Who Are the Key Stakeholders?

The Political Landscape

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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Fire Department Leadership

Fire departments are the institutional home for the majority of documented overdose response programs,³ and fire leadership has been among the model’s consistent champions.

Milwaukee Fire Captain Dave Polachowski described his own evolution from frustration to advocacy. He began with the same question many skeptics ask: “How come you can’t see what you are doing?” directed at people who overdosed repeatedly.¹ The repeated calls to the same addresses, the emotional toll on his crews, and the absence of any follow-up mechanism changed his perspective. He became the supervisor of Milwaukee’s Overdose Response Initiative and one of the model’s most quoted practitioners nationally.

Portland Deputy Fire Chief Stephanie Sullivan championed the Community Health Assess and Treat (CHAT) program’s two defining innovations: direct response to active overdose calls and field-based buprenorphine administration. Her framing focused on system impact: as of November 2024, 68% of overdose patients treated in the field without ER transport, saving an estimated $9 million in healthcare costs.²

Colerain Township Assistant Fire Chief Will Mueller led the nation’s first overdose response team, launched in July 2015, and now serves as a national mentor through the DOJ’s Bureau of Justice Assistance (BJA) program.³

Polachowski described the institutional logic: overdose calls consume EMS resources that could respond to cardiac events, strokes, and accidents. A program that reduces repeat overdose calls frees ambulance capacity for medical emergencies.¹

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Law Enforcement

Law enforcement support for overdose response teams is more direct and less contested than for other alternative response models. In Milwaukee, Colerain Township, Huntington, and Austin, law enforcement leaders have actively supported and participated in these programs.^{1 2 3 4}

Austin Police Association President Michael Bullock has argued publicly that law enforcement should not be the primary responder to overdose calls, a position consistent with his broader advocacy for reducing non-criminal demands on officers.⁴ A police union president advocating for this kind of workload reduction signals that the model is perceived as relieving rather than replacing police.

In Colerain Township, police are equal partners on the Quick Response Team, with an officer serving as a formal team member alongside a paramedic and an addiction counselor.³ In Huntington, a law enforcement member is one of four people on every team.¹⁶ In Sterling Heights, Michigan, Police Chief Andy Satterfield credited the city’s Quick Response Team with a 45% decrease in overdose deaths since 2021: “The old ways of just arresting someone and getting them in the system and they get out and still have the addiction problem doesn’t work, because we didn’t give them any solutions.”¹⁹

Polachowski described the partnership’s operational logic: “Our badge gets us in the door, and then the peer support takes over.”⁶ The fire department’s institutional credibility opens access to homes where a social worker or peer specialist alone might not be admitted. The peer specialist then does the clinical and relational work that the paramedic cannot.

The law enforcement political dynamic is less contentious here than in other alternative response models because overdose response teams are not dispatched through 911 in competition with police calls. They operate primarily through post-crisis follow-up triggered by EMS data, in a timeline and mode that does not intersect with active law enforcement operations.

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Public Health Officials

Public health departments provide the epidemiological infrastructure that drives program targeting in several documented programs, including Milwaukee and Sacramento.^{5 7}

Burlington Fire Chief Michael La Chance described the dual purpose: the overdose response team “responds to suspected overdoses and unresponsive patient calls” to “help patients break the ongoing cycle of addiction” and “free up resources to respond to more needs in the city.”²⁰

Carteret County Health Director Nina Oliver described the persistence that defines the model: “Even if those who have overdosed don’t want help at the time, team members continue to follow up with each person and family within 72 hours” and connect them “to suitable care, provide overdose education about addiction, and reduce overdose mortality.”²¹

Sacramento County’s Behavioral Health Division Chief Lori Miller framed the results in system terms: “This reduction isn’t necessarily due to fewer people using fentanyl, but rather a direct result of the comprehensive support systems we’ve implemented.”⁵

Dr. Richard Bruno, Multnomah County’s Health Officer, championed field-based buprenorphine as a medical innovation: “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.”⁷

Dr. Rahul Gupta, as director of the White House Office of National Drug Control Policy, specifically cited Huntington’s program as a national model.⁸ His endorsement carried federal authority and helped secure the DOJ’s BJA mentor site designation.

Public health officials bring population-level framing (community-wide overdose trends, mortality data, treatment capacity gaps) and epidemiological targeting (using overdose data to direct team resources to the highest-need areas). Sacramento’s data-driven proactive outreach model reflects this orientation.

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Elected Officials

Political support for overdose response teams spans the partisan spectrum more cleanly than for most alternative response models.

Republican Mayor Erin Stewart of New Britain, Connecticut described her city’s 51% decline in opioid deaths as exceeding the goal she set in 2022.⁹ Her framing was results-oriented and nonideological: set a target, invest in programs, measure the outcome.

Mayor Steve Williams of Huntington celebrated the program’s BJA mentor site designation: “The QRT’s inclusion in this mentoring initiative is another example of how collaboration in Huntington is leading to innovation.”¹⁰

Travis County Judge Andy Brown allocated $860,000 from opioid settlement funds for overdose response.¹¹ Austin Mayor Kirk Watson described the shift from reactive crisis management to systemic prevention: “We are no longer in Austin and Travis County reacting to a crisis. We are building a system that prevents it.”¹²

Stewart, Williams, Brown, and Watson illustrate that support spans the partisan spectrum — from Republican mayors to progressive county judges.^{9 10 11 12}

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Peer Recovery Specialists

The workforce that makes overdose response teams function also has its own interests and perspectives that shape program design.

Amy Molinski of Milwaukee described the commitment that defines the role: “There’s no limit on the amount of times we’ll go back if they want us to come back.”⁶ Ryan Gorman, a recovery counselor and former drug user, described the mechanism of peer engagement: specialists connect “in ways others cannot because they’ve been there.”¹³

Connie Priddy, the registered nurse who coordinates Huntington’s team, described what even unsuccessful contacts accomplish: “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.”¹⁴

The peer recovery specialist workforce faces a structural constraint: the job requires people with lived experience in addiction and recovery who are stable enough to do emotionally demanding field work. This is a smaller labor pool than the general clinical workforce, and it is the binding constraint on program scale. Programs compete for a limited number of qualified individuals, and the emotional toll of the work creates turnover risk. Peer specialists who burn out or relapse are not easily replaced, because the specific combination of personal experience and professional stability is what makes the role effective.

Claire Hubbard of Buncombe County described the tension between structure and autonomy that shapes the peer role: “A core tenet of the program is that team members let people choose the level of help they get.”¹⁵ Peer specialists navigate between institutional requirements (data reporting, contact documentation, program protocols) and the relational flexibility that makes them effective (meeting people where they are, following the person’s lead, being present without agenda).

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Faith Communities

Huntington’s program is the only documented overdose response team to include clergy as formal team members.¹⁶ The Huntington Black Pastors Ministerial Association, led by Bishop Shaw, provides an on-call rotation of ministers from multiple denominations.¹⁶

Clergy described their motivation by pointing to the toll the crisis had taken on their congregations. Pastors initially asked just to provide sandwiches and open food pantries, then pushed for direct involvement: “I’m tired of doing funerals for young people. I want to change all that and help.”¹⁶ One pastor noted: “We want to make a difference and help save lives; we’re not doing this for the money.” Priddy described the faith component as integral: “The whole team agrees that the spiritual component is critical in helping persons get and stay clean.”¹⁶

Huntington’s model has not been widely replicated elsewhere, and the spiritual component raises legitimate questions about church-state boundaries in publicly funded programs. But the Huntington experience demonstrates that faith communities can serve as operational partners, not just sources of moral support, in communities where religious institutions are trusted points of access.

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Families

Families of overdose survivors are rarely named in policy discussions but consistently present in program operations. Teams report that family members are often the first point of contact when the overdose survivor cannot be reached. Teams leave naloxone and information with families, provide grief support, and in some cases maintain contact with family members over months.

Huntington’s clergy team members reported that their visits help families “feel less helpless after burying so many people, ranging from young to old, rich to poor and everyone in between.”¹⁶ The emotional burden on families, particularly families that have experienced multiple overdose events or lost a member to overdose, is a dimension of the crisis that the emergency medical system does not address and that overdose response teams encounter on nearly every visit.

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Named Critics and Opposition Arguments

The opposition to overdose response teams comes less from political opponents and more from philosophical critics and operational skeptics. The model does not generate the same ideological fault lines as other alternative response programs, but it does face specific arguments that local leaders should expect to encounter.

Abstinence-only advocates argue that providing naloxone and harm reduction supplies without requiring treatment enables continued drug use. This is the most common community-level objection. Polachowski addressed it directly: “People call it enabling. We don’t look at it like that. We say it’s enabling you to stay alive until you are willing to get treatment.”¹³ The empirical response is that programs with voluntary engagement models report treatment connection rates of 30% to 92%, and that requiring treatment as a precondition for help would exclude the majority of overdose survivors who are not ready on the day the team arrives. This is a genuine values disagreement between harm reduction and abstinence-first philosophies, and communities answer it differently.

Operational critics and program evaluators have raised the response timing gap. Ohio research found that many programs averaged six to eight weeks between contacts rather than the intended 72 hours.¹⁷ This is a documented operational shortcoming, not a theoretical objection. Polachowski acknowledged it: “Biggest barrier, honestly, is making contact” because of incomplete or incorrect information on EMS reports.¹⁸ Programs with better data access and dedicated data analysts achieve faster contact, but the gap between design intent and operational reality is real.

Fiscal skeptics question whether dedicated funding for overdose response teams is the most effective use of limited resources when treatment capacity is the bottleneck. If the team connects someone to treatment but no treatment bed is available, the contact has limited immediate impact. Polachowski identified housing as “one of the biggest barriers that MORI encounters.”⁶ Molinski described the geographic barrier: “When you have an individual that lives on the North Side of Milwaukee and you’re asking them to travel to West Allis every single day” for methadone treatment, the distance undermines recovery.⁶ This criticism points to a real system capacity constraint, not a flaw in the team’s design, but it is a legitimate question for budget prioritization.

Researchers and policymakers note the lack of standardized evaluation. The 2022 Ohio study of 22 programs documented wide variation in definitions, timeframes, and outcome metrics.¹⁷ No randomized controlled trial has been conducted on the model.¹⁷

Federal funding critics have raised concerns about sustainability in the context of announced cuts to addiction and mental health grants. The Trump Administration revoked roughly $11.4 billion in COVID-era funding for grants linked to addiction, mental health, and other programs in March 2025.²² Programs dependent on federal grants face potential closure. The counter-argument is that opioid settlement funds provide a separate, multi-year funding stream not subject to federal budget decisions, but programs that rely primarily on federal grants remain exposed.

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The Bottom Line: Overdose response teams draw support from fire departments, law enforcement, public health officials, elected officials across the political spectrum, peer recovery specialists, faith communities, and families. The model generates less ideological opposition than other alternative response programs because it extends rather than replaces existing emergency services. Critics raise legitimate concerns about the enabling question (a genuine values disagreement), operational timing gaps (a documented shortcoming), system capacity constraints (a real but external limitation), the lack of standardized evaluation (the most substantive evidence gap), and federal funding vulnerability. A local leader building support for this model will find allies in expected places (fire, health) and in places that may be surprising for alternative response (law enforcement, conservative elected officials). The most productive conversations with critics will focus on whether the community’s treatment and housing infrastructure can absorb the connections the team creates.