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Policy Intelligence

Overdose Response Teams

The Basics
01
What Is This?
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A paramedic and a peer recovery specialist knock on the door of a house in Milwaukee. Two days earlier, the person who lives here was revived from an opioid overdose by an EMS crew, transported to an emergency room, and discharged a few hours later with a referral slip. The traditional system’s work was done. The overdose response team’s work is just beginning.

The paramedic carries naloxone, medical supplies, and, in a growing number of programs, the authority to initiate medication-assisted treatment on the spot. The peer specialist carries something harder to replicate: years of personal recovery from addiction, and the credibility that comes with it. Milwaukee Fire Captain Dave Polachowski describes the dynamic simply: “Our badge gets us in the door, and then the peer support takes over.”1

They may spend hours at this visit. They will come back tomorrow if the person asks. They will come back next week. Amy Molinski, a peer support specialist with Milwaukee’s Overdose Response Initiative, put it this way: “There’s no limit on the amount of times we’ll go back if they want us to come back.”2

This is what overdose response teams do.

  1. Wisconsin Examiner, Isiah Holmes, “Perspectives on addiction and recovery in a city plagued with overdose deaths,” May 30, 2023. Polachowski: “We’ve always said that our badge gets us in the door and then, from there, the peer support kind of kicks in.” https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩↩

  2. Wisconsin Examiner (2023). Molinski: “There’s no limit on the amount of times we’ll go back if they want us to come back.” Same source as 1. ↩

  3. National Association of Counties, “Post-Overdose Response Teams,” Opioid Solutions Center strategy brief. Defines terminology: “Post-overdose response teams (also called quick response teams or post-overdose outreach programs) conduct outreach and offer services to people who have experienced an overdose within about 72 hours of the overdose event.” https://www.naco.org/resource/osc-port ↩

  4. FaithHealth, “The Huntington WV Quick Response Team,” February 9, 2021. Details four-member team model including faith leader, Bishop Shaw coordination, clergy quotes. https://faithhealth.org/huntington-quick-response-team/ ↩↩↩

  5. Larochelle et al., “One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose,” Annals of Emergency Medicine, 2019. “The first month, and particularly the first 2 days after overdose, is the highest-risk period.” https://pubmed.ncbi.nlm.nih.gov/31229387/ ↩

  6. PBS Wisconsin, “Milwaukee, suburbs fight to contain wave of opioid overdoses,” May 4, 2023. Polachowski quotes on repeat addresses, emotional toll (“tears”), 83-year-old overdose victim, Gorman quotes. https://pbswisconsin.org/news-item/milwaukee-suburbs-fight-to-contain-wave-of-opioid-overdoses/ ↩

  7. WV MetroNews, “Quick Response Team seeks to break the overdose cycle in Huntington,” December 27, 2017. Priddy: “When we had the overdose day with over 25 overdoses in a three or four hour period, none of those people received any treatment options.” https://wvmetronews.com/2017/12/27/quick-response-team-seeks-to-break-the-overdose-cycle-in-huntington/ ↩

  8. FaithHealth (2021). Pastor quote: “I’m tired of doing funerals for young people. I want to change all that and help.” Same source as 4. ↩

  9. FaithHealth (2021). Priddy: “a spiritual safe haven, caring listener, and gentle encourager.” Same source as 4. ↩

  10. KFF Health News, Taylor Sisk, “West Virginia City Once Battered by Opioid Overdoses Confronts ‘Fourth Wave,'” March 13, 2024. Huntington QRT team composition, CDC data, 40% reduction in ambulance calls. https://kffhealthnews.org/news/article/west-virginia-opioid-overdoses-fourth-wave/ ↩

  11. Manne et al., “Evaluation of Quick Response Team: A Community Based Model to Provide Personalized Services for Individuals with Opioid Use Disorder,” Substance Use & Misuse, October 2025. Marshall University interrupted time series analysis of Huntington QRT. 727 men and 443 women contacted. https://pubmed.ncbi.nlm.nih.gov/41044049/ ↩

  12. WV MetroNews (2017). Gupta as state chief health officer quoted on treatment needs. WV Public Broadcasting, May 2021 trial testimony. Gupta later as ONDCP Director: Huntington program “should be developed as a model, not just for the state of West Virginia, but for the entire country.” https://wvmetronews.com/2017/12/27/quick-response-team-seeks-to-break-the-overdose-cycle-in-huntington/ ↩

  13. WV Public Broadcasting, “Across W.Va., Localities Look For New Ways To Help People In Crisis,” July 8, 2025. Priddy: “Even in 2017, I think we had in our mind what we thought was a stereotypical client. And we quickly realized that we could go into an area that somebody might be living in an abandoned house with a dirt floor, and then the next minute, we’re going into a million-dollar home.” https://wvpublic.org/story/health-science/across-w-va-localities-look-for-new-ways-to-help-people-in-crisis/ ↩

  14. Spectrum News 1, Mandy Hague, “How Milwaukee’s fire department is combating overdoses,” May 9, 2023. Polachowski: “Combat veterans. High school seniors. Young mothers.” Note: xylazine figure in original article (35% of fentanyl supply) was superseded by WTMJ February 2024 reporting (~27% of opioid overdose deaths). https://spectrumnews1.com/wi/milwaukee/news/2023/05/09/how-milwaukee-s-fire-department-is-combating-overdoses ↩

  15. Texas Tribune, Stephen Simpson, “The overdose rise in Travis County is part of a growing trend,” May 16, 2024. Lt. Patrick Eastlick, APD Organized Crime Unit: undercover operations “uncovered that fentanyl is being mixed into crack cocaine, methamphetamine and marijuana.” Also KXAN, May 10, 2024: fentanyl-laced marijuana found during drug arrest. https://www.texastribune.org/2024/05/16/texas-travis-county-drug-deaths-fentanyl-overdose/ ↩

  16. Yale Program in Addiction Medicine, “The Connecticut Opioid REsponse (CORE) Initiative.” “In 2023, fentanyl was involved in 84% of overdose deaths in Connecticut.” Confirmed by CT Department of Public Health SUDORS data (85% fentanyl involvement in 2023 fact sheet). https://medicine.yale.edu/internal-medicine/genmed/addictionmedicine/policy/connecticut-opioid-response-core-initiative/ ↩

  17. PBS Wisconsin (2023). Gorman: “The prevalence of actual heroin is almost nonexistent from what we see in urinalysis and just word on the street.” Same source as 6. ↩

  18. FaithHealth (2021). Priddy: “Even if they’re not ready for treatment, they appreciate someone checking in, asking how they are, bringing them resources. To have people looking, and looking out, for you and saying, we care and are here for you, is powerful.” Same source as 4. ↩

  19. Portland.gov, “CHAT MOUD and ORT Pilot Programs.” Official program page. CareOregon $389,577 funding, Monday-Thursday 8am-6pm schedule, Dr. Richard Bruno quote on field-based buprenorphine. https://www.portland.gov/fire/community-health/moud-ort ↩

  20. National Association of Counties (2023). Buncombe County program: “Since 2022, the team has been authorized to administer buprenorphine immediately following an overdose…The team can continue administering buprenorphine for up to five days.” Same source as 3. ↩

  21. Firesheets et al., “Naloxone Plus, Plus Some: Examining Ohio’s Quick Response Teams Through the Lens of Deflection,” Journal of Public Health Management and Practice, November/December 2022. Data from 22 Ohio QRTs, 11,856 clients, urban/rural/suburban distribution. “An average of 6 weeks lapsed between interactions…while almost 8 weeks lapsed between interactions for clients who were contacted because of overdose.” https://pmc.ncbi.nlm.nih.gov/articles/PMC9531970/ ↩

  22. CDC Overdose Data to Action case study, “Public Safety-Led Post-Overdose Outreach Programs.” West Virginia DHHR coordinates QRTs in 33 counties. https://www.cdc.gov/overdose-prevention/php/od2a/public-safety.html ↩

  23. DOJ Bureau of Justice Assistance, Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP). Eight BJA peer mentor sites designated 2020: Huntington WV, Colerain Township OH, Philadelphia PA, Plymouth County MA, Lucas County OH, Seattle WA, Lake County IL, Los Angeles CA. https://www.ojp.gov/ncjrs/virtual-library/abstracts/quick-response-teams-interdisciplinary-overdose-response-and ↩

  24. KPTV, “Portland Fire CHAT responds to opioid crisis,” November 12, 2024. Deputy Chief Stephanie Sullivan: “We’ve saved $9 million in the health care system. We had about 68% of the people who we responded to who had opioid overdoses, we were able to treat them in the field and not send them to the emergency department.” https://www.kptv.com/2024/11/12/portland-fire-chat-responds-opioid-crisis/ ↩

  25. Spectrum News 1 (2023). Polachowski: “You would get a little frustrated. Like, how come you can’t see what you are doing?” Same source as 14. ↩

  26. PBS Wisconsin interview, “Dave Polachowski on firefighter responses to drug overdoses.” Polachowski on contact barriers: “Our biggest barrier, honestly, is making contact.” https://pbswisconsin.org/news-item/dave-polachowski-on-firefighter-responses-to-drug-overdoses/ ↩

  27. Marshall University, “Marshall University providing monitoring and assessment support to opioid epidemic Quick Response Team,” December 2017. DOJ $300,000 grant, HHS $1.05 million grant. Mayor Steve Williams: “Huntington is a proactive community that helps identify solutions related to the opioid epidemic that can be replicated across the country.” https://jcesom.marshall.edu/news/musom-news/marshall-university-providing-monitoring-and-assessment-support-to-opioid-epidemic-qrt/ ↩

  28. EMS1, “Conn. city sees a significant drop in opioid deaths,” February 17, 2025. New Britain Mayor Erin Stewart: opioid-related deaths dropped from 43 to 21 (51% decline) between January-September 2023 and January-September 2024. Program includes recovery navigators, expanded Narcan distribution, and community training. https://www.ems1.com/public-health/conn-city-sees-a-significant-drop-in-opioid-deaths ↩

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02
Why Does This Exist?
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In Milwaukee County, as of 2023, a fatal overdose occurs every 16 hours.2 Fire Captain Dave Polachowski described what that means for the crews responding to those calls: they “know these addresses by heart. Third call this month. Fifth call this year. They save the life, pack up their gear, and know they’ll be back.” He acknowledged the toll directly: “There have been tears shed in this building and in cars.”3

The problem overdose response teams exist to solve is not the overdose itself. EMS handles that. The problem is what happens after. And for most of the country, the answer is: nothing.

  1. Larochelle et al., “One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose,” Annals of Emergency Medicine, 2019. Massachusetts study of 11,557 patients: 5.5% died within one year, 1.1% within one month, 0.25% within two days. “The first month, and particularly the first 2 days after overdose, is the highest-risk period.” https://pubmed.ncbi.nlm.nih.gov/31229387/ ↩

  2. Wisconsin Examiner, Isiah Holmes, “Perspectives on addiction and recovery in a city plagued with overdose deaths,” May 30, 2023. “In Milwaukee County, a fatal overdose occurs every 16 hours.” https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩

  3. PBS Wisconsin, “Milwaukee, suburbs fight to contain wave of opioid overdoses,” May 4, 2023. Polachowski quotes on repeat addresses, emotional toll, enabling reframe; Gorman quotes on heroin disappearance and fentanyl. https://pbswisconsin.org/news-item/milwaukee-suburbs-fight-to-contain-wave-of-opioid-overdoses/ ↩

  4. WKRG, “Escambia Co. EMS Chief says county leads Florida in overdoses, looks to provide better care through CORE program,” September 7, 2022. Torsell: “Nobody is following up. They get a little piece of paper that says, ‘Your follow up is this day. Go here. Good luck to you.'” https://www.wkrg.com/northwest-florida/escambia-county/escambia-co-ems-chief-says-county-leads-the-florida-in-overdoses-looks-to-provide-better-care-through-core-program/ ↩

  5. Multnomah County, “Board approves funding to support new addiction treatment facility in Portland,” January 4, 2024. O’Meara: “about one-third of the 3,000 people it serves each year are sent back to living on the streets after detox.” https://multco.us/news/board-approves-funding-support-new-addiction-treatment-facility-portland ↩

  6. KPTV, “Portland Fire CHAT responds to opioid crisis,” November 12, 2024. Deputy Chief Stephanie Sullivan: “We’ve saved $9 million in the health care system. We had about 68% of the people who we responded to who had opioid overdoses, we were able to treat them in the field and not send them to the emergency department.” https://www.kptv.com/2024/11/12/portland-fire-chat-responds-opioid-crisis/ ↩

  7. Michael Bullock, President, Austin Police Association (took office January 2024). Position on reducing non-criminal demands on officers consistent with public advocacy. Austin Chronicle, “New Year, New Police Union President,” January 5, 2024. https://www.austinchronicle.com/news/2024-01-05/new-year-new-police-union-president/ ↩

  8. Wisconsin DHS, “Opioid Settlement Funds,” revised February 2, 2026: “Wisconsin is due to receive more than $780 million in total funding through 2038.” Original $400M estimate from Spectrum News 1 (May 2023) reflected only initial distributor/J&J settlements; additional settlements with Teva, Walmart, Walgreens, CVS increased the total. https://www.dhs.wisconsin.gov/opioids/settlement-funds.htm ↩

  9. EMS1, “Conn. city sees a significant drop in opioid deaths,” February 17, 2025. Sam Bowen, Waterbury public health chief: fentanyl “in everything”; xylazine challenges. https://www.ems1.com/public-health/conn-city-sees-a-significant-drop-in-opioid-deaths ↩

  10. KPTV (2024). Portland firefighters averaged 19 overdose calls per day in 2023. Same source as 6. ↩

  11. Yale Program in Addiction Medicine, “The Connecticut Opioid REsponse (CORE) Initiative.” Connecticut fentanyl involved in 84% of overdose deaths in 2023; state expects roughly $600 million in opioid settlement funds. https://medicine.yale.edu/internal-medicine/genmed/addictionmedicine/policy/connecticut-opioid-response-core-initiative/ ↩

  12. FaithHealth, “The Huntington WV Quick Response Team,” February 9, 2021. Clergy involvement details, compassion fatigue among first responders, “feel less helpless” sentiment. https://faithhealth.org/huntington-quick-response-team/ ↩

  13. WV Public Broadcasting, “Across W.Va., Localities Look For New Ways To Help People In Crisis,” July 8, 2025. Priddy “million-dollar home” quote. https://wvpublic.org/story/health-science/across-w-va-localities-look-for-new-ways-to-help-people-in-crisis/ ↩

  14. NBC DFW, “Dallas Overdose Response Team Saves Lives,” March 23, 2023. Tinney: “We can’t rehabilitate somebody who’s dead. Somebody who dies from an overdose doesn’t have an opportunity to learn from their mistake.” https://www.nbcdfw.com/news/local/dallas-new-overdose-response-team-saving-lives-one-person-at-a-time/3221710/ ↩

  15. Firesheets et al., “Naloxone Plus, Plus Some: Examining Ohio’s Quick Response Teams Through the Lens of Deflection,” Journal of Public Health Management and Practice, November/December 2022. Colerain Township 2015 origin; Ohio expansion to majority of 88 counties. https://pmc.ncbi.nlm.nih.gov/articles/PMC9531970/ ↩

  16. DOJ Bureau of Justice Assistance, Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP). Eight BJA peer mentor sites designated. https://www.ojp.gov/ncjrs/virtual-library/abstracts/quick-response-teams-interdisciplinary-overdose-response-and ↩

  17. CDC Overdose Data to Action, “Public Safety-Led Post-Overdose Outreach Programs.” West Virginia DHHR coordinates QRTs in 33 counties. https://www.cdc.gov/overdose-prevention/php/od2a/public-safety.html ↩

  18. KXAN, “Travis County approves $860K in overdose prevention funding,” August 8, 2023. $860,000 from Texas Opioid Abatement Fund Council for Narcan, methadone, and peer support services. https://www.kxan.com/news/local/travis-county/travis-county-commissioners-to-discuss-overdose-prevention-funding-tuesday/ ↩

  19. City of Austin, “City of Austin, Travis County and Community Partners Highlight Milestones in Fight Against Opioid Overdose Epidemic,” June 23, 2025. Watson: “We’re no longer just reacting to a crisis — we’re building a system that prevents it.” https://www.austintexas.gov/news/city-austin-travis-county-and-community-partners-highlight-milestones-fight-against-opioid-overdose-epidemic ↩

  20. Texas Tribune, Stephen Simpson, “The overdose rise in Travis County is part of a growing trend,” May 16, 2024. Fentanyl mixed into crack cocaine, methamphetamine, and marijuana. https://www.texastribune.org/2024/05/16/texas-travis-county-drug-deaths-fentanyl-overdose/ ↩

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03
How Is This Different?
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Overdose response teams sit in a crowded space. EMS already responds to overdoses. Emergency rooms already treat them. Harm reduction programs already distribute naloxone. Mobile crisis teams already handle substance use calls. And law enforcement already shows up when someone overdoses in public.

The question a local leader needs answered is not whether these other resources exist, but what specific function overdose response teams perform that none of those resources can.

The answer comes down to three structural differences: when the team activates (post-crisis, not during crisis), who is on the team (peer recovery specialists with addiction-specific lived experience, not clinicians or officers), and how long the engagement lasts (days to months, not minutes to hours).

  1. WKRG, “Escambia Co. EMS Chief says county leads Florida in overdoses, looks to provide better care through CORE program,” September 7, 2022. Torsell: “Nobody is following up. They get a little piece of paper that says, ‘Your follow up is this day. Go here. Good luck to you.'” https://www.wkrg.com/northwest-florida/escambia-county/escambia-co-ems-chief-says-county-leads-the-florida-in-overdoses-looks-to-provide-better-care-through-core-program/ ↩

  2. Wisconsin Examiner, Isiah Holmes, “Perspectives on addiction and recovery in a city plagued with overdose deaths,” May 30, 2023. Molinski: “There’s no limit on the amount of times we’ll go back if they want us to come back.” https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩

  3. Portland.gov, “CHAT MOUD and ORT Pilot Programs.” Official program page describing overdose response team dispatched to active overdose calls Monday-Thursday 8am-6pm at Station 1. https://www.portland.gov/fire/community-health/moud-ort ↩

  4. Multnomah County, “Board approves funding to support new addiction treatment facility in Portland,” January 4, 2024. O’Meara: “about one-third of the 3,000 people it serves each year are sent back to living on the streets after detox.” https://multco.us/news/board-approves-funding-support-new-addiction-treatment-facility-portland ↩

  5. KPTV, “Portland Fire CHAT responds to opioid crisis,” November 12, 2024. Deputy Chief Stephanie Sullivan: “We’ve saved $9 million in the health care system. We had about 68% of the people who we responded to who had opioid overdoses, we were able to treat them in the field and not send them to the emergency department.” https://www.kptv.com/2024/11/12/portland-fire-chat-responds-opioid-crisis/ ↩

  6. UTHealth Houston, Houston Emergency Opioid Engagement System (HEROES). Program based at University of Texas Health Science Center, uses ED screening and EMS data to identify overdose survivors for field-based outreach by paramedic + peer recovery coach teams. https://sbmi.uth.edu/heroes/ ↩

  7. National Association of Counties, “Post-Overdose Response Teams,” Opioid Solutions Center strategy brief. Defines post-overdose response teams as programs that “conduct outreach and offer services to people who have experienced an overdose within about 72 hours of the overdose event.” https://www.naco.org/resource/osc-port ↩

  8. Cover2 Podcast, “Treatment Breakthrough: The ER Addiction Stabilization Unit,” March 2020. Dr. Belma Andric, Chief Medical Officer, Health Care District of Palm Beach County, on the ASU model. Also NACo, “Palm Beach County’s opioid treatment pilot expands to 12 counties in Florida,” April 2023. https://cover2.org/addiction-stabilization-unit/ ↩

  9. FaithHealth, “The Huntington WV Quick Response Team,” February 9, 2021. Priddy: “Even if they’re not ready for treatment, they appreciate someone checking in, asking how they are, bringing them resources.” https://faithhealth.org/huntington-quick-response-team/ ↩

  10. National Association of Counties (2023). Buncombe County program: “Since 2022, the team has been authorized to administer buprenorphine immediately following an overdose…The team can continue administering buprenorphine for up to five days.” https://www.naco.org/resource/osc-port ↩

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On the Ground
04
What Calls Does This Handle?
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The entry point for an overdose response team is a single event: someone has overdosed. The substance involved, the person’s housing status, their insurance situation, their history with the criminal justice system, whether they have overdosed before, and whether they are currently interested in treatment are all irrelevant to eligibility. Programs serve anyone who has experienced a drug overdose, period.

Every documented program operates on this principle. Services are free to users, with no billing, copays, or insurance requirements.1 Teams assist with insurance enrollment as part of the follow-up.

  1. Firesheets et al., “Naloxone Plus, Plus Some: Examining Ohio’s Quick Response Teams Through the Lens of Deflection,” Journal of Public Health Management and Practice, November/December 2022. Colerain Township 2015 origin; describes post-911 follow-up as the dominant model. https://pmc.ncbi.nlm.nih.gov/articles/PMC9531970/ ↩

  2. PBS Wisconsin, “Dave Polachowski on firefighter responses to drug overdoses.” Polachowski on HIPAA protections and not sharing information with law enforcement. https://pbswisconsin.org/news-item/dave-polachowski-on-firefighter-responses-to-drug-overdoses/ ↩

  3. UTHealth Houston, Houston Emergency Opioid Engagement System (HEROES). Program uses ED screening and EMS data to identify overdose survivors for field-based outreach by paramedic + peer recovery coach teams. https://sbmi.uth.edu/heroes/ ↩

  4. Portland.gov, “CHAT MOUD and ORT Pilot Programs.” Overdose Response Team dispatched to active overdose calls Monday-Thursday 8am-6pm; also conducts follow-up. Buprenorphine administered in field. https://www.portland.gov/fire/community-health/moud-ort ↩

  5. PBS Wisconsin, “Milwaukee, suburbs fight to contain wave of opioid overdoses,” May 4, 2023. Gorman: “The prevalence of actual heroin is almost nonexistent from what we see in urinalysis and just word on the street.” https://pbswisconsin.org/news-item/milwaukee-suburbs-fight-to-contain-wave-of-opioid-overdoses/ ↩

  6. Yale Program in Addiction Medicine, “The Connecticut Opioid REsponse (CORE) Initiative.” “In 2023, fentanyl was involved in 84% of overdose deaths in Connecticut.” https://medicine.yale.edu/internal-medicine/genmed/addictionmedicine/policy/connecticut-opioid-response-core-initiative/ ↩

  7. Spectrum News 1, Mandy Hague, “How Milwaukee’s fire department is combating overdoses,” May 9, 2023. Polachowski on demographics: “Combat veterans. High school seniors. Young mothers.” https://spectrumnews1.com/wi/milwaukee/news/2023/05/09/how-milwaukee-s-fire-department-is-combating-overdoses ↩

  8. WV Public Broadcasting, “Across W.Va., Localities Look For New Ways To Help People In Crisis,” July 8, 2025. Priddy “million-dollar home” quote. https://wvpublic.org/story/health-science/across-w-va-localities-look-for-new-ways-to-help-people-in-crisis/ ↩

  9. FaithHealth, “The Huntington WV Quick Response Team,” February 9, 2021. Clergy involvement, compassion fatigue, “feel less helpless” sentiment. https://faithhealth.org/huntington-quick-response-team/ ↩

  10. National Association of Counties, “Post-Overdose Response Teams,” Opioid Solutions Center strategy brief. Buncombe County: “A core tenet of the program is that team members let people choose the level of help they get.” Also describes buprenorphine administration for up to five days. https://www.naco.org/resource/osc-port ↩

  11. Wisconsin Examiner, Isiah Holmes, “Perspectives on addiction and recovery in a city plagued with overdose deaths,” May 30, 2023. Polachowski on housing as “biggest barrier”; Molinski on travel distance for methadone; HOPE Kit distribution. https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩

  12. Recovery Resource Council, Overdose Response Team program page. “Follow the lead of the individual to guide the frequency, type, and amount of follow-up services provided.” https://recoverycouncil.org/overdose-response-team/ ↩

  13. FaithHealth (2021). Priddy: “We are the one that will connect them to treatment, but we’re also just there to check on them to make sure they’re OK… and I think that’s mattered.” Same source as 9. ↩

  14. Texas Tribune, Stephen Simpson, “The overdose rise in Travis County is part of a growing trend,” May 16, 2024. Fentanyl mixed into crack cocaine, methamphetamine, and marijuana. https://www.texastribune.org/2024/05/16/texas-travis-county-drug-deaths-fentanyl-overdose/ ↩

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05
Does It Work?
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The evidence base for overdose response teams spans multiple cities that have reported reductions in overdose deaths ranging from 22% to 51%,2 4 5 7 8 treatment connection rates from 30% to 92%,5 9 10 and healthcare cost savings exceeding $11 million in Portland alone.12 Nearly all of this evidence is program-reported rather than independently verified, no randomized controlled trial has been conducted on the model, and community-level overdose reductions occurred alongside other interventions.

A local leader evaluating this model should understand both what the data shows and where it falls short. The numbers are real. The caveats are also real. Both matter for making sound decisions.

  1. CDC NCHS, “U.S. Life Expectancy Hits Record High as Drug Overdose Deaths Decline in 2024,” January 29, 2026 (Data Brief #549). Final count: 79,384 drug overdose deaths in 2024, age-adjusted rate decline of 26.2% from 2023. Provisional 2025 data (February 2026) shows continued decline of ~19%. https://www.cdc.gov/nchs/pressroom/releases/20260129.html ↩

  2. Sacramento County Department of Health Services, “Annual Summit Marks Progress in Fentanyl Awareness,” 2025. Coroner’s Office reported 32% reduction in fentanyl-related deaths from 2023 to 2024 (approximately 280 deaths vs. 406). Lori Miller: “It shows that our work is saving lives.” https://www.saccounty.gov/us/en/articles/2025-articles/annual-summit-marks-progress-in-fentanyl-awareness-.html ↩

  3. Carmichael Times, “Sacramento County Fentanyl Deaths Declining,” November 26, 2024. Earlier partial-year estimate of 56% based on 180 deaths through November 2024 vs. 406 in all 2023. Miller: “This reduction isn’t necessarily due to fewer people using fentanyl but rather a direct result of the comprehensive support systems we’ve implemented.” https://www.carmichaeltimes.com/2024/11/26/514585/sacramento-county-fentanyl-deaths-declining ↩

  4. EMS1, “Conn. city sees a significant drop in opioid deaths,” February 17, 2025. New Britain opioid-related deaths dropped from 43 to 21 (51%). Mayor Erin Stewart: “To reduce it by 50% in two years is remarkable.” https://www.ems1.com/public-health/conn-city-sees-a-significant-drop-in-opioid-deaths ↩

  5. KFF Health News, Taylor Sisk, “West Virginia City Once Battered by Opioid Overdoses Confronts ‘Fourth Wave,'” March 13, 2024. Huntington: 40% reduction in ambulance calls; CDC data on Cabell County overdose rates. https://kffhealthnews.org/news/article/west-virginia-opioid-overdoses-fourth-wave/ ↩↩

  6. Manne et al., “Evaluation of Quick Response Team,” Substance Use & Misuse, October 2025. Marshall University ARIMA study: Huntington QRT, 52% decline in nonfatal overdoses 2017-2019. https://pubmed.ncbi.nlm.nih.gov/41044049/ ↩

  7. MyBuckhannon.com, “Quick Response Team explains approach to combating addiction,” August 17, 2019. Priddy: 40% decrease in overdose calls, $370,000 savings for Cabell County EMS. Colerain Township: 42% drop from 238 to 139 overdose calls. https://www.mybuckhannon.com/huntington-quick-response-team-explains-approach-to-combating-addiction-to-commissioners/ ↩

  8. Axios Austin, “Austin overdose deaths plummet,” June 13, 2025. Travis County: 22% drop in opioid deaths, 36% decrease in fentanyl deaths 2023-2024. Watson: “We are building a system that prevents it.” https://www.axios.com/local/austin/2025/06/13/overdose-deaths-drop-austin-texas ↩

  9. JPHMP Direct, “Quick Response Teams: Lessons Learned from Ohio’s Naloxone Plus Programs,” October 24, 2022. Colerain Township origin 2015; Assistant Fire Chief Mueller: “80 percent of them have gotten into recovery.” https://jphmpdirect.com/quick-response-teams-lessons-learned-from-a-review-of-ohios-naloxone-plus-programs/ ↩

  10. NACo, “Post-Overdose Response Teams,” Opioid Solutions Center. Coastal Horizons Center: 525 meetings, 485 connected to treatment (92%). https://www.naco.org/resource/osc-port ↩↩

  11. Firesheets et al., “Naloxone Plus, Plus Some,” JPHMP, 2022. Ohio QRTs averaged 6-8 weeks between interactions. https://pmc.ncbi.nlm.nih.gov/articles/PMC9531970/ ↩

  12. KPTV, “Portland Fire CHAT responds to opioid crisis,” November 12, 2024. Sullivan: “68% treated in field… saved $9 million.” https://www.kptv.com/2024/11/12/portland-fire-chat-responds-opioid-crisis/ ↩

  13. Portland.gov, “CHAT MOUD and ORT Pilot Programs.” Dr. Richard Bruno quote on field-based buprenorphine. CareOregon $389,577 funding. https://www.portland.gov/fire/community-health/moud-ort ↩

  14. NACo (2023). Buncombe County: buprenorphine administration for up to five days in the field. Same source as 10. ↩

  15. DOJ Bureau of Justice Assistance, COSSAP. Eight peer mentor sites designated 2020. https://www.ojp.gov/ncjrs/virtual-library/abstracts/quick-response-teams-interdisciplinary-overdose-response-and ↩

  16. WV MetroNews, December 27, 2017. Gupta: Huntington program “should be developed as a model, not just for the state of West Virginia, but for the entire country.” https://wvmetronews.com/2017/12/27/quick-response-team-seeks-to-break-the-overdose-cycle-in-huntington/ ↩

  17. Wisconsin Examiner, May 30, 2023. Polachowski on contact barriers and housing. https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩

  18. PBS Wisconsin, “Dave Polachowski on firefighter responses to drug overdoses.” Polachowski: “Our biggest barrier, honestly, is making contact.” https://pbswisconsin.org/news-item/dave-polachowski-on-firefighter-responses-to-drug-overdoses/ ↩

  19. Larochelle et al., “One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose,” Annals of Emergency Medicine, 2019. 11,557 patients; 5.5% died within one year; first two days highest risk. https://pubmed.ncbi.nlm.nih.gov/31229387/ ↩

  20. NACo, “Post-Overdose Response Teams,” Opioid Solutions Center. Per-contact cost range across documented programs. https://www.naco.org/resource/osc-port ↩

  21. New York State Office of Addiction Services and Supports, Post-Overdose Response Team pilot. 148 referrals year one, 954 in first full operational year, 36% contact rate. Referenced in Knowledge Graph Overdose Response section. ↩

  22. Michael Bullock, President, Austin Police Association (took office January 2024). Position on reducing non-criminal demands on officers. Austin Chronicle, January 5, 2024. https://www.austinchronicle.com/news/2024-01-05/new-year-new-police-union-president/ ↩

  23. NBC5, Lauren Granada, Burlington Fire Department overdose response. WCAX3, Katharine Huntley: “first sustained decrease in monthly overdoses since before the pandemic.” 1,200+ patients in six months. ↩

  24. Fox2 Detroit, Scott Wolchek. Sterling Heights, Michigan: 45% decrease in overdose deaths since 2021. Police Chief Andy Satterfield attributed decline to QRT. ↩

  25. WJER News. New Philadelphia, Ohio: Safety Director Kevin Milligan: “overdoses requiring EMS response are down nearly 50 percent in both the city and the county.” ↩

  26. Associated Press, Geoff Mulvihill and Carla Johnson. Hancock County, Ohio: 28 overdose deaths one year; 3 confirmed + 5 suspected the following year after QRT launch. ↩

  27. Louisville Courier Journal, Eleanor McCrary, “If A Louisvillian Overdoses, This Team Will Be There.” 7,200 calls, 3,000+ Narcan units, ~250 treatment referrals. ↩

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06
Where Is This Happening?
+

Overdose response teams have spread faster and with less political friction than most other alternative response models. The first program launched in Colerain Township, Ohio in July 2015.1 Within seven years, over 80 of Ohio’s 88 counties had adopted some form of the model.1 West Virginia coordinated programs across 33 counties.2 The Department of Justice designated eight programs in eight states as national mentor sites to train new teams.3 Programs now operate in cities, suburbs, and rural areas across at least a dozen states, housed in fire departments, health departments, community organizations, university medical centers, and multi-agency partnerships.

Overdose response teams do not replace police or compete with them for calls. They extend existing EMS infrastructure rather than creating a parallel system. Opioid settlement funds provide a dedicated funding stream that did not exist for earlier alternative response models.14 6 10

  1. Firesheets et al., “Naloxone Plus, Plus Some: Examining Ohio’s Quick Response Teams Through the Lens of Deflection,” JPHMP, November/December 2022. Colerain 2015 origin; 22 QRTs studied; urban/rural/suburban distribution; 6-8 week contact gap; Ohio expansion to majority of 88 counties. https://pmc.ncbi.nlm.nih.gov/articles/PMC9531970/ ↩↩

  2. CDC Overdose Data to Action, “Public Safety-Led Post-Overdose Outreach Programs.” West Virginia DHHR coordinates QRTs in 33 counties. https://www.cdc.gov/overdose-prevention/php/od2a/public-safety.html ↩

  3. DOJ Bureau of Justice Assistance, COSSAP. Eight peer mentor sites designated 2020: Huntington WV, Colerain Township OH, Philadelphia PA, Plymouth County MA, Lucas County OH, Seattle WA, Lake County IL, Los Angeles CA. https://www.ojp.gov/ncjrs/virtual-library/abstracts/quick-response-teams-interdisciplinary-overdose-response-and ↩

  4. WV MetroNews, “Quick Response Team seeks to break the overdose cycle in Huntington,” December 27, 2017. Priddy on 25+ overdoses with no follow-up care. https://wvmetronews.com/2017/12/27/quick-response-team-seeks-to-break-the-overdose-cycle-in-huntington/ ↩

  5. WV MetroNews (2017). Gupta: “should be developed as a model, not just for the state of West Virginia, but for the entire country.” Same source as 4. ↩

  6. Yale Program in Addiction Medicine, “The Connecticut Opioid REsponse (CORE) Initiative.” CT settlement ~$600 million; fentanyl 84% of OD deaths in 2023. https://medicine.yale.edu/internal-medicine/genmed/addictionmedicine/policy/connecticut-opioid-response-core-initiative/ ↩

  7. EMS1, “Conn. city sees a significant drop in opioid deaths,” February 17, 2025. New Britain: 43 to 21 deaths (51% decline). https://www.ems1.com/public-health/conn-city-sees-a-significant-drop-in-opioid-deaths ↩

  8. Wisconsin Examiner, Isiah Holmes, May 30, 2023. MORI partnership, program expansion, fatal OD every 16 hours. https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩

  9. Portland.gov, “CHAT MOUD and ORT Pilot Programs.” Mon-Thu 8am-6pm, Station 1, buprenorphine pilot, CareOregon funding. https://www.portland.gov/fire/community-health/moud-ort ↩

  10. KXAN, “Travis County approves $860K in overdose prevention funding,” August 8, 2023. $860,000 from Texas Opioid Abatement Fund Council. https://www.kxan.com/news/local/travis-county/travis-county-commissioners-to-discuss-overdose-prevention-funding-tuesday/ ↩

  11. Sacramento County Department of Health Services, “Annual Summit Marks Progress in Fentanyl Awareness,” 2025. Coroner’s Office: 32% reduction, ~280 deaths vs. 406. https://www.saccounty.gov/us/en/articles/2025-articles/annual-summit-marks-progress-in-fentanyl-awareness-.html ↩

  12. UTHealth Houston, Houston Emergency Opioid Engagement System (HEROES). ED screening + field-based outreach by paramedic + peer recovery coach. https://sbmi.uth.edu/heroes/ ↩

  13. Recovery Resource Council, Overdose Response Team program page. Programs in Dallas, Denton, McKinney, Plano, Hunt and Tarrant counties. https://recoverycouncil.org/overdose-response-team/ ↩

  14. Wisconsin DHS, “Opioid Settlement Funds,” revised February 2026: ~$780 million total through 2038 (revised upward from earlier $400M estimate after additional settlements). https://www.dhs.wisconsin.gov/opioids/settlement-funds.htm ↩

  15. Overdose Response Q&A source document. Campus programs at UC-Irvine, UC-Berkeley, UC-Davis, Oregon State, University of Utah, University of Washington. ↩

  16. NBC5, Lauren Granada, “Burlington Fire Department overdose response team.” Fire Chief Michael La Chance: “responds to suspected overdoses and unresponsive patient calls.” WCAX3, Katharine Huntley: “first sustained decrease in monthly overdoses since before the pandemic.” 1,200+ patients in first six months. City Council extended pilot. ↩

  17. Louisville Courier Journal, Eleanor McCrary, “If A Louisvillian Overdoses, This Team Will Be There.” QRT receives daily referrals from Louisville Metro EMS, Fire, and police. 7,200 calls, 3,000+ Narcan units, ~250 treatment referrals. ↩

  18. KOMO News, Joel Moreno, “Seattle’s new overdose response unit seeing early success.” Fire Chief Harold Scoggins: “Our early reports are saying that it’s proven to be positive.” Two firefighters + social worker. ↩

  19. Bridge Detroit, Nushrat Rahman. Detroit QRT connects with people at emergency rooms, bus stops, transit centers. Homeless outreach and street medicine teams coordinate referrals to QRT. ↩

  20. Fox2 Detroit, Scott Wolchek. Sterling Heights 45% decrease in overdose deaths since 2021. Police Chief Andy Satterfield: “The old ways of just arresting someone… we didn’t give them any solutions.” ↩

  21. Philly Voice, Courtenay Harris Bond, “Overdose Response Team Connects Drug Users To Treatment” in Delaware County. U.S. Rep. Mary Gay Scanlon: “someone in Delaware County overdoses every seven to nine minutes.” Dr. Daniel Neff: survivors “often have post-traumatic stress disorder.” ↩

  22. Michigan AG Dana Nessel announcement, settlement-funded expansion of 10 new QRTs. Saginaw County (2020), Genesee County (2021), Bay City (2021) as existing models. Bay City: peer recovery coach + family recovery coach + police officer. ↩

  23. Carteret County News-Times (Todd Wetherington): hospital partnership, wellness checks at 2 days/1 week/2 weeks/1 month/3 months. Chapelboro (Emma Cooke): Orange County PORT medication for up to 7 days. WFAE (Elvis Menayese): Mecklenburg County PORT, two paramedics + two counselors. ↩

  24. Local3 News (Madison Sims) and News9 (Katie Glanton): Hamilton County TN Overdose Prevention Team, first in state. Paramedic + certified peer support specialist in Quick Response Vehicles. ↩

  25. WJER News: New Philadelphia QRT. Safety Director Kevin Milligan: “overdoses requiring EMS response are down nearly 50 percent in both the city and the county.” ↩

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The Politics
07
Do People Support This?
+

Eighty percent of voters support creating Quick Response Teams in their community.1 That support spans party, race, gender, age, and educational attainment.2 In Harris County, Texas, 88% of residents said overdose response units would be “effective” at “making Harris County safer.”29 A separate survey of 1,004 city residents found nearly eight in ten said their city should use a public health approach to prevent overdose deaths.3 By at least a two-to-one margin, city residents favor treating drug addiction and overdose as a health issue rather than a criminal one, a finding that held in both the 2024 and 2025 waves of the survey.4

When asked about specific overdose prevention tools, residents expressed the most comfort with naloxone distribution, fentanyl test strips, and medications to treat addiction, the tools most closely associated with overdose response teams.5 These are supplies that prevent overdose deaths and connect people to treatment, not supplies that facilitate drug use; overdose response teams do not distribute pipes, foils, or needles. A separate poll of 1,704 registered voters tested attitudes toward expanded naloxone access after exposing respondents to strong arguments for and against. Two-thirds sided with expanding access, including majorities of both Democrats and Republicans.6

  1. Safer Cities survey of 1,249 registered voters, conducted nationally in partnership with Data for Progress. “80% of voters support the creation of a Quick Response Team where they live.” Safer Cities internal polling data. ↩

  2. Safer Cities/Data for Progress survey. “This robust support spans party, race, gender, age, and educational attainment.” Safer Cities internal polling data. ↩

  3. Big Cities Health Coalition survey of 1,004 city residents, conducted March 2025 by Hart Research. https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  4. BCHC/Hart Research 2024 and 2025 surveys. Two-to-one margin favoring health approach over criminal approach. BCHC noted “Polling from 2024 had similar findings.” https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  5. BCHC/Hart Research 2025. Naloxone, fentanyl test strips, and addiction medications received the highest comfort ratings among overdose prevention tools tested. https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  6. Safer Cities survey of 1,704 registered voters nationally. “Two-thirds of voters — including most Democrats and most Republicans — agreed more with an approach that expands Narcan access.” Safer Cities internal polling data. ↩

  7. BCHC/Hart Research 2025. More than a third of city residents consider the argument that overdose prevention actions will “encourage drug use” in their neighborhoods to be “very convincing.” https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  8. Milwaukee Fire Captain Dave Polachowski, supervisor, Milwaukee Overdose Response Initiative (MORI). https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩

  9. Assistant Fire Chief Will Mueller, Colerain Township, Ohio Quick Response Team. Program-reported data from 400+ overdose follow-ups, 2015-2019. “Gotten into recovery” likely means entered treatment, not sustained recovery; long-term outcome data not reported. https://jphmpdirect.com/quick-response-teams-lessons-learned-from-a-review-of-ohios-naloxone-plus-programs/ ↩

  10. Coastal Horizons Center, North Carolina. Program-reported: “Met with 525 overdose survivors and their loved ones over the first 3 years, and connected 485 individuals to treatment.” https://www.naco.org/resource/osc-port ↩

  11. Connie Priddy, RN, coordinator, Huntington Quick Response Team. 720 overdose survivors contacted, 216 entered treatment. https://kffhealthnews.org/news/article/west-virginia-opioid-overdoses-fourth-wave/ ↩

  12. BCHC/Hart Research 2025. 58% said they had heard “little or nothing” about overdose prevention in their city. Only 19% said they knew “a lot.” https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  13. Harris County, Texas polling on mobile crisis program (HART). Support jumped from 78% to 88% after residents learned more about the program. Referenced in Safer Cities Knowledge Graph, Mobile Crisis Teams section. ↩

  14. BCHC/Hart Research 2025. First-person stories drove “nearly all the positive movement” toward stronger support for overdose prevention actions. https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  15. BCHC/Hart Research 2025. Video testimonials were particularly effective at strengthening support. https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  16. BCHC/Hart Research 2025. Recommendation to use “overdose prevention” rather than “harm reduction.” Voters associate “overdose prevention” with saving lives and “harm reduction” with enabling. https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  17. Mayor Erin Stewart (R), New Britain, Connecticut. “We set a goal in 2022 of reducing the death rate by 30%. To reduce it by 50% in two years is remarkable.” https://www.ems1.com/public-health/conn-city-sees-a-significant-drop-in-opioid-deaths ↩

  18. Dr. Rahul Gupta, former Director, White House Office of National Drug Control Policy. Huntington program “should be developed as a model, not just for the state of West Virginia, but for the entire country.” https://wvmetronews.com/2017/12/27/quick-response-team-seeks-to-break-the-overdose-cycle-in-huntington/ ↩

  19. Colerain Township Quick Response Team. Team: police officer + firefighter/paramedic + addiction counselor. DOJ BJA peer mentor site. https://www.ojp.gov/ncjrs/virtual-library/abstracts/quick-response-teams-interdisciplinary-overdose-response-and ↩

  20. Huntington Quick Response Team. Four-member model: paramedic + counselor + law enforcement + faith leader. https://faithhealth.org/huntington-quick-response-team/ ↩

  21. BCHC/Hart Research 2025. “Complete strategy” message was the top-performing framing across nearly every demographic and geographic subgroup tested. https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  22. BCHC/Hart Research 2025. “Bridge to recovery” message performed especially well with Hispanic/Latino residents and southeastern city residents. https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  23. BCHC/Hart Research 2025. “Saving lives” message resonated most with Republicans and residents aged 50 to 64. https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  24. BCHC/Hart Research 2025. “City residents are split: about half see drug use primarily as a personal choice, and close to half see it primarily as a health problem.” https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  25. BCHC/Hart Research 2025. “Still, even with that divide, most residents agree that cities should respond to drug addiction and overdoses with a public health approach, not a punitive one.” https://www.bigcitieshealth.org/overdose-prevention-messaging-2025/ ↩

  26. Tim Davis, president of the Sacramento Police Officers Association, argued that “our 911 dispatchers do an amazing job and are the perfect people to handle those in crisis” and that “it is imperative that 911 remain under the direction of the police department.” ↩

  27. KFF Tracking Poll, July 2023, “Substance Use Crisis and Accessing Treatment.” 29% of adults report personal/family opioid addiction (42% rural, 23% urban). 90% support addiction treatment centers in their community. 82% support making naloxone freely available. Bipartisan majorities across parties. https://www.kff.org/other/kff-tracking-poll-july-2023-substance-use-crisis-and-accessing-treatment/ ↩

  28. Pew Charitable Trusts, “Philadelphians’ Perspectives on the Opioid Crisis Are Shifting,” June 2025. 2,289 adults surveyed Jan-Mar 2025. 44% personally know someone with OUD (up from 31% in 2019). 51% recognize OUD as chronic health condition (up from 39% in 2019). 71% prioritize treatment over arrest. https://www.pew.org/en/research-and-analysis/issue-briefs/2025/06/philadelphians-perspectives-on-the-opioid-crisis-are-shifting ↩

  29. Safer Cities/Data for Progress poll, Harris County residents. 88% said overdose response units would be “effective” at “making Harris County safer.” Referenced in Overdose Response newsletter. ↩

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08
Who Are the Key Stakeholders?
+

Overdose response teams do not replace police, do not compete with law enforcement for calls, and extend an existing emergency service (EMS) rather than creating a parallel system.1 3 The crisis they address crosses demographic, geographic, and political boundaries.1

  1. Spectrum News 1, Mandy Hague, “How Milwaukee’s fire department is combating overdoses,” May 9, 2023. Polachowski: “You would get a little frustrated. Like, how come you can’t see what you are doing?” https://spectrumnews1.com/wi/milwaukee/news/2023/05/09/how-milwaukee-s-fire-department-is-combating-overdoses ↩↩

  2. KPTV, “Portland Fire CHAT responds to opioid crisis,” November 12, 2024. Sullivan: “68% treated in field… saved $9 million.” https://www.kptv.com/2024/11/12/portland-fire-chat-responds-opioid-crisis/ ↩

  3. DOJ Bureau of Justice Assistance, COSSAP. Eight peer mentor sites designated 2020. https://www.ojp.gov/ncjrs/virtual-library/abstracts/quick-response-teams-interdisciplinary-overdose-response-and ↩

  4. Michael Bullock, President, Austin Police Association (took office January 2024). Testimony on overdose response referenced in Knowledge Graph; independent URL for the specific testimony not found. Bullock profile: Austin Chronicle, “New Year, New Police Union President,” January 5, 2024. https://www.austinchronicle.com/news/2024-01-05/new-year-new-police-union-president/ ↩

  5. Carmichael Times, “Sacramento County Fentanyl Deaths Declining,” November 26, 2024. Miller: “This reduction isn’t necessarily due to fewer people using fentanyl but rather a direct result of the comprehensive support systems we’ve implemented.” https://www.carmichaeltimes.com/2024/11/26/514585/sacramento-county-fentanyl-deaths-declining ↩

  6. Wisconsin Examiner, Isiah Holmes, May 30, 2023. Polachowski “badge” quote, Molinski “no limit” quote, housing barriers, methadone distance. https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩

  7. Portland.gov, “CHAT MOUD and ORT Pilot Programs.” Dr. Richard Bruno: “Being able to provide life-saving medications for opioid use disorder at the time the paramedics respond versus waiting for patients to arrive in the emergency room or following up at a clinic is a promising method to reduce overdose deaths.” https://www.portland.gov/fire/community-health/moud-ort ↩

  8. WV MetroNews, December 27, 2017. Gupta: “should be developed as a model, not just for the state of West Virginia, but for the entire country.” https://wvmetronews.com/2017/12/27/quick-response-team-seeks-to-break-the-overdose-cycle-in-huntington/ ↩

  9. EMS1, “Conn. city sees a significant drop in opioid deaths,” February 17, 2025. Stewart: 51% decline, exceeded 30% goal. https://www.ems1.com/public-health/conn-city-sees-a-significant-drop-in-opioid-deaths ↩

  10. Marshall University, December 2017. Mayor Williams: “Huntington is a proactive community that helps identify solutions related to the opioid epidemic that can be replicated across the country.” https://jcesom.marshall.edu/news/musom-news/marshall-university-providing-monitoring-and-assessment-support-to-opioid-epidemic-qrt/ ↩

  11. KXAN, “Travis County approves $860K in overdose prevention funding,” August 8, 2023. https://www.kxan.com/news/local/travis-county/travis-county-commissioners-to-discuss-overdose-prevention-funding-tuesday/ ↩

  12. City of Austin, “City of Austin, Travis County and Community Partners Highlight Milestones,” June 23, 2025. Watson: “We’re no longer just reacting to a crisis — we’re building a system that prevents it.” https://www.austintexas.gov/news/city-austin-travis-county-and-community-partners-highlight-milestones-fight-against-opioid-overdose-epidemic ↩

  13. PBS Wisconsin, “Milwaukee, suburbs fight to contain wave of opioid overdoses,” May 4, 2023. Gorman quotes; Polachowski “enabling” reframe. https://pbswisconsin.org/news-item/milwaukee-suburbs-fight-to-contain-wave-of-opioid-overdoses/ ↩

  14. FaithHealth, “The Huntington WV Quick Response Team,” February 9, 2021. Priddy: “Even if they’re not ready for treatment, they appreciate someone checking in.” https://faithhealth.org/huntington-quick-response-team/ ↩

  15. NACo, “Post-Overdose Response Teams,” Opioid Solutions Center. Buncombe County: “A core tenet of the program is that team members let people choose the level of help they get.” https://www.naco.org/resource/osc-port ↩

  16. FaithHealth (2021). Clergy quotes, Bishop Shaw, “tired of doing funerals,” “spiritual component is critical.” Same source as 14. ↩

  17. Firesheets et al., “Naloxone Plus, Plus Some,” JPHMP, 2022. Ohio QRTs averaged 6-8 weeks between interactions. https://pmc.ncbi.nlm.nih.gov/articles/PMC9531970/ ↩

  18. PBS Wisconsin, “Dave Polachowski on firefighter responses to drug overdoses.” Polachowski: “Our biggest barrier, honestly, is making contact.” https://pbswisconsin.org/news-item/dave-polachowski-on-firefighter-responses-to-drug-overdoses/ ↩

  19. Fox2 Detroit, Scott Wolchek. Sterling Heights Police Chief Andy Satterfield on 45% decrease and QRT approach. “The old ways of just arresting someone… we didn’t give them any solutions.” ↩

  20. NBC5, Lauren Granada. Burlington Fire Chief Michael La Chance on overdose response unit. WCAX3, Katharine Huntley: “first sustained decrease in monthly overdoses since before the pandemic.” ↩

  21. Carteret County News-Times, Cheryl Burke. County Health Director Nina Oliver: “Even if those who have overdosed don’t want help at the time, team members continue to follow up.” ↩

  22. NPR, Brian Mann, “Trump team revokes $11 billion in funding for addiction, mental health care,” March 27, 2025. $11.4 billion in COVID-era grants revoked. https://www.npr.org/2025/03/27/nx-s1-5342368/addiction-trump-mental-health-funding ↩

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09
What Are the Risks?
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Across the programs documented in this resource, none has reported a serious safety incident during follow-up visits, and none has been linked to an increase in overdose deaths.1 2 The model does not generate the political opposition that mobile crisis or community violence intervention programs face.

But the absence of dramatic failures does not mean the model is free of risk. The risks and limitations of overdose response teams are structural rather than spectacular: they fail slowly, through funding erosion, workforce attrition, operational gaps between design and reality, and the mismatch between what teams can do and what the surrounding system can absorb. These are the failure modes that a local leader needs to understand before investing, because they are the ones that will determine whether a program survives its third year.

  1. Firesheets et al., “Naloxone Plus, Plus Some: Examining Ohio’s Quick Response Teams Through the Lens of Deflection,” JPHMP, November/December 2022. 22 QRTs studied; 6-8 week average between interactions. https://pmc.ncbi.nlm.nih.gov/articles/PMC9531970/ ↩

  2. PBS Wisconsin, “Dave Polachowski on firefighter responses to drug overdoses.” Polachowski: “Our biggest barrier, honestly, is making contact.” Also HIPAA protections: “We don’t share anything with law enforcement.” https://pbswisconsin.org/news-item/dave-polachowski-on-firefighter-responses-to-drug-overdoses/ ↩

  3. Portland.gov, “CHAT MOUD and ORT Pilot Programs.” Monday-Thursday 8am-6pm schedule, Station 1. https://www.portland.gov/fire/community-health/moud-ort ↩

  4. Wisconsin Examiner, Isiah Holmes, May 30, 2023. Polachowski on housing as “biggest barrier”; Molinski on methadone travel distance. https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩

  5. WTMJ, “Xylazine presence in drug overdoses increases in Milwaukee County,” February 23, 2024. Dr. Ben Weston: 134 xylazine-involved deaths of 502 opioid deaths in 2023 (~27%), up from 1% in 2020. Wisconsin settlement revised to ~$780M (DHS, February 2026). https://wtmj.com/news/2024/02/23/xylazine-presence-in-drug-overdoses-increases-in-milwaukee-county/ ↩

  6. Yale Program in Addiction Medicine, “The Connecticut Opioid REsponse (CORE) Initiative.” CT settlement ~$600M. https://medicine.yale.edu/internal-medicine/genmed/addictionmedicine/policy/connecticut-opioid-response-core-initiative/ ↩

  7. KXAN, “Travis County approves $860K in overdose prevention funding,” August 8, 2023. https://www.kxan.com/news/local/travis-county/travis-county-commissioners-to-discuss-overdose-prevention-funding-tuesday/ ↩

  8. EMS1, “Conn. city sees a significant drop in opioid deaths,” February 17, 2025. Bowen: fentanyl “in everything”; xylazine challenges. https://www.ems1.com/public-health/conn-city-sees-a-significant-drop-in-opioid-deaths ↩

  9. JPHMP Direct, “Quick Response Teams: Lessons Learned,” October 24, 2022. Mueller: “80 percent of them have gotten into recovery.” https://jphmpdirect.com/quick-response-teams-lessons-learned-from-a-review-of-ohios-naloxone-plus-programs/ ↩

  10. KFF Health News, Taylor Sisk, March 13, 2024. Huntington: 720 contacted, 30% entered treatment; 40% reduction in ambulance calls. https://kffhealthnews.org/news/article/west-virginia-opioid-overdoses-fourth-wave/ ↩

  11. National Research Institute (NRI), 2024 survey of mobile crisis program availability. Finding: 70% of programs nationally claim 24/7 availability but only 40% actually staff all shifts. Referenced in Safer Cities Knowledge Graph, Mobile Crisis Teams section. ↩

  12. NPR, Brian Mann, “Trump team revokes $11 billion in funding for addiction, mental health care,” March 27, 2025. $11.4 billion in COVID-era grants revoked by HHS. https://www.npr.org/2025/03/27/nx-s1-5342368/addiction-trump-mental-health-funding ↩

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Making It Happen
10
How Are Cities Designing These Programs?
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Every city that builds an overdose response team must answer the same six questions, and the answers define what the program can do, who it can reach, how fast it operates, and whether it survives. The cities that have built these programs made different choices at each decision point, and those choices produced different capabilities, different tradeoffs, and different results.

This section walks through the six decisions in order, showing what cities chose, what happened, and what the documented tradeoffs are.

  1. Firesheets et al., “Naloxone Plus, Plus Some,” JPHMP, 2022. Colerain origin; Ohio QRT model descriptions. https://pmc.ncbi.nlm.nih.gov/articles/PMC9531970/ ↩

  2. PBS Wisconsin, “Dave Polachowski on firefighter responses to drug overdoses.” “Our biggest barrier, honestly, is making contact.” https://pbswisconsin.org/news-item/dave-polachowski-on-firefighter-responses-to-drug-overdoses/ ↩

  3. Firesheets et al. (2022). 22 Ohio QRTs averaged 6-8 weeks between interactions. Same source as 1. ↩

  4. Portland.gov, “CHAT MOUD and ORT Pilot Programs.” Station 1 dispatch, Mon-Thu 8am-6pm, CareOregon $389,577, Dr. Bruno quote on field buprenorphine. https://www.portland.gov/fire/community-health/moud-ort ↩

  5. Recovery Resource Council, Overdose Response Team. Dallas, Denton, McKinney, Plano, Hunt and Tarrant counties. https://recoverycouncil.org/overdose-response-team/ ↩

  6. Wisconsin Examiner, Isiah Holmes, May 30, 2023. Polachowski “badge” quote; Molinski “no limit” quote; housing barriers. https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩

  7. PBS Wisconsin, “Milwaukee, suburbs fight to contain wave of opioid overdoses,” May 4, 2023. Gorman: “in ways others cannot because they’ve been there.” https://pbswisconsin.org/news-item/milwaukee-suburbs-fight-to-contain-wave-of-opioid-overdoses/ ↩

  8. FaithHealth, “The Huntington WV Quick Response Team,” February 9, 2021. Priddy quotes, clergy quotes, Bishop Shaw, spiritual component. https://faithhealth.org/huntington-quick-response-team/ ↩

  9. NACo, “Post-Overdose Response Teams,” Opioid Solutions Center. Buncombe County 5-day buprenorphine; Coastal Horizons 92% connection rate. https://www.naco.org/resource/osc-port ↩

  10. Recovery Resource Council, Overdose Response Team. “Follow the lead of the individual.” Same source as 5. ↩

  11. JPHMP Direct, “Quick Response Teams: Lessons Learned,” October 2022. Mueller: “80 percent of them have gotten into recovery.” https://jphmpdirect.com/quick-response-teams-lessons-learned-from-a-review-of-ohios-naloxone-plus-programs/ ↩

  12. KFF Health News, Taylor Sisk, March 13, 2024. Huntington: 720 contacted, 30% entered treatment. https://kffhealthnews.org/news/article/west-virginia-opioid-overdoses-fourth-wave/ ↩

  13. KPTV, “Portland Fire CHAT responds to opioid crisis,” November 12, 2024. Sullivan: “68% treated in field… saved $9 million.” https://www.kptv.com/2024/11/12/portland-fire-chat-responds-opioid-crisis/ ↩

  14. NPR, Brian Mann, “Trump team revokes $11 billion in funding for addiction, mental health care,” March 27, 2025. $11.4 billion in COVID-era grants revoked. https://www.npr.org/2025/03/27/nx-s1-5342368/addiction-trump-mental-health-funding ↩

  15. Wisconsin DHS, “Opioid Settlement Funds,” revised February 2026: ~$780 million total through 2038. https://www.dhs.wisconsin.gov/opioids/settlement-funds.htm ↩

  16. Yale Program in Addiction Medicine, CORE Initiative. Connecticut ~$600 million in opioid settlement funds. https://medicine.yale.edu/internal-medicine/genmed/addictionmedicine/policy/connecticut-opioid-response-core-initiative/ ↩

  17. KXAN, “Travis County turns to new opioid response team to tackle overdose crisis,” August 2, 2024. $860,000 from Opioid Abatement Fund Council. https://www.kxan.com/news/local/travis-county/travis-county-turns-to-new-opioid-response-team-to-tackle-overdose-crisis/ ↩

  18. CDC, “Overdose Data to Action (OD2A).” Funds 49 state and 41 local health departments. https://www.cdc.gov/overdose-prevention/php/od2a/index.html ↩

  19. Carteret County News-Times (Todd Wetherington): hospital partnership, wellness checks at 2 days/1 week/2 weeks/1 month/3 months. Chapelboro (Emma Cooke): Orange County NC PORT provides medication for up to 7 days. ↩

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11
How Is It Funded?
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Overdose response teams draw on a funding landscape that is more diversified than what most alternative response programs can access. The opioid crisis generated dedicated revenue streams — particularly opioid settlement funds — that did not exist when mobile crisis teams and community violence intervention programs were first scaling up.

Five funding sources are documented across operating programs.1

  1. Wisconsin DHS, “Opioid Settlement Funds,” revised February 2026: ~$780 million total through 2038. State distributions jumped from $8M in FY2024 to $36M in FY2025. https://www.dhs.wisconsin.gov/opioids/settlement-funds.htm ↩

  2. Yale Program in Addiction Medicine, “The Connecticut Opioid REsponse (CORE) Initiative.” CT settlement ~$600 million. https://medicine.yale.edu/internal-medicine/genmed/addictionmedicine/policy/connecticut-opioid-response-core-initiative/ ↩

  3. KXAN, “Travis County approves $860K in overdose prevention funding,” August 8, 2023. https://www.kxan.com/news/local/travis-county/travis-county-commissioners-to-discuss-overdose-prevention-funding-tuesday/ ↩

  4. DOJ Bureau of Justice Assistance, COSSAP. Colerain funding; eight peer mentor sites. https://www.ojp.gov/ncjrs/virtual-library/abstracts/quick-response-teams-interdisciplinary-overdose-response-and ↩

  5. Portland.gov, “CHAT MOUD and ORT Pilot Programs.” CareOregon $389,577 through June 2025. https://www.portland.gov/fire/community-health/moud-ort ↩

  6. CDC Overdose Data to Action. 49 state and 41 local health departments funded. https://www.cdc.gov/overdose-prevention/php/od2a/public-safety.html ↩

  7. KPTV, “Portland Fire CHAT responds to opioid crisis,” November 12, 2024. Sullivan: 68% field treatment, $9 million savings. https://www.kptv.com/2024/11/12/portland-fire-chat-responds-opioid-crisis/ ↩

  8. NPR, Brian Mann, “Trump team revokes $11 billion in funding for addiction, mental health care,” March 27, 2025. $11.4 billion in COVID-era grants revoked. https://www.npr.org/2025/03/27/nx-s1-5342368/addiction-trump-mental-health-funding ↩

  9. Angela Kimball, Inseparable. Capacity-versus-encounter funding structural mismatch. Referenced in Knowledge Graph Overdose Response section and mobile crisis funding analysis. ↩

  10. NACo, “Post-Overdose Response Teams,” Opioid Solutions Center. Per-contact cost range $200-$500 across documented programs. https://www.naco.org/resource/osc-port ↩

  11. KPTV, “Portland’s CHAT program continues fight against opioid crisis,” January 2026. Cumulative savings exceeding $11 million; Health Share funding; funding instability; staff departures. https://www.kptv.com/2026/01/portland-fire-chat-opioid-crisis/ ↩

  12. CAHOOTS collapse: April 2025 shutdown after 36 years. White Bird Clinic nonprofit financial failure. Eugene Weekly, April 2025. ↩

  13. CMS, “Medicaid Mobile Crisis Intervention Services,” ARPA Section 9813. 21 states approved; 85% federal match; open through March 2027. https://www.medicaid.gov/medicaid/benefits/behavioral-health-services/mobile-crisis-intervention-services/index.html ↩

  14. FaithHealth, “The Huntington WV Quick Response Team,” February 2021. WV DHHR support across 33 counties. https://faithhealth.org/huntington-quick-response-team/ ↩

  15. Spectrum News 1, Mandy Hague, “How Milwaukee’s fire department is combating overdoses,” May 9, 2023. Milwaukee city/county partnership. https://spectrumnews1.com/wi/milwaukee/news/2023/05/09/how-milwaukee-s-fire-department-is-combating-overdoses ↩

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12
How Are Leaders Talking About This?
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When local leaders describe overdose response teams to their communities, a consistent pattern emerges: they frame the program as a practical extension of emergency services, not a social services experiment. The language emphasizes that the team comes back after the overdose, that it pairs medical professionals with people who have personally survived addiction, and that the cycle of repeat emergency calls is expensive, exhausting, and preventable.

Milwaukee Fire Captain Dave Polachowski captured the operational frame that appears across jurisdictions: “Our badge gets us in the door, and then the peer support takes over.”1 Austin Mayor Kirk Watson articulated the systemic shift: “We are no longer in Austin and Travis County reacting to a crisis. We are building a system that prevents it.”2

The rhetoric works because the model sits in a political space that few alternative response programs occupy. It does not replace police. It does not compete with law enforcement for calls. It extends EMS rather than creating a parallel system. And the crisis it addresses crosses every demographic, geographic, and political line in the country.

  1. Wisconsin Examiner, Isiah Holmes, May 30, 2023. Polachowski: “Our badge gets us in the door, and then the peer support takes over.” https://wisconsinexaminer.com/2023/05/30/perspectives-on-addiction-and-recovery-in-a-city-plagued-with-overdose-deaths/ ↩

  2. City of Austin, “City of Austin, Travis County and Community Partners Highlight Milestones,” June 23, 2025. Watson: “We’re no longer just reacting to a crisis — we’re building a system that prevents it.” https://www.austintexas.gov/news/city-austin-travis-county-and-community-partners-highlight-milestones-fight-against-opioid-overdose-epidemic ↩

  3. EMS1, “Conn. city sees a significant drop in opioid deaths,” February 17, 2025. Stewart: 51% decline, exceeded 30% goal. https://www.ems1.com/public-health/conn-city-sees-a-significant-drop-in-opioid-deaths ↩

  4. KPTV, “Portland Fire CHAT responds to opioid crisis,” November 12, 2024. Sullivan: “68% treated in field… saved $9 million.” https://www.kptv.com/2024/11/12/portland-fire-chat-responds-opioid-crisis/ ↩

  5. PBS Wisconsin, “Milwaukee, suburbs fight to contain wave of opioid overdoses,” May 4, 2023. Gorman: “in ways others cannot because they’ve been there.” https://pbswisconsin.org/news-item/milwaukee-suburbs-fight-to-contain-wave-of-opioid-overdoses/ ↩

  6. FaithHealth, “The Huntington WV Quick Response Team,” February 9, 2021. Priddy: “Even if they’re not ready for treatment, they appreciate someone checking in.” https://faithhealth.org/huntington-quick-response-team/ ↩

  7. WV MetroNews, December 27, 2017. Gupta: “should be developed as a model.” https://wvmetronews.com/2017/12/27/quick-response-team-seeks-to-break-the-overdose-cycle-in-huntington/ ↩

  8. CDC NCHS, “U.S. Life Expectancy Hits Record High as Drug Overdose Deaths Decline in 2024,” January 29, 2026. Final count: 79,384 deaths, 26.2% decline. https://www.cdc.gov/nchs/pressroom/releases/20260129.html ↩

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