Franklin County Public Health's Overdose Prevention and Substance Use Surveillance Project - Introduction - Franklin County Public Health (FCPH) is applying for the CDC’s OD2A Limiting Overdose through Collaborative Action in Localities (LOCAL) grant, to sustain and enhance our efforts of Empowering Communities by Building Resilience in addressing the County’s addiction crisis. FCPH will apply for Component A, Component B, the optional ME/Coroner Component, and Component C to continue our collaborations with partners in the community, healthcare setting and public safety. FCPH proposes to expand its: use of data to drive action in reducing overdose morbidity and mortality; linkage to and retention in care and recovery, boots on the ground harm reduction efforts including naloxone distribution, while increasing implementation of clinician and health system best practices. FCPH has elected to prioritize populations that have been historically underserved and experience disparities in overdose morbidity and mortality. Priority populations include black males 45+, active users, those recently incarcerated, and individuals having recently experienced a drug overdose. Approach: FCPH in alignment with the Columbus and Franklin County Addiction Plan (CFCAP), Health Works Franklin County (HWFC) and the FCPH Equity Advisory Council (EAC) will utilize a collective impact model to reduce overdoses, drug overdose deaths, increase data capacity and surveillance, implement a surveillance system for drug product and paraphernalia testing, provide wrap around services for people who use substances, and decrease stigma in the County. Purpose: the CDC OD2A LOCAL funding will sustain and create greater reductions in overdose deaths by maintaining and expansion of programs, partnerships and systems created under the current OD2A grant. This application will develop interconnected networks of care between the community, public safety, and health systems settings. The work outlined will build linkage to and retention in care, enhance harm reduction efforts, reduce stigma, and develop clinical education programs informed by local morbidity/mortality data, drug testing, and the Cascade of Care (CoC) model. Outcomes: implementation of Components A - C will address a variety of obstacles faced by our target populations who often live in low opportunity areas. FCPH will emphasize the importance of addressing equity and the social determinants of health in alignment with our Community Health Improvement Plan (CHIP). By the end of the five-year performance period for OD2A: LOCAL, FCPH expects to achieve the following long-term outcomes: • Decrease fatal and nonfatal drug overdoses among all FC residents with a focus on populations disproportionately affected by overdose death. o Target populations: people using illicit opioids and stimulants, people that recently experienced an overdose, Black males, unsheltered individuals, and justice-involved individuals. • Improved health equity among target populations by identifying and closing gaps in access to care/services and increases in linkages to and retention in care. • Increased adoption of non-judgmental and empathetic harm reduction strategies, prioritizing meeting people where they are and reducing stigma. • Lead collaborative local surveillance of morbidity/mortality data and expansion of data on emerging drug threats for use in shared decision making. • Increase capacity for local surveillance infrastructure to collect, analyze, and report data on linkage to and retention in care among people at high risk of overdose to improve quality of care.