This framework recognizes the critical role of public health leaders and partners in carrying out a comprehensive, cross-sector response to the opioid crisis. With effective leadership and cross-sector partnerships, states and territories can leverage four key strategies in their work, including (1) training and education; (2) monitoring and surveillance; (3) treatment, recovery and harm reduction; and (4) primary and overdose prevention. Each element of the framework was assessed for the level of evidence supporting the recommendation.

Monitoring and Surveillance

Training and Education

Primary and Overdose Protection

Treatment, Recovery and Harm Reduction


National Roadmap on State-Level Efforts to End the Opioid Epidemic

The American Medical Association and Manatt Health analyzed responses to the opioid crisis and outlined recommendations for the country to continue to address this public health problem.

State Variation in Medicaid Prescriptions for Opioid Use Disorder from 2011 to 2018

Researchers at The Urban Institute investigated Medicaid data to identify state usage trends of medication assisted treatment for opioid use disorder.  

HHS Proposes 42 CFR Part 2 Reforms to Increase Coordinated Care, Reduce Provider Burden, and Improve Substance Use Disorder Treatment

This proposed rule change would relax health record privacy regulations for patients with a history of addiction.

Leadership from key leaders in governmental and nongovernmental agencies across multiple levels (federal, state, and local) and sectors (health, public safety, corrections, drug control, and education) is needed to comprehensively address the opioid epidemic within states and territories. Partnerships promote the cross-cutting, multisector collaboration needed to develop and sustain appropriate strategies and tactics for accomplishing state and local goals and objectives around addressing the opioid epidemic. Resources are critical for the successful implementation of these strategies and tactics.