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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 there 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.

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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

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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.

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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.

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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?
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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.

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The Politics
07
Do People Support This?
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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

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08
Who Are the Key Stakeholders?
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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

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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.

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Making It Happen
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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.

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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.

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Program Profiles
Quick Response Team (QRT) — Huntington, West Virginia
Milwaukee Overdose Response Initiative (MORI)
Community Health Assess and Treat (CHAT) — Portland, Oregon
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