As the opioid epidemic has taken hold, city and county leaders are taking action. The number and scope of programs in place are a testament to the problem-solving skills of local officials. With both determination and imagination, local leaders are expanding prevention and treatment programs and giving more flexibility to public safety personnel who interact daily with individuals struggling with addiction. Knowing that localities cannot end this epidemic alone, these leaders are actively seeking partnerships and exploring innovative strategies that challenge old conventions about the stigma of addiction.

In early 2016, the National League of Cities and the National Association of Counties convened a joint task force to identify the local policies and practices that reduce opioid abuse and related fatalities. The task force met twice, in Washington, D.C., and in northern Kentucky. These meetings, coupled with countless conversations with local officials from across the country, including public health directors, prosecutors, law enforcement officials and substance abuse directors, enabled the task force to produce this report and its recommendations.

The recommendations are aimed at city and county officials and are divided into four sections: 1) leadership, 2) education and prevention, 3) treatment and 4) public safety and law enforcement. Several of the recommendations are accompanied by existing local practices from cities and counties. The report also includes recommendations for state and federal officials, who are pivotal partners in local efforts to combat opioid misuse, diversion, overdose and death. The contents of this report, in addition to expanded case studies and further resources to aid local officials in addressing the opioid crisis, are also available online at