Following a fatal overdose at an apartment complex, the Massachusetts Overdose Response Strategy (ORS) team and partners delivered naloxone training to five building staff, equipping them to recognize the signs of an opioid-related overdose and respond effectively. In addition, through in-service training at the Worcester Police Department, the MA ORS team trained all officers on compassionate overdose response and on adapting strategies to address the growing prevalence of veterinary sedatives, including xylazine and medetomidine, in the drug supply.

Building on this work, the team extended its reach through two additional community events. At Assumption University’s Alumni-Student Partnerships in Reflective Engagement (ASPIRE) event, the MA ORS team presented on current drug trends and overdose prevention strategies alongside students who provided naloxone training to attendees. At a National Night Out event hosted by the Worcester Police Department and other local law enforcement and community organizations, the MA ORS team distributed naloxone, offered naloxone training and connected residents with prevention resources. Across these events, 36 participants were trained and received naloxone kits.

By embedding overdose education into the spaces where community members live, learn and gather, the MA ORS team strengthens prevention awareness and helps communities respond to overdose where it happens.

Pictured from left to right are founder of demandZERO Lisa Deane, CT DIO Bobby Lawlor, CT PHA Anna Gasinski, The Rendon Group Senior Producer Ellie Barkett, The Rendon Group Senior Vice President Tricia Raynard, The Rendon Group Director of Youth Marketing Kari Johnston, The Rendon Group Co-founder/Senior Partner Rick Rendon.


Today’s youth face an evolving drug environment where fentanyl and fake pills pose serious risks, making it more important than ever to reach students with tailored prevention messaging. In April 2026, the Connecticut Overdose Response Strategy (ORS) team, in partnership with The Rendon Group, demandZERO, the New England High Intensity Drug Trafficking Areas (HIDTA) program and other national prevention partners, produced The Risks Are Real: The Truth About Fentanyl and Fake Pills, a national virtual student assembly designed to educate, engage and empower middle and high school youth.


The 60-minute production delivered evidence-informed prevention messaging in a format built for today’s youth, combining student reporters, expert guests, personal stories, interactive elements and a video message from the Director of the White House Office of National Drug Control Policy. The CT ORS team served as executive producers and subject matter experts, helping shape the vision, messaging and educational value of the broadcast, and the CT Public Health Analyst (PHA) was featured to share practical prevention resources. Students came away with clear, relevant information they could apply, including the dangers of fentanyl and fake pills, how social media can increase risk, what to do in an emergency, how naloxone saves lives and how to make informed decisions to protect themselves and their peers.


The live broadcast reached approximately 30,000 youth and adults across 46 states and multiple countries, streaming directly into classrooms nationwide. A live studio audience of approximately 100 youth elevated youth voices and participation.


Early educator feedback pointed to strong results. Among respondents, 92 percent rated the program as good or excellent and 84 percent saw a moderate or significant increase in students’ understanding of the dangers of fentanyl and fake pills. Educators reported gains in more specific areas as well: 70 percent noted improvement in students’ understanding the risk of overdose from a single use, 66 percent in recognizing that fentanyl can be present in counterfeit pills, 44 percent in grasping why counterfeit pills cannot be identified by appearance alone, and 39 percent in knowing where to seek help and prevention resources. Looking ahead, 84 percent would recommend the program to other educators, and 75 percent expressed interest in future assemblies.


Following the assembly, educators were encouraged to continue classroom conversations using the program’s free on-demand recording and companion resources on The Risks Are Real website. Schools can build the content into health education, prevention programming, assemblies, Red Ribbon Week activities and student wellness initiatives, using the resources to reinforce key concepts, encourage help-seeking, and connect students with trusted adults and local resources. The production team also hosted a vision session at the 2026 Rx and Illicit Drug Summit, presenting broadcast snippets and an overview of the program’s development and learning objectives. A moderated panel highlighted how this approach can expand reach, strengthen collaboration and better engage youth through real-world education. Over the summer, additional video content will be made available on the website including interviews with subject matter experts.


Other key partners and coalition members were integral to the initiative’s national reach, including the national coordinator of the Drug Threat Analysis Group, a HIDTA national initiative, who helped guide the effort. ORS teams across the country recruited schools and expanded participation in their regions, strengthening cross-sector collaboration and positioning the CT ORS team as a leader in large-scale prevention initiatives.


The virtual assembly is available on demand at www.therisksarereal.org,.

In 2025, Overdose Response Strategy (ORS) teams in multiple states partnered with the Association of State and Territorial Health Officials (ASTHO) to strengthen overdose spike preparedness through the Overdose Spike Exercise-in-a-Box Toolkit pilot program. Selected as part of a five-state cohort, ORS teams collaborated with public health, public safety and behavioral health partners to plan and conduct tabletop exercises designed to improve coordination and response to overdose spikes.

In Delaware, the ORS team partnered with the Delaware Division of Public Health and the Division of Substance Abuse and Mental Health to prepare for and host a statewide spike response tabletop exercise. In July 2025, 25 leaders from key state agencies convened at the state fusion center for a four-hour facilitated workshop. The Delaware Public Health Analyst (PHA) guided participants through discussions on surveillance, alert triggers, partner notifications, response coordination, drug testing and external messaging. The exercise allowed partners to examine current practices, identify gaps and validate existing strengths, generating momentum for continued collaboration. Following the workshop, partners held follow-up meetings to address unresolved questions, and the Delaware ORS team shared lessons learned with ASTHO and the ORS Overdose Spike Response Learning Community.

In Mississippi, the ORS team and state partners participated in the pilot through a series of guided planning sessions and mock scenario exercises held from March through June 2025. The exercises brought together public health and safety partners to test a coordinated response to a mock local overdose spike, including complex challenges such as emerging drugs and cross-state coordination. The effort generated a key recommendation to develop an addendum to the state’s Comprehensive Emergency Management Plan outlining a coordinated statewide response to overdose spikes, helping formalize cross-agency collaboration and strengthen preparedness.


Pictured on the right are Sullivan County partners participating in the exercise.
Similarly, in Tennessee, the ORS team partnered with Sullivan County to conduct a large tabletop exercise using the toolkit in June 2025. The exercise convened more than 50 participants from a wide range of sectors and resulted in improvements to the local overdose response plan, new partnerships and data-sharing opportunities and identification of critical gaps to inform future planning.

Pictured from left to right are MD DIO Brent Kluttz, Lt. Chad Atkins, MD PHA Sabrina Gattine, Michelle Marshall, Jessica Ellis and Shawn Dennison.

In Maryland, the ORS team partnered with Frederick County to host a hybrid spike response tabletop exercise. The event brought together public libraries, community organizations, public safety, public health, hospitals and law enforcement—uniting all sectors of the community involved in addressing overdose at the same table. The group tested potential weak spots and identified previously unrecognized gaps. The group also worked to clarify the definition of an overdose spike in their jurisdiction and strengthen the chain of communication in the event of an overdose spike. After the exercise, Frederick County continues to meet and improve their spike response framework.

In Alaska, the ORS team partnered with the Alaska Division of Public Health (DPH) and the Overdose Data to Action (OD2A) team to host a statewide spike response tabletop exercise. The exercise aimed to strengthen existing preparedness efforts and test a draft statewide spike response protocol. In March and April 2025, the Alaska PHA and the DPH Spike Response Workgroup convened more than 22 representatives from public and behavioral health, public safety and Tribal public health. Participants engaged in a two-part exercise that walked through spike surveillance, notification and response using a realistic urban scenario. Through this effort, agency roles and communication channels were clarified, and the draft spike response protocol was further refined.

Together, these exercises demonstrate how the ASTHO/ORS Spike Response Toolkit supports states and local partners in strengthening preparedness, improving cross-sector coordination and developing more effective responses to emerging overdose threats.

Pictured from left to right are ORS partners and staff including NY PHA Lisa Worden, NY DIO Jim Hawley, ORS Technical Advisor Nava Bastola, HIDTA Deputy National Coordinator Chris Jakim and NY/NJ HIDTA Director Chauncey Parker, National Police Lt. Sonthor Prum (Cambodia), National Authority for Combatting Drugs Deputy Director Chumnith Meas (Cambodia), Ministry of Interior Captain Ali Majid Al-Jaberi (Iraq), Anti-Narcotics Department Lt. Col. Mu’ath Al-Dwaikat (Jordan), Anti-Narcotics Department Major Yazan Abu Alghanam (Jordan) and Hak-Qazar Public Foundation Chairman Nurzhan Zhakupov (Kazakhstan).

In 2025, the New York Overdose Response Strategy (ORS) team in partnership with ORS leadership played a central role in an international learning exchange that brought together 17 senior law enforcement and drug policy leaders from nine countries to explore coordinated approaches to overdose prevention. Syracuse University’s Department of Public Health hosted the U.S. Department of State sponsored Distinguished Humphrey Fellowship Program to Combat Illicit Drug Trafficking, the initiative aligned seamlessly with the ORS mission to strengthen collaboration between public health and public safety. The NY ORS team and ORS staff led a full day of sessions during the Executive Academic Seminar, sharing the ORS framework and highlighting initiatives such as the Overdose Detection Mapping Application Program (ODMAP), Domestic Highway Enforcement and the Rochester Police Department’s Leave-Behind Naloxone model. The day also included a presentation from an ORS partner who is an addiction medicine expert; the expert led a discussion on the physiology of addiction and a recovery-oriented system of care. The Distinguished Humphrey Fellows engaged deeply throughout the day and received guidance on policy development, adaptations for their home countries and approaches to integrating public health strategies within enforcement systems.

Building on the Executive Education Week discussions, the exchange continued with an immersive site visit to the NY/NJ HIDTA, where fellows observed meetings to coordinate gun violence prevention and response efforts, learned from cross-sector response teams and engaged with over 15 programs addressing drug trafficking, overdose prevention, community outreach and data-driven enforcement. Fellows expressed renewed commitment to building trust with communities, advancing compassionate response strategies and adopting data-informed strategies in their own countries. Reflecting the emphasis on compassion and cross-sector collaboration, one fellow noted, “It was an inspiring visit… What really touched me wasn’t just the knowledge that was shared, but the passion behind it. Every speaker had a story that reflected true dedication, sacrifice and deep care. Seeing agencies work hand in hand was incredibly powerful and gave me real hope. I will take what I’ve learned, share it in my country, and work to put it into action.” The NY ORS team and partners also gained valuable insight from the global perspectives of the fellows, reinforcing that sustainable progress depends on collaboration, compassion and measurable outcomes. By uniting international partners, the New York ORS team and ORS leadership strengthened cross-border relationships and demonstrated how the ORS model can inform global efforts to build coordinated, data-driven overdose prevention and response while bridging public safety and public health.

Pictured left to right are New England HIDTA Deputy Director Dave Kelley, Peer Recovery Coach Donald Rose, Sharece Sellem-Hannah, David Hannah, CT PHA Anna Gasinski, CT DIO Bobby Lawlor, New England HIDTA ORS Coordinator Jack Foster, URI Provost and Executive Vice President for Academic Affairs Barbara Wolfe, URI President Marc Parlange and RI PHA Tom Chadronet.

In November 2025, the Connecticut and Rhode Island Overdose Response Strategy (ORS) teams partnered with the University of Rhode Island (URI), New England HIDTA and filmmaker and community educator Sharece Sellem-Hannah to host a week-long storytelling residency designed to advance overdose prevention education among college-aged young adults. Held in recognition of the 30th Anniversary of the John Hazen White Sr. Center for Ethics and Public Service, the residency demonstrated how culturally grounded storytelling can deepen understanding of the overdose crisis and strengthen collaboration across public health, law enforcement and higher education.

Working closely with URI faculty and leadership, the CT and RI ORS teams developed a learning series that blended creative arts, ethics, research, public health and public safety. CT and RI ORS teams, alongside New England HIDTA leadership, jointly planned and delivered the residency, modeling the collaborative approach that defines the ORS network.

Across five days, ORS teams and partners engaged more than 500 students, faculty and community members through facilitation of classroom discussions, creative workshops, student forums and community panels. Students from criminal justice, theatre, film arts and related fields explored how data and lived experience inform one another, how creative expression can support community-based overdose prevention and how compassionate, non-judgmental communication reduces barriers to care. Engagement extended beyond the classroom as faculty and tribal leaders joined lunch and learn sessions on drug trends and prevention gaps. Students also led conversations that opened space for honest dialogue on race, trauma, substance-use misconceptions and access to care. These sessions surfaced opportunities for future curriculum development and campus-based prevention work.

The residency concluded with a screening of the Silence on the Streets documentary that drew more than 350 attendees and sparked student interest in continued engagement, volunteer opportunities and campus-based prevention initiatives. By pairing creative storytelling with public health strategy, the residency strengthened cross-state ORS collaboration, expanded university partnerships for long-term prevention work and advanced efforts to counter perceptions surrounding substance use.

Demonstrating how collaboration can turn funding into impactful action, South Dakota is expanding access to naloxone through innovative partnerships, resource investments and coordinated community engagement. Using opioid settlement funds, the Attorney General’s Office, the Department of Social Services and Emily’s Hope (a non-profit organization) acquired 20,000 naloxone kits. Emily’s Hope spearheaded the first statewide distribution effort, installing AED retrofits and newspaper-style naloxone distribution boxes to reach communities with the greatest need. With support from the South Dakota Overdose Response Strategy (ORS) team, who connected partners with local organizations to identify priority sites, 10,385 kits (20,770 doses) have been distributed and 28 naloxone boxes installed across the state, including six on tribal reservations.

The SD ORS team also identified an opportunity to expand naloxone access during the Sturgis Rally, the world’s largest annual motorcycle gathering with more than 500,000 attendees, marking the first time naloxone was distributed at the event. The ORS team convened planning meetings and coordinated logistics while strengthening community engagement through partnerships with security teams at high-traffic bars and by providing education and support to local organizations to address misinformation and engage businesses unfamiliar with naloxone. In partnership with Action for the Betterment of the Community (ABC) and Emily’s Hope, 461 naloxone kits were distributed through 47 participating businesses. Law enforcement partners received 50 kits for foot patrol teams, while a naloxone distribution box at the Sturgis Armory dispensed 182 kits during the event and 39 more once relocated to a local hospital. Three reported overdose reversals directly linked to naloxone access during the Rally highlighted the lifesaving impact of this work. Direct engagement with local businesses also surfaced valuable insight on the perspective and understanding of naloxone, helping shape future outreach strategies and highlighting the need for ongoing education and support among business owners who may be hesitant to engage.

Through sustained collaboration between public health agencies, community partners and law enforcement, South Dakota strengthened naloxone access statewide and built infrastructure that supports ongoing overdose prevention.

When a suspected opioid overdose case in southwest Virginia raised alarms about a potentially dangerous substance spreading across state lines, the Tennessee and Virginia Overdose Response Strategy (ORS) teams enabled rapid cross-state coordination that strengthened partnerships and sparked efforts to improve overdose response processes. In September 2025, emergency department staff at a community hospital in southwest Virginia discovered a small package containing a yellow powdery substance during treatment for a suspected opioid overdose. This substance closely resembled material connected to recent overdose spikes in West Virginia and Kentucky. Concerned the same substance could be circulating in Virginia, the hospital’s director of security reached out to Tennessee task force partners who contacted the TN Public Health Analyst (PHA). The TN PHA connected the hospital security with the Appalachia HIDTA team, who then also connected with Washington/Baltimore HIDTA and the Virginia Drug Intelligence Officer (DIO). This rapid cross-state chain of communication occurred in less than 30 minutes.

While the substance was not ultimately recovered for testing, the incident led to a new direct connection between the hospital and the Virginia DIO, highlighted areas to expand hospital and law enforcement communication protocols and initiated planning conversations around evidence-handling and information-sharing. This event demonstrated the value of the ORS network in enabling rapid cross-state coordination during an emerging threat, with the established task forces and the I-81 Work Group providing streamlined communication and response.