Opioid and Illicit Drug Use

Governors have long been at the forefront of efforts to prevent and treat opioid use disorder (OUD), working with health care providers, law enforcement and other stakeholders to mount a comprehensive response to the opioid epidemic. Since 2012, the National Governors Association Center for Best Practices (NGA Solutions) has supported states in their efforts to address this crisis and save lives. Over the years, NGA Health and NGA Homeland Security & Public Safety have worked with states to implement best practices focused in three key areas: 

  • PreventionNGA Solutions works with states to identify and implement public health and public safety strategies for prevention and early identification to help stem the tide of new opioid addictions. Strategies include optimizing prescription drug monitoring programs and promoting non-pharmacological pain management treatment options. 
  • Treatment & Recovery: NGA Solutions has focused on helping states improve access to the full continuum of care for all individuals with opioid use disorder, with a special focus on Medicaid and justice-involved populations. This includes access to Medication Assisted Treatment (MAT), peer recovery specialists, and care for Neonatal Abstinence Syndrome (NAS). 
  • Response: NGA Solutions provides guidance to states on how to respond to individuals with an overdose. This includes implementing programs to deploy naloxone, creating successful diversion programs and working with states to respond to illicit supply of opioids and synthetic drugs such as fentanyl. 

NGA’s Opioid Work with Governors  

The Governors’ Compact to Fight Opioid Addiction 2016 

  • In a landmark effort, 46 states signed on to the Compact and committed to redoubling their efforts to address the opioid epidemic. This was the first time in more than 10 years that governors developed a compact through NGA to spur collective action on an urgent national issue.

Finding Solutions to the Prescription Opioid and Heroin Crisis: A Road Map for States 2016  

  • NGA Solutions created an evidence-based guide to help governors operationalize the Compact and implement effective strategies across the continuum from prevention through treatment and recovery. 

Governors’ Recommendations for Federal Action to End the Nation’s Opioid Crisis 2018 

  • NGA released recommendations to aid the federal government’s response to the opioid epidemic. Many of the recommendations were included in the 2018 SUPPORT Act.



  • Opioid State Action Network: A Monthly State-Only Forum on Best Practices and Lessons Learned 
  • Medication Assisted Treatment for Justice Involved Populations Regional Workshops (June 2019) 
  • Coordinating State and Local Opioid Data Frameworks and Response Efforts (Oct. 2018) 
  • Using Data to Combat the Opioid Epidemic: A Roundtable Discussion with State Public Safety and Public Health Experts 
  • Leveraging State Emergency Powers to Address the Epidemic (Nov. 2017) 
  • Expert Roundtable on State Opioid Emergency Declarations 
  • Medication Assisted Treatment for Justice-Involved Populations (June 2017) 
  • Improving Access to Addiction Treatment in Rural Areas (Nov. 2016) 
  • Experts Roundtable on Rural Opioid Abuse and Addiction in Rural Areas and Among Special Populations 
  • Heroin and Illicit Fentanyl Learning Lab (Oct. 2016) 
  • Experts Roundtable on Heroin 
  • State Strategies for Reducing Overdose and Deaths from Heroin and Illicit Fentanyl: Improving Information Sharing and Data Analysis Between Law Enforcement and Public Health 
  • Information Sharing Learning Lab (Aug. 2016) 
  • Prescription Drug Abuse Policy Academy (2015