project, which trains individuals with substance use disorder, their families or anyone who may live in their communities who wants to help people suffering from overdoses. the dope project, the largest single city naloxone-distribution effort in the us, instructs its advocates in the use of the nasal spray naloxone, an opioid reversal antidote. the group, able to save nearly 1,800 overdosing people in 2019, is currently challenged by the rise in fentanyl and methamphetamine use. colorado overdose death from the drug fentanyl increased by 300% from 2018 to 2019, according to the denver department of public health and environment. overall death from all drug overdoses increased slightly over the same time period. denver has created an “early warning system” to let drug rehab organizations know if fentanyl has been found in the area's recreational drug supply. the harm reduction action center, one of those organizations, provides substance users with a needle exchange and fentanyl-testing strips. in 2016, then colorado attorney general cynthia coffman launched the naloxone for life initiative which initially distributed 7,000 naloxone kits around the state. the state medical director then issued an order to make the drug available without prescription. applying the drug has been successful. denver's paramedics administered the opioid-overdose reversal drug to over 700 individuals in 2018. colorado experienced a small decrease in opioid overdose deaths between 2017 and 2018. connecticut in 2019 there were 1,200 opioid deaths in the state, a figure that will be reached shortly as 2020 has seen a 22% increase in opioid overdose mortality. the isolation of the covid-19 pandemic, compounded by personal financial and other anxieties, has caused intense difficulty for people coping with addiction disorders as well as depression. most traditional businesses have been affected by the pandemic, and the narcotic channel has remained active. delaware delaware, which has the 12th-highest overdose death rate in the us, introduced bills to limit doctors' ability to over-prescribe painkillers and improve access to treatment. in 2015, 228 people had died from overdose, which increased 35%—to 308—in 2016. district of columbia the district began a program of free distribution of the nasal spray naloxone in 2018 with 17 locations dispensing the non-injection overdose-reversing drug. in 2020, due to a 50% increase in opioid overdose deaths, the district doubled the distribution to 35 locations in every ward throughout the city. the death statistics from d.c.’s office of the chief medical examiner are grim: 75% of overdose mortality are individuals 40-69, 70% are male, 84% are black. florida in 2011, florida passed a law creating a program that would provide monitoring and enforcement against illegal diversion of prescription pills in florida (sometimes called the "flamingo express"). the law had not yet been enacted when governor rick scott took office, and scott proposed to repeal it before it came into practice. scott told reporters the program "had no state funding, is complicated by contract challenges, is unproven and could infringe on innocent people’s privacy." georgia the isolation accompanying the covid-19 pandemic is hurting georgians with opioid use disorder. nationwide, overdoses of opioids jumped 42% in may 2020, according to the overdose detection mapping application program, a united states government operation that tracks data from hospitals, ambulance, and police reports. the georgia council on substance abuse advised all first responders in the state to carry and be conversant with the administration of naloxone “…at all times.” the nasal version of naloxone is critical for first responders during the pandemic as it can be dispensed at arm's length very quickly. the council further brought forth a substantial increase in emergency department visits due to opioid overdose. because of the covid-19 pandemic, individuals, they said, are missing personal counseling and 12-step meetings. the group also stated that calls to its cares warm line grew by 65 percent in three months with a higher intensity than ever experienced. hawaii in 2020, the overdose detection mapping program noted an 18% increase in opioid overdoses, prompting the us department of health and human services (hhs) to provide hawaii with a $2 million (us) grant to increase opioid use disorder treatments. the grant will be divided between the hawaii state rural health association and the west hawaii community health center to develop new addiction therapy programs or grow access to existing initiatives. illinois the 2020 coronavirus pandemic resulted in a crisis within a crisis in chicago as opioid overdose mortality doubled in the first five months of the year, compared to 2019 from 416 deaths to 924. overdose deaths increased throughout the state, with the largest upturn in cook county. fentanyl, usually combined with heroin, was the drug at the center of 81% of the deaths, up from 74% in 2019. indiana indiana has been one of the states seriously affected by the epidemic. in 2015, 1,600 people died from drug overdose; 1,000 of those deaths were opioid-related. by 2017, opioid-related deaths had increased to over 1,200, followed by a small, measured decline since then. in 2018, drug overdose deaths fell 12.9%, almost three times the us average decline, as the state government focused on evidence-based, transformative programs to continue the decline. in 2020, samsha provided a $1 million grant to the state of indiana and its social services administration to distribute the nasal spray naloxone to individuals in the state whom the issa determined were at risk from opioid overdose. the chief of police of lawrence, in, (pop.40,000) ordered his officers to cease the administration of the opioid antagonist nasal spray naloxone during the coronavirus pandemic, fearing that his first responders risk covid-19 infection exposure by dispensing the intra-nasal drug. the indiana department of homeland security rejected the chief's order as not being evidence-based and encouraged the administration of the drug by the city's police. a near-by city, ft. wayne's (pop.267,000), police continue to disburse the drug which resulted in 233 individuals restored by narcan in the first quarter 2020. kansas in september 2017, kansas received over $500,000 to implement programs and changes to help stop the opioid epidemic. a majority of the money went to drug courts to help prevent crimes and intervene with addicts early on. kentucky kentucky has been one of the most hard-hit states in the fentanyl crisis. in 2021, fentanyl accounted for 70% of the 2,250 overdose deaths in kentucky. the state passed 2,000 overdoes deaths again in 2022, reaching that figure in august, with 73% of the deaths involving fentanyl. the 2020 covid-19 pandemic contributed to a significant increase in drug overdose in kentucky, as the state's second largest county, fayette, witnessed overdose increases of over 40% in the first few months of the year. the county does have an anti-overdose program which, over five years, has distributed over 8,000 naloxone doses. additionally, the state monitors drug overdose through its kentucky overdose data to action (kyod2a) program run by the department for public health, collecting raw data and linking those in need of treatment with available centers as well as supporting community interventions as needed. kyod2a also partners with the state's prescription electronic reporting system to monitor opioid prescriptions. louisiana in 2017, the louisiana department of health documented an increase in opioid overdoses. respondents to the state's hidta drug treatment and prevention survey reported high levels of fentanyl use and an 83% increase of inpatient admissions for fentanyl and other opioids. in response to the growing epidemic in louisiana, the advisory council on heroin and opioid prevention and education, also known as the hope council, was created as an effort to combat opioid use and established a health surveillance and data collection strategy through interagency coordination. in 2019, the louisiana comprehensive opioid abuse program action plan and the louisiana's opioid response plan 2019 were released. these types of efforts, however, have been hindered by continued opioid overprescription. in 2018, louisiana providers wrote 79.4 opioid prescriptions for every 100 persons, compared to the average u.s. rate of 51.4 prescriptions, making louisiana among the top five of opioid prescribers in the u.s. that year. in new orleans, nola ready, the city of new orleans emergency preparedness campaign, sponsors a 1-hour training with the new orleans health department where the general public can learn how to identify an overdose and administer naloxone. the new orleans public library (nopl) has also responded by training librarians and the public on opioid prevention and overdose treatment. opioid overdose mortality grew by over 90% in some parishes in louisiana due to the coronavirus pandemic which has affected the capacity of many state residents to remain drug-free. state officials feared this would lead to still more overdose-related deaths and a long-term effect of more addiction-related disease, ushering in more homelessness and family-alienation. on the reverse of that phenomena, state experts fear that those with substance use disorder are more vulnerable to covid-19 due to damaged lungs and respiratory systems causing a higher rate of infection. added to that is the fact that those individuals are affected by stay-at-home orders, where they are more likely to succumb the temptation of use and overdose. there are many social services groups, like capital area human services, providing therapy as well as opioid-reversal drugs; and no overdose baton rouge, which offers clean syringes, the opioid antagonist nasal spray naloxone, and sterile smoking devices, attempting to help. maine in maine, new laws were imposed which capped the maximum daily strength of prescribed opioids and limited prescriptions to seven days. maryland in march 2017, the governor of maryland declared a state of emergency to combat the rapid increase in overdoses by increasing and speeding up coordination between the state and local jurisdictions. the previous year about 2,000 people in the state had died from opioid overdoses. massachusetts boston medical center has changed its approach to addiction and overdose treatment, due to the pandemic. it now offers telehealth appointments which officials believe are more effective than tradition in-person treatment, as more people are participating. additionally patients are able to get doses of methadone and addiction medications like buprenorphine without an in-person visit. the state's department of public health indicated that there was a downturn in total overdose deaths in the first quarter of 2020 but that rates of overdose mortality among black men and women, as well as hispanic men's overdose incidents, showed a notable increase. a covid-19 rapid response fund disbursed grants to nonprofits serving opioid addiction sufferers and the boston resiliency fund awarded $500k to similar groups. in 2016, the number of deaths within massachusetts was the highest it had ever been and twice the national average with 29.7 deaths per 100,000. in order to regulate the use of opioids, governor charlie baker signed bill h.4056 or the step act into law on march 14, 2016. due to the step act, opioid prescribing rates fell by 29 percent. according to the boston indicators, in 2020 the rate of overdoses related to opioid use disorder was 30.2 per 100,000 people. this was about 1.6% lower than the rate in 2016. the step act's primary focus is on limiting the supply of opioids and providing patients with the opportunity to request less than their total prescribed amount of opioids at the pharmacy. these components of the step act are broken down as follows: seven day limit on opioid prescription: opioid prescriptions given to all adults and minors cannot exceed the seven day supply limit. the only individuals that are exempt from this ruling and therefore can receive an opioid prescription that exceeds the seven day limit are those that are suffering from chronic pain. patients can request partial fill of opioids: when opioids are being prescribed, the prescriber must inform the patient about the risks of taking opioids; and their option to request an amount less than the prescribed amount. if they feel inclined, patients have the option to request a smaller quantity of opioids than the amount that has been prescribed to them. pharmacists must comply with the patient's request and inform the prescriber about the amount of opioids given. michigan a similar plan to massachusetts was created in michigan, when the state introduced the michigan automated prescription system (maps), allowing doctors to check when and what painkillers had already been prescribed to a patient, and thereby help keep addicts from switching doctors to receive drugs. minnesota on may 22, 2019, minnesota governor, tim walz, signed the