In San Francisco, Opioid Addiction Treatment Offered on the Streets

Assertive community treatment teams working through outreach-centered programs in Maricopa County have become an industry standard for treating those with persistent and severe mental illnesses who have recently been incarcerated. They provide a long-term approach, aiming to halt a cycle of incarceration and hospitalization by focusing on underlying issues such as what caused the police interaction and incarceration.

In Colorado, four communities are piloting a program that offers low-level drug or prostitution offenders an alternative to prison. This program, known as Law Enforcement Assisted Diversion, matches the offender with a case manager who in turn connects them with treatment and training resources.

Across New Hampshire, youth are leading the fight against substance abuse. Programs like Dover’s Youth-to-Youth, Stand Up Sachems, Youth Leadership Through Adventure, and the Making it Happen Coalition, are all youth-led, adult-supported initiatives that are empowering young adults to create and disseminate substance abuse awareness and prevention campaigns. Fundamental to each of these efforts effective communication and creating a sense of community as key to prevention.

Activists in Berkeley, California, are filling in what they say is a gap in homeless services during the coronavirus outbreak. Volunteers are safely delivering food and other supplies to those without shelter.

Vermont's hub and spoke model of care has gained notoriety as being a system that has successfully played a positive role in creating better access to health care, especially as it relates to the opioid crisis. Now, officials in New Hampshire are looking to scale and adapt the program to work in their state.

As an alternative to traditional courts, community courts provide resources to those experiencing homelessness. Fines and jail time are often the punishment in traditional courts for those charged with trespassing or loitering, but community courts provide services that help people find housing, jobs, health care, and even offer mobile showers, food stamp assistance, and mental health care. While the long-term data are lacking and don't offer a clear picture of recidivism rates, community courts do provide a better quality of life for those living on the streets.

Fifty years on, America's war on drugs has failed at its principal goals: to eradicate illicit drug use and sales, to repair communities damaged by the drug trade, and to prevent drug-related deaths. Despite massive amounts spent on law enforcement, which has created great social harms and fueled incarceration, drug use has rebounded to 40-year highs, drug overdose deaths are peaking, and supply of illegal drugs is abundant. Policy advocates say a combination of legalization and public-health approaches to the problems would accomplish more than the wasteful, ineffective "war" mentality used to date.

The New Leaf project ran a controlled trial to test the power of direct cash transfers with people experiencing homelessness. Fifty people were given a one-time cash payment of $7,500, which roughly equaled the sum of government income assistance spread out across the year. The impact was measured over 12 months and found that people in the cash group moved into stable housing faster, spent fewer days homeless, and saved more money. The organization found the lump sum, rather than monthly increments, allowed people to make decisions about how they could move their lives forward aimed at stabilization.

San Francisco considers the scaling of safe injection sites, which were successfully piloted in Vancouver, to become the first city in the United States to offer this service. However, the main challenge of starting such a service in San Francisco is helping the public get over the concern that safe injection sites encourage drug use for non-abusers. Community groups actively educated the public on the benefits of safe injection sites and politicians made trips to Vancouver to observe the success in action.

A Mumbai school located in a remodeled shipping container meets kids on the street where they are at. Signal School results from a collaborative effort between the city and a non-profit, and focuses on bringing education to migrant children, so that they are less likely to be forced into child labor or street begging. Signal School does more than just teach, it also provides meals, works with families to change the cultural perspective that education is an amenity for the privileged, and helps migrant families find permanent housing.