Addiction Data, Legislation & Public Policy

State And Territory Approaches To Improving Care For Individuals Affected By Stimulant And Polysubstance Use

Stimulant And Polysubstance Use Policy Academy Final Report


The drug overdose epidemic continues to worsen and has evolved over time. Many states are experiencing a resurgence in use and harms related to stimulants—particularly illicit stimulants—such as cocaine and methamphetamine. Although opioids—mainly synthetic opioids such as illicitly manufactured fentanyls—are currently the main driver of drug overdose crisis, deaths involving psychostimulants, especially methamphetamine, are increasing with and without opioid involvement.

As states and their leaders continue to address the drivers of drug overdose and substance use disorder, many are confronting challenges with illicit stimulant and polysubstance use that present new hurdles—including a lack of medications to treat stimulant use disorder and the complexity of treating polysubstance use disorders. Using the infrastructure and evidence-based strategies employed to address the ongoing opioid overdose crisis may help states pivot to effectively address stimulant and polysubstance use as the overdose epidemic evolves.

The National Governors Association hosted a series of learning calls with national experts, Governors’ office staff and senior officials, researchers, academics, and local organizations to better understand the current landscape and challenges facing state leaders for addressing stimulant and polysubstance use at the state level. These conversations culminated in a roundtable in July 2021, where eight focus areas emerged that Governors and their senior state officials could consider in developing and implementing equitable approaches to reducing stimulant and polysubstance use: effective governance and partnership, funding, prevention, treatment, law enforcement, recovery and support services, data and quality information, and harm reduction.

To build on these efforts and continue to support Governors, NGA launched a yearlong Stimulant and Polysubstance Use Policy Academy from October 2021 through October 2022 with American Samoa, Connecticut, Michigan, and West Virginia. The aim of the policy academy was to help move states and territories away from single drug-driven approaches and reorient them to be more comprehensive and consider polysubstance use within broader policy approaches.

An NGA policy academy is a yearlong opportunity for states and territories to assess their current operating environment, share successes and best practices, learn from experts, exchange ideas with other states and territories, and develop and execute an action plan to achieve program and policy change based on identified jurisdictional goals. This policy academy focused on ensuring state and territorial responses to stimulant and polysubstance use challenges (e.g., strategic plans, health and safety partnership models, funding, policies, programs, practices, etc.) are braided together into a singular, comprehensive approach to overdose and treatment options. NGA worked with core teams that were made up of representatives from the Governors’ offices, alcohol and drug abuse directors, Medicaid directors, senior health and public health agency leadership, state opioid coordinators, state administering agencies, and other policymakers and stakeholders.