What Is This?

Overdose Response Teams

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.

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The Model

Overdose response teams (also called Quick Response Teams, Post-Overdose Response Teams, or Rapid Response Teams depending on the jurisdiction) are specialized units that follow up with people who have survived an overdose, typically within 24 to 72 hours of the event.³ They pair a medical professional (usually a paramedic or EMT) with a peer recovery specialist (someone who has lived experience with addiction and is in sustained recovery). Some programs add a social worker, a law enforcement member, or, in Huntington, West Virginia’s case, a faith leader.⁴

The teams operate under a concept documented in the Ohio research as “naloxone plus”: the overdose reversal is the beginning of the intervention, not the end.²¹ After the acute medical emergency is over, the team returns to wherever the person is (a house, a shelter, an encampment) and offers sustained engagement: treatment connection, harm reduction supplies, help with insurance enrollment, housing applications, and the kind of unhurried presence that traditional emergency response cannot provide.

The timing is deliberate. A 2019 Massachusetts study found that the first month after an overdose, and particularly the first two days, is the highest-risk period for a subsequent fatal event.⁵ The 24-to-72-hour window after an event represents both peak vulnerability and, according to Priddy in Huntington and Polachowski in Milwaukee, a period when some people are most open to accepting help. The window does not open on anyone else’s schedule. As Priddy described it: “Most people aren’t ready for treatment the night they overdose.”⁴

The core logic runs like this: Traditional EMS revives the person and moves to the next call. The emergency room stabilizes and discharges. Nobody follows up. The person returns to the same conditions, the same environment, the same cravings. The cycle repeats. Polachowski described what that looks like from the fire department side: responders “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.” The emotional toll is severe. Polachowski acknowledged that “there have been tears shed in this building and in cars.”⁶

The overdose response team is designed to interrupt this pattern by returning, staying, and continuing to return.

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What a Real Response Looks Like

In Huntington, West Virginia, the catalyst was unmistakable. Over a four-to-eight-hour period in 2016, between 26 and 28 people overdosed on opioids. Not a single one received follow-up care.⁷ That failure became the origin of what is now a national model.

Huntington built a team unlike any other in the country: a paramedic, a counselor or recovery coach, a law enforcement member, and a faith leader. The clergy are scheduled through the Huntington Black Pastors Ministerial Association, with Bishop Shaw coordinating an on-call rotation across multiple denominations. Pastors had initially been asked to provide sandwiches and open food pantries. They pushed for direct involvement. As one put it: “I’m tired of doing funerals for young people. I want to change all that and help.”⁸

When a Huntington team responds to a follow-up visit, the paramedic handles medical needs. The counselor assesses readiness for treatment. The law enforcement member provides community presence and data access. And the faith leader provides what Connie Priddy, the program’s registered nurse coordinator, described as “a spiritual safe haven, caring listener, and gentle encourager.”⁹

Since its launch in December 2017, the team has contacted nearly 1,200 overdose survivors. Approximately one-third entered treatment.¹⁰ A 2025 Marshall University study published in Substance Use & Misuse confirmed the outcomes using interrupted time series analysis.¹¹ CDC data showed Cabell County’s fatal overdose rate fell 24% between 2017 and 2018, and nonfatal overdose cases declined 52% between 2017 and 2019.^{10 11} The White House Office of National Drug Control Policy director, Dr. Rahul Gupta, said the Huntington program “should be developed as a model, not just for the state of West Virginia, but for the entire country.”¹²

Priddy described encounters that defy the stereotype of what this work looks like: “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.”¹³

The opioid crisis does not sort neatly by income or neighborhood. Milwaukee’s Polachowski reported fatal overdoses ranging from teenagers to an 83-year-old. “Combat veterans. High school seniors. Young mothers.”¹⁴ Fentanyl has rewritten the demographics of addiction entirely. In Austin, police found fentanyl mixed into crack cocaine, methamphetamine, and marijuana.¹⁵ In Connecticut, fentanyl was involved in 84% of overdose deaths in 2023, declining to approximately 77% in 2024 as total overdose deaths fell 26% to 990.¹⁶ Milwaukee recovery counselor Ryan Gorman, who is in recovery himself, reported that “the prevalence of actual heroin is almost nonexistent from what we see in urinalysis and just word on the street.”¹⁷

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The Peer Recovery Specialist

The people on overdose response teams are different from the staff on other alternative response programs. Mobile crisis teams rely on licensed clinicians with clinical assessment authority. Community violence intervention programs rely on credible messengers whose legitimacy comes from lived experience with violence and incarceration. Overdose response teams rely on peer recovery specialists whose credibility comes from lived experience with addiction and sustained recovery.

The distinction matters operationally. Ryan Gorman explained that peer specialists connect “in ways others cannot because they’ve been there.”¹⁷ The trust that a person in active addiction extends to someone who has been through recovery themselves is qualitatively different from the trust extended to a clinician with credentials but no personal experience with the condition. This is not a lesser version of clinical care. It is a different mechanism, relational rather than clinical.

Priddy described what the encounter provides even when treatment does not result: “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.”¹⁸

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Where It Fits

Overdose response teams fill a gap that no other part of the emergency system covers. They are not first responders to active overdoses; that remains EMS. They are not ongoing case managers who provide months of wraparound services; that is the function of treatment programs and outpatient services. They are the bridge between the two: post-crisis but proactive, following up without waiting for the person to ask for help.

Upstream, the team depends on EMS data. A paramedic crew responds to the overdose, administers naloxone, and generates a run report. The overdose response team reviews that report and initiates follow-up. Downstream, the team connects the person to treatment: an addiction stabilization unit, outpatient services, medication-assisted treatment, or a recovery support network. In some programs, the team can initiate that treatment on the spot: Portland’s Community Health Assess and Treat (CHAT) team administers field-based buprenorphine immediately after reversing an overdose, treating 68% of patients in the field without ER transport,^{19 24} and Buncombe County, North Carolina can administer buprenorphine for up to five days, bridging the gap to formal treatment enrollment.²⁰

The model has spread from a single program in Colerain Township, Ohio in 2015 to operations across the majority of Ohio’s 88 counties,²¹ 33 West Virginia counties,²² and programs in Milwaukee, Portland, Austin, Sacramento, Connecticut, and communities across the Midwest, Northeast, and Pacific Northwest. The Department of Justice designated eight programs as national mentor sites to train new teams across the country.^{23 27}

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What We Don’t Know Yet

The evidence base for overdose response teams is growing but carries important limitations. Most outcome data is program-reported, not independently verified. Treatment connection rates vary widely. Colerain Township reports 80% “gotten into recovery” based on follow-ups conducted between 2015 and 2019,²¹ Coastal Horizons Center in North Carolina reports 92% connected to treatment,³ Huntington reports 30% entering treatment.¹⁰ These programs use different definitions, different timeframes, and different denominators, making direct comparison unreliable.

A 2022 study of Ohio’s Quick Response Teams found that despite the name, many programs averaged six to eight weeks between interactions rather than the intended 72-hour window.²¹

The strongest evidence involves overdose and death reductions at the jurisdiction level: Colerain Township’s 42% drop in overdose calls between 2017 and 2019,²¹ Huntington’s 52% decline in nonfatal overdoses between 2017 and 2019,¹⁰ New Britain, Connecticut’s 51% decline in opioid-related deaths between 2023 and 2024.²⁸ But these figures reflect community-wide trends that may be influenced by factors beyond the overdose response team itself, including broader treatment access, naloxone distribution, and law enforcement strategies.

No randomized controlled trial of overdose response teams has been published.²¹ The field has strong program-reported data and encouraging community-level trends, but the kind of independent, controlled evaluation that exists for some other alternative response models (like the Stanford evaluation of Denver’s mobile crisis program) has not yet been conducted for overdose response.

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The Bottom Line: Overdose response teams are specialized units, typically a paramedic paired with a peer recovery specialist, that follow up with overdose survivors within days of the event, providing the sustained engagement and treatment connection that traditional emergency response cannot. The model has spread from one Ohio program in 2015 to operations in dozens of states, with documented reductions in overdose rates across multiple jurisdictions. The evidence is encouraging but mostly program-reported; no independent controlled evaluation has been published. What is well-established is the gap these teams fill: between saving a life and helping a person find a path to recovery.