Priority Areas for Targeted RFPs

The removal of barriers to care to create a more stable community.

The ways that communities experience health is not based only on health care services – there are other widely recognized factors that are described as either the social determinants of health or the social drivers of community wellness. Simply put, these are the conditions in which people live that affect a wide range of health outcomes and risks. To curb the impacts of the opioid crisis in Mobile County, meeting the following needs is critical:

• Accessible and dependable transportation, particularly in the municipalities.

• Safe, stable, and affordable housing.

• Transitional housing for those leaving the judicial system and those leaving a treatment environment.

• Job opportunities, particularly for those that have had a substance use disorder.

• Wraparound services for those that are leaving the judicial system, including basic skill education, job placement, housing and transportation assistance.

• Inpatient substance use treatment services within Mobile County.

• Long-term mental health care services within Mobile County.

While some of these at first glance may appear to be outside the scope of opioid abatement efforts, research shows that those in safe, stable communities have both lower substance use and greater rates of recovery for those that have a history of substance misuse.

The reduction of new users through wide-ranging prevention and education activities.

It is widely accepted that prevention education is an essential part of reducing drug use; to date, a good portion of efforts in the opioid space have followed the same tenets used for decades that showed success in reducing tobacco use, alcohol use, and marijuana use. However, at the heart of it, opioids are different from alcohol, cigarettes, or other illicit drugs because they are often prescribed by a medical professional, and in many cases, one’s exposure risks increases with age due to the higher likelihood for surgery and pain diagnoses.

Filling the prevention and education gaps that have been identified that will have a short- and long-term impact on reducing the user pool in Mobile County. Some example programs include:

• Targeted prevention education efforts outside of a school-based population, particularly for adult and elderly patients.

• Re-education for medical professionals, including doctors, nurses, physician assistants, and dentists, about the dangers and risks of opioid overprescribing.

• School-based prevention campaigns that reflect the unique circumstances of opioid use, including empowerment efforts to prevent adult misuse, peer-to-peer mentorship and education, and youth-targeted messaging that reflects the reality of drug use currently.

• Stigma reduction campaign efforts that focus on the addiction as a disease and not a moral failing, as well as other messaging determined by focus groups and data efforts in the target population.

The support of current care providers within Mobile County to have an immediate impact.

There are numerous care providers already working on the ground here; these individuals and organizations work constantly to help those most impacted by and most vulnerable to the impacts of the opioid crisis. That said, given limited resources. their good work does not go as far as it could. There is a timely opportunity to provide additional support to these entities that could have an immediate positive effect within the community. The biggest challenges faced to care providers of this vulnerable population are often tied to the lack of financial resources and the needs to resolve this in Mobile County include:

• Funding to assist kinship guardians, who are often overlooked by formal foster program fundings.

• Funding to cover required day-to-day expenses beyond just food and shelter, including items like school supplies and uniforms.

• Funding to assist transitions between care situations and safety plans when families are reunified to ease the burden.

One additional gap is there is no single place to access services or information about them. There is a need to unify service providers into a single venue within Mobile County; this will benefit the broader population by making social services more accessible, efficient, and coordinated.

The creation of safe spaces in existing County infrastructures for those misusing substances or impacted by those misusing substances.

In addition to prescription opioid use and misuse in Mobile County, there is an active illegal drug market. Fentanyl and heroin are two products that have surged in use since the beginning of the current opioid crisis, and they are frequently found on the street alongside cocaine, methamphetamine, and marijuana. With such an expansive illegal drug market comes a high number of justice-involved individuals that either are in active substance use disorder, misuse substances, or perpetuate an illegal market. That makes the judicial system — beginning with sentencing courts, through all programs, and ending with post-incarceration release conditions — an ideal place to make an immediate but lasting impact on Mobile County.

It is not only adults that are a part of the judicial system. In Mobile County, minors can be involved with the justice system in two ways: juvenile incarceration at Strickland Youth Center and the Helping Families Initiative, a program run by the Mobile County District Attorney’s Office to reduce school truancy rates.

The coordination and communication of new and existing efforts throughout the County and its municipalities.

The opioid crisis is a multi-faceted, complex issue that will require a comprehensive and coordinated approach that goes beyond health care. Uniting law enforcement, health care professionals, social services, and public safety organizations, while also engaging the broader community, presents a greater opportunity to achieve the shared goal of ending the opioid crisis.

Traditionally, attempts to improving substance use outcomes have focused mainly on individual behavior, even though research has shown that community engagement approaches have a lasting positive impact. For success in Mobile County, there needs to be intentional engagement among government stakeholders, community providers along the continuum of care, medical professionals, subject matter experts, and communications professionals to not only find solutions but also share the scope and scale of the programs available to those in need.