol, or another drug. 53 Turn the Tide on the Opioid Epidemic Create opioid-informed and prepared communities Improve appropriate use of opioids for nonmalignant pain Reduce harm for those addicted to opioids Improve management of opioid addiction as a chronic disease Source: 100 Million Healthier Lives

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