Description and Purpose of the Framework

The framework includes elements identified as part of a comprehensive public health approach for states and territories responding to the opioid epidemic. The framework also builds on ASTHO’s 2017 President’s Challenge on Substance Misuse and Addictions, a national effort to unite and rally state health officials, affiliates, and other cross-sector partners to use proven public health approaches to prevent substance misuse, addictions, and the related consequences. Given the scale and complexity of the opioid epidemic, the framework outlines a multi-pronged, government-wide, and multi-sector approach that relies on both public and private commitments to reverse the nation’s substance use disorder epidemic.

Used effectively, this framework will help states and territories identify where planning and implementation are strong, where there are gaps, and where they can expand collaboration and engage in strategic conversations with partners across sectors to coordinate planning.

Framework Strategies and Supports

The framework is grouped into four overarching and interconnected strategies:

ASTHO assessed each strategy included in the framework for quality of evidence, with regard to its direct effects on opioid misuse, opioid use disorder, opioid overdose, and related harms (see Definitions page). The framework will be updated and improved as evidence for previously untested approaches emerge.

To be successful, all four strategies depend on leadership, partnerships, and resources.