The Alaska PDO Initiative will develop and implement a whole community opioid overdose prevention and education program and naloxone distribution program, known as Project HOPE (Harm-reduction, Overdose Prevention, and Education) in five high need communities. Project HOPE will utilize prevention principles that: encourage community-level activities; use data-driven decision-making; are coalition-driven; use multiple strategies to change policies, systems, and environments; are evidence-based; and have clear outcome evaluation measures.

The goals of the Arkansas PDO program are to: develop a comprehensive PDO prevention program; reduce the number of Rx opioid overdose-related deaths and adverse events among Arkansans aged 18+; address behavioral health disparities among racial/ethnic minorities; and replicate a successful local police department naloxone program, Intranasal Naloxone Program. Two or three high-needs communities will be selected to be the target of community level grant activities. A PDO Advisory Council will make policy, recommend best practices, and complete strategic planning and the Community Services Contractor will implement community-based activities and build capacity for population-level change.

The Illinois PDO program will address three goals: expand existing infrastructure responsible for assessing, planning, and implementing strategies to prevent PDO-related deaths of those 18 years of age and older; reduce numbers of PDO-related deaths in six high need counties; and measure short and long-term outcomes. Five sub-recipients will serve six counties (63% of Illinois population) by delivering nine program components. They will be responsible for convening a local coalition, coordinating outreach and educational activities, delivering training activities for by-standers and first responders, purchasing and distributing Naloxone kits, and assisting IDHS/DCFS in complying with SAMHSA/CSAP data collection and reporting expectations. Over the course of the five-year grant period more than 25,500 Naloxone kits will be distributed.

The proposed Missouri Heroin Overdose Prevention and Education (MO-HOPE) project will
reduce prescription drug/opioid overdoses in Missouri through training, education, and distribution of naloxone to qualified individuals. MO- HOPE partners will develop and implement a comprehensive prevention and overdose reversal program that reduces opioid misuse and overdose deaths among individuals age 18+. The primary goals of MO-HOPE include reducing intentional, unintentional, and undetermined intentional opioid overdose through (1) overdose education and training initiatives; and (2) widespread distribution of naloxone. MO-HOPE will train at least 3,600 eligible professionals and provide 36,000 doses of naloxone during the grant award.

With the Opioid Overdose Prevention Network (OOPN) initiative, the NJ Division of Mental Health and Addiction Services (DMHAS) will receive real-time, statewide information about drug overdoses from the state's police fusion center that uses cutting edge data collection and transmission technology. This capability will allow DMHAS to almost immediately alert front- line practitioners and to make data-driven decisions about where to deploy prevention interventions, which includes community education and distribution of naloxone. A key aspect of our project will involve extensive training using a variety of formats and development of a naloxone distribution plan specific to this initiative. Plans are to reach 3,000 individuals through training and distribute a minimum of 2,500 naloxone kits annually.

The New Mexico will implement the PDO program in high need communities in New Mexico. The project aims to prevent overdose death through the: 1) purchase and distribution of naloxone for overdose reversal, and; 2) training to a wide variety of first responders to administer naloxone. In this initiative, training of first responders will include not only law enforcement and EMT officials, but also family members, friends and social networks, and organizations that work with people with addiction and who may be a first responder in the event of an overdose, such as treatment providers and shelters. Strategies that integrate overdose prevention and naloxone as a harm reduction strategy into state and local treatment program strategies and settings, including the state's Medicaid managed care programs, will be used.

The Oklahoma PDO initiative aims to prevent opioid overdose-related death and adverse events among individuals 18 years of age and older through a comprehensive and sustainable approach to overdose prevention education and naloxone distribution (OEND) and organizational/community capacity building. This will be accomplished through a strategic rollout of OEND services among high-need populations and policy development that will sustain program outcomes long-term. High-need populations for this project include: those with substance use disorder; those using opioids after a period of abstinence in drug courts and releasing from correctional settings; rural residents living long distances from hospital settings; and patients on opioid therapy.

With the goal of reducing the overall mortality related to opioid misuse, the South Carolina PDO Project will train first responders, and opioid use disorder patients and their family members to recognize opioid overdose and administer naloxone when overdose occurs. The development of a state-wide distribution system will make naloxone available and easily accessible to trained first responders and to at-risk citizens, despite their ability to pay for the medication. The objectives of this project are to establish statewide infrastructure for naloxone administration, increase the number of first responders and community members trained in the administration of naloxone by 25% each year of the grant, and to ensure access to naloxone for those individuals seeking treatment who are at risk of opioid overdose for each and every client that wishes to have the drug.

The Washington State Project to Prevent Prescription Drug/Opioid Overdose is a statewide network of organizations mobilizing communities, providing overdose response training, and distributing naloxone through syringe exchange programs in four high- need areas. Activities engage professional and lay first responders, pharmacies, local and regional stakeholders, and health care providers to reduce overdose risk and deaths among people who use heroin and prescription opioids. Core interventions include stakeholder engagement, overdose prevention/response training, and naloxone distribution.

The Wisconsin Prescription Drug/Opioid Overdose-Related Deaths Prevention Project (WI-PDO) will focus on the reduction of deaths and adverse events among individuals ages 18 years and older by training first responders and other key community sectors on the prevention of overdose-related deaths and implementing secondary prevention strategies, including the purchase and distribution of naloxone to first responders. Evidence-based prevention efforts for reducing problems related to the non-medical use of opioids will be funded in three high need counties in the first year. Wisconsin will use a comprehensive approach focusing on two main goals: 1) Reduce the number of opioid overdose-related deaths and adverse events by 10% among individual's ages 18 years and older; and 2) Develop and implement a comprehensive secondary prevention campaign to address opioid overdose-related deaths and adverse events in high risk communities.

The purpose of the West Virginia (WV) PDO program is to address the current overdose epidemic in WV by implementing and supporting a data-driven and collaborative process for preventing overdose-related deaths and adverse events among adults in high-risk WV communities. Goals of the program include (1) Reduce the number of Rx and illicit opioid overdose-related deaths and adverse events among persons aged 18 +and (2) Coordinate state- level overdose mortality, morbidity and prescription monitoring surveillance, prevention practice, and policy activities addressing Rx and illicit opioid overdose deaths and other adverse events among individuals aged 18+.

The Wyoming PDO programs aims to develop the infrastructure necessary to increase access and use of naloxone through funding, distribution, and collaborative training and education. The Wyoming PDO will implement evidence-based prevention strategies on state and community levels, targeting communities of high need. Program goals include: 1) Enhance system capacity/infrastructure, 2) Improve data infrastructure, and 3) Develop and implement an effective and comprehensive strategic prevention plan. The Strategic Prevention Framework (SPF) public health model, as well as SAMHSA's Opioid Overdose Prevention Toolkit will be fully utilized to implement data- driven and comprehensive opioid overdose prevention plans.