Overdose deaths have declined in the United States for two years in a row, a promising trend and a reminder that we must continue to build and support evidence-driven, health-oriented responses to the overdose crisis. Through partnerships with states, local jurisdictions, Native communities, care providers and people who use drugs, Vital Strategies continues to support and scale practical and innovative solutions—promoting a healthier and more equitable landscape for people who use drugs.
Read on to learn more about 12 standout projects from 2025.
Access to Medications for Opioid Use Disorder Expands Across Pennsylvania
We continued to collaborate with community partners and government agencies across Pennsylvania to expand medications for opioid use disorder access, including in carceral settings. The landscape of treatment available to incarcerated people has been thoroughly transformed since we began work in Pennsylvania several years ago. In January 2025, the Pennsylvania Department of Corrections began providing screening for substance use treatment needs at all state correctional facilities and is now offering initiation of buprenorphine treatment to incarcerated people.
Moreover, the Pennsylvania Institutional Law Project has worked for several years with Vital Strategies’ support to advocate for treatment access. This year they released “Let Us Live,” a storytelling project highlighting the voices of currently and formerly incarcerated people with opioid use disorder. With funding support from Vital Strategies, the project aims to reduce stigma and discrimination against incarcerated people with opioid use disorder, while also working toward increasing access to medications for opioid use disorder for incarcerated people in Pennsylvania.
Overdose Prevention Efforts Helped to Reduce Deaths in Michigan
Since 2019, Vital Strategies has worked with state agencies, community partners, and local leaders across Michigan to expand overdose prevention resources, and the impact is notable. A study released by the Michigan Department of Health and Human Services examining the state’s overdose prevention efforts between 2017 and 2024 found that harm reduction programs helped save lives. More specifically, the study reported that more than 1,650 prevented deaths and more than 13,000 prevented hospitalizations are attributable to the expansion of harm reduction in Michigan during this period. The study names efforts that Vital Strategies helped to shape, such as the launch of the state’s Naloxone Direct Portal and the expansion of syringe services programs.
Vital Strategies Staff at the Kentucky Association of Counties Create New Statewide Resources
Through the work of Vital Strategies embedded staff, the Kentucky Association of Counties (KACo) has implemented practices and achieved key milestones toward guiding counties on settlement funds planning, creating opportunities to promote evidence-based practices like harm reduction and low-barrier medications for opioid use disorder. KACo has launched an online resource library with FAQs, templates and planning tools, and other best-practice information. KACo has also been conducting county surveys to assess current spending priorities, better understanding where there is interest or resistance to investment toward access to medications for opioid use disorder.
Drug Checking Services Grow in New Jersey
The Kind Collective, with support from Vital Strategies, launched mail-based drug checking services in Paterson, NJ, during the summer of 2025. The team at The Kind Collective also increased harm reduction outreach in underserved areas of Trenton, NJ, and distributed over 3,700 lifesaving resources such as naloxone and drug checking supplies. The organization hosted community pop-ups and trainings on drug-checking tools and overdose prevention across the state, and presented their innovative Project-News program to regional partners, building momentum for broader collaboration across the state.
Guidance Continues on Opioid Settlement Funds Spending in New Mexico’s Doña Ana County
Vital Strategies continued to provide technical guidance to Doña Ana County on the development of a strategic plan for spending of opioid settlement funds. Informed by Vital Strategies’ recommendations, four strategies were formally selected by county officials for the initial use of opioid settlement funds: Medication Assisted Treatment; Warm Hand-Off Programs/Recovery Services; Prevention Programs, and; Data Collection/Research. Vital Strategies is issuing a grant to the county that will fund two staff positions to implement and monitor these strategies with technical assistance on program and policy, and the application of data collection and metrics tools, developed for this purpose by Vital Strategies’ collaboration with partners at Johns Hopkins Bloomberg School of Public Health and others.
Project CARA: Supporting Pregnant and Parenting People with Substance Use Disorders
Project “Care that Advocates Respect/Resilience/Recovery for All” (CARA), originally founded in 2014 by the Mountain Area Health Education Center, provides evidence-based care for pregnant and parenting people with substance use disorders. With support from Vital Strategies, Project CARA is providing additional support to partner clinics across Western North Carolina, improving access to perinatal substance use care. This funding from Vital Strategies also supports regular education for providers, including quarterly trainings, a retreat, and a statewide Perinatal Substance Exposure Summit, along with updates to the Transitions, Access, and Continuity of Care resource tool.
Scaling Community Engagement in Milwaukee with Samad’s House
Vital Strategies continued to work with Samad’s House, a solution-based harm reduction organization and sober living home for women with substance use disorders, on strengthening community naloxone access in Milwaukee, WI. Samad’s House Harm Reduction Ambassadors provided free training on how to use naloxone at numerous Milwaukee events throughout the year, and all staff were certified to train trainers on naloxone administration. In addition, Samad’s House founder Tahira Malik was featured in the PBS Independent Lens documentary, “Coming Home.” The film can be viewed here.
Legal Action Center and Disability Rights North Carolina Reach Settlement in Discrimination Case Against Care Facility
In August 2025, Vital Strategies partner Legal Action Center, working with Disability Rights North Carolina, reached a settlement in a case against Sunnybrook Rehabilitation, challenging discrimination at the skilled nursing facility against patients with substance use disorder. This case has the potential to set a precedent for facilities across the U.S., which includes adopting new antidiscrimination policies.
“The Americans with Disabilities Act prohibits the denial of health services to people on the basis of current drug use,” Rebekah Joab, an attorney with the New York-based Legal Action Center, told STAT. “Somebody with the disability of substance use disorder has to be treated the same as anyone else.”
“You Have the Power to Save Lives”
Vital Strategies launched a major communication campaign, “You Have the Power to Save Lives in March 2025 to address the overdose crisis in Black communities. The campaign was designed to raise awareness and promote the availability of naloxone across seven cities—Newark, NJ; Durham, NC; Philadelphia, PA; Detroit, MI; Louisville, KY; Milwaukee, WI; and Albuquerque, NM—uniting community leaders, public officials, and health experts to spread the word. Partners included the National Black Harm Reduction Network, the Elton John AIDS Foundation, Ghost Note Agency, Zebra Strategies, and Sharda Sekaran Consulting. In November, the campaign won three silver awards in the 2025 Anthem Awards in recognition of its widespread impact.
Indigenous Initiatives: Funding Grants for Culturally Based Harm Reduction by and for Native Communities in New Mexico
To address health inequities in Native communities, Vital Strategies partnered with the New Mexico Tribal Behavioral Health Providers Association and Americans for Indian Opportunity to launch Culturally Based Harm Reduction by and for Native Communities in New Mexico, a yearlong funding initiative that will distribute $1.68 million to Native nations, Tribal health programs, Native-led organizations, and Native-focused initiatives. The 16 grantees selected will implement community-based solutions to overdose that center Indigenous harm reduction principles and practices, drawing on the strengths of Indigenous cultures in developing responses to the overdose crisis.
American Society for Addiction Medicine Guide Published: “Prescribing Controlled Psychostimulants for Stimulant Use Disorder”
With the American Society for Addiction Medicine, Vital Strategies published a legal landscape explainer for controlled stimulant prescribing as medication treatment for stimulant use disorder. The resource provides practitioners with an overview of the federal legal framework, a step-by-step guide on assessing state-level legal considerations for prescribing, and additional resources. It is designed to be a complementary document to clinical guidance on stimulant use disorder, so that practitioners can understand both best clinical practices and the policy landscape for those practices., so that practitioners can understand both best clinical practices and the policy landscape for those practices.
Guaranteed Income Pilot Launches in Wisconsin and New Jersey
A guaranteed income pilot program rolled out in Wisconsin and New Jersey to provide direct monthly financial support to pregnant and parenting people with substance use disorders towards the goal of improving treatment retention and reducing overdose mortality. The program provides $500 monthly cash transfers to participants for 12 consecutive months. Since launching the program in July, over 50 people have been enrolled across the two recruitment cities. The project implementation partner FORWARD has collaborated with partners in Camden, New Jersey and Milwaukee, Wisconsin to recruit program participants and collect data on spending.
Vital Strategies is working with the Johns Hopkins team to evaluate the program’s success, with the goal of expanding to other cities and local jurisdictions. Initial surveys were already completed and a follow-up survey, along with qualitative interviews, are planned for spring 2026. In the upcoming year we look forward to continuing our efforts to advance solutions to the overdose crisis grounded in health-based and evidence-driven practices, centering racial equity and human dignity. Read our December newsletter to learn about some of our work from the last quarter of 2025.
About Vital Strategies’ Overdose Prevention Program
Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. Our overdose prevention program works to strengthen and scale evidence-based, data-driven policies and interventions to create equitable and sustainable reductions in overdose deaths in several U.S. states and local jurisdictions.