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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.

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.