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  1. Overdose Prevention Strategy
  2. Primary Prevention

Primary Prevention

Prevention is critical to reducing overdoses and overdose deaths. The strategy promotes tiered, multidisciplinary prevention activities, ranging from population-level strategies to targeted interventions aimed at high-risk individuals. These activities engage health and human services providers directly and facilitate cross-sector collaboration on prevention. 

This page highlights current federal activities that support prevention by expanding research of new and improved prevention efforts, investing in community resources to help prevent harms related to substance use, increasing access to high-quality pain management to reduce preventable suffering, and promoting responsible prescription of medications to protect patient safety.

 

Support research and surveillance to develop and improve delivery of prevention interventions.

Featured Activity

The HEAL Preventing Opioid Use Disorder Research Program

This program aims to prevent opioid misuse and use disorder through investments in research on risk identification; intervention development; social determinants, health equity, and policy; and dissemination, implementation, and sustainability of effective prevention strategies.

Learn more about the program

Lead Agency:
NIH

Surveillance for Overdose and Substance Use Related Harms

Lead Agency:
CDC

NIH's Adolescent Brain and Cognitive Development (ABCD) Study

Lead Agency:
NIH
Partner Agency:
CDC

Transformed-Medicaid Statistical Information System (T-MSIS) Data for Substance Use Disorder Trends

Lead Agency:
CMS

Facilitate the development and implementation of evidence-based primary prevention across the lifespan.

Featured Activity

Strategic Prevention Framework - Partnerships for Success (SPF-PFS) grant program

SPF-PFS provides grants for states and grants for communities, local governments, universities, colleges and tribes/tribal organizations. A foundational investment for substance use prevention in the U.S., the program focuses on preventing substance use initiation and reducing the progression of substance use and related problems by supporting the development and delivery of state and community substance use prevention and mental health promotion strategies. In FY 2023, SAMHSA awarded $42.6 million in SPF-PFS grants to 17 states and 60 communities.

View the SPF-PFS grant recipients

Lead Agency:
SAMHSA

Overdose Data to Action (OD2A)

Lead Agency:
CDC

Preventing Adverse Childhood Experiences: Data to Action

Lead Agency:
CDC

2021 State Pilot Grant Program for Treatment for Pregnant and Postpartum Women

Lead Agency:
SAMHSA

Prioritize Opioid Treatment Program (OTP) Admissions for Pregnant Patients

Lead Agency:
SAMHSA

Support development of and promote evidence-based treatments to effectively manage pain.

Featured Activity

CDC Guideline for Prescribing Opioids – United States, 2022 and Other Health System Activities

CDC is updating and expanding the 2016 Guideline for Prescribing Opioids for Chronic Pain, based on updated evidence and data, drawing from the contributions of multiple stakeholder groups of researchers, patients, providers, and other key participants. The updated guideline will be supplemented with a set of enhanced communication resources and training materials.

Explore frequently asked questions on prescribing opioids for chronic pain

Lead Agency:
CDC
Partner Agency:
AHRQ, CMS, FDA, HHS, HRSA, IHS, NIH, ONC, SAMHSA

NIH HEAL Initiative Clinical Research in Pain Management

Lead Agency:
NIH

Systematic Review Series on Pain Management

Lead Agency:
AHRQ
Partner Agency:
CDC

Reduce clinically inappropriate prescribing of medications with misuse potential.

Featured Activity

Addressing the Safe Use of Benzodiazepines

To better educate the patient and prescriber communities about the safe use of benzodiazepines (medications also known as sedatives or tranquilizers), the FDA is working with the medical community to improve patient education, support research on tapering and withdrawal, and more effectively gather perspectives from patients, providers and communities.

Learn about the safe tapering guideline

Lead Agency:
FDA

Over Prescriber Support Strategy (OPSS)

Lead Agency:
CMS

General Research.

Featured Activity The impact of hydrocodone rescheduling on utilization, abuse, misuse, and overdose deaths

Lead Agency:
FDA

Acute pain pathways: protocol for a prospective cohort study

Lead Agency:
FDA

Evaluating opioid analgesic prescribing limits: A narrative review

Lead Agency:
FDA
Partner Agency:
CDC, NIH

Assessment of a Modified Sandwich Estimator for Generalized Estimating Equations with Application to Opioid Poisoning in MIMIC-IV ICU Patients

Lead Agency:
FDA

This is your teen brain on drugs: In search of biological factors unique to dependence toxicity in adolescence

Lead Agency:
FDA

Pain Severity and Interference and Substance Use among Community Pharmacy Patients Prescribed Opioids: A Secondary Analysis of the PHARMSCREEN Study

Lead Agency:
NIH

Assessment of Screening Tools to Identify Substance Use Disorders Among Adolescents

Lead Agency:
NIH

Development and implementation of a prescription opioid registry across diverse health systems

Lead Agency:
NIH

Development and implementation of a prescription opioid registry across diverse health systems

Lead Agency:
NIH

A Brief Screening and Assessment Tool for Opioid Use in Adults: Results from a Validation Study of the Tobacco, Alcohol, Prescription Medication, and Other Substances Tool

Lead Agency:
NIH

AI-based analysis of social media language predicts addiction treatment dropout at 90 days

Lead Agency:
NIH

Methodological Strategies for Prospective Harmonization of Studies: Application to 10 Distinct Outcomes Studies of Preventive Interventions Targeting Opioid Misuse

Lead Agency:
NIH

Need for comprehensive and timely data to address the opioid overdose epidemic without a blindfold

Lead Agency:
NIH

Including Community Partners in the Development and Adaptation of Intervention Strategies to Prevent Initiation or Escalation of Opioid Misuse

Lead Agency:
NIH

COVID-related social determinants of substance use disorder among diverse U.S. racial ethnic groups

Lead Agency:
NIH

Transforming the Future of Adolescent Health: Opportunities from the Adolescent Brain Cognitive Development Study

Lead Agency:
NIH

The prevalence of opioid use disorder in Kentucky's counties: A two-year multi-sample capture-recapture analysis

Lead Agency:
NIH

Linguistic predictors from Facebook postings of substance use disorder treatment retention versus discontinuation

Lead Agency:
NIH

The Rural Opioid Initiative Consortium description: providing evidence to Understand the Fourth Wave of the Opioid Crisis

Lead Agency:
NIH

Prevention of Opioid Use and Disorder Among Youth Involved in the Legal System: Innovation and Implementation of Four Studies Funded by the NIDA HEAL Initiative

Lead Agency:
NIH

Culturally Responsive Opioid and Other Drug Prevention for American Indian/Alaska Native People: A Comparison of Reservation- and Urban-Based Approaches

Lead Agency:
NIH

Leveraging the Full Continuum of Care to Prevent Opioid Use Disorder

Lead Agency:
NIH

Predicting U.S. county opioid poisoning mortality from multi-modal social media and psychological self-report data

Lead Agency:
NIH

Introduction to Helping to End Addiction Long-Term Prevention Cooperative: Overview and Strategies

Lead Agency:
NIH

Measuring disadvantage: A systematic comparison of United States small-area disadvantage indices

Lead Agency:
NIH

Opioid death projections with AI-based forecasts using social media language

Lead Agency:
NIH

Role of the media in promoting the dehumanization of people who use drugs

Lead Agency:
NIH

The impact of the national stay-at-home order on emergency department visits for suspected opioid overdose during the first wave of the COVID-19 pandemic

Lead Agency:
NIH

Opioid Use Disorder Among Ohio's Medicaid Population: Prevalence Estimates From 19 Counties Using a Multiplier Method

Lead Agency:
NIH

Disparities in Opioid Overdose Death Trends by Race/Ethnicity, 2018-2019, From the HEALing Communities Study

Lead Agency:
NIH

Racial and Ethnic Disparities in Drug Overdose Deaths in the US During the COVID-19 Pandemic

Lead Agency:
NIH
Partner Agency:
CDC

Impact of Medicaid expansion and methadone coverage as a medication for opioid use disorder on foster care entries during the opioid crisis

Lead Agency:
CDC

Cannabis sales increases during COVID-19: Findings from Alaska, Colorado, Oregon, and Washington

Lead Agency:
CDC

Notes from the Field: Testing for Nonprescribed Fentanyl and Percentage of Positive Test Results Among Patients with Opioid Use Disorder — United States, 2019–2020

Lead Agency:
CDC

Opioid Overdose Surveillance: Improving Data to Inform Action

Lead Agency:
CDC

Prevalences of and Characteristics Associated with Single-and Polydrug-Involved U.S. Emergency Department Visits in 2018

Lead Agency:
CDC

Trends and Characteristics of Drug Overdose Deaths Involving Illicitly Manufactured Fentanyls - United States, 2019-2020

Lead Agency:
CDC

The evolution of the overdose epidemic and CDC's research response: A commentary

Lead Agency:
CDC

Association between county-level sociodemographic characteristics and county-level differences in opioid dispensing

Lead Agency:
CDC

Drug overdose deaths involving cocaine and psychostimulants with abuse potential among racial and ethnic groups - United States, 2004-2019

Lead Agency:
CDC

Impact of Community-Level Prevention Strategies on High-Dose Opioid Dispensing Rates: 2014-2019

Lead Agency:
CDC

Congruence of opioid prescriptions and dispensing using electronic records and claims data

Lead Agency:
CDC

Characteristics of Adults Reporting Illicitly Manufactured Fentanyl or Heroin Use or Prescription Opioid Misuse in The United States, 2019

Lead Agency:
CDC

Signals of increasing co-use of stimulants and opioids from online drug forum data

Lead Agency:
CDC

Concerns among people who use opioids during the COVID-19 pandemic: a natural language processing analysis of social media posts

Lead Agency:
CDC

Evaluating opioid analgesic prescribing limits: A narrative review

Lead Agency:
FDA
Partner Agency: 
CDC, NIH

Notes from the Field: Increase in Drug Overdose Deaths Among Hispanic or Latino Persons — Nevada, 2019–2020

Lead Agency:
CDC
 

Drugs and Drug Classes Involved in Overdose Deaths Among Females, United States: 1999-2017

Lead Agency:
CDC
 

Prescription History Among Individuals Dispensed Opioid Prescriptions, 2017-2020

Lead Agency:
CDC
 

Adverse Childhood Experiences and Overdose: Lessons from Overdose Data to Action

Lead Agency:
CDC
 

The Martinsburg Initiative: a collaboration between public safety, public health, and schools to address trauma and substance use

Lead Agency:
CDC
 

Development and Validation of a Syndrome Definition for Suspected Nonfatal Unintentional/Undetermined Intent Stimulant-Involved Overdoses

Lead Agency:
CDC
 

Notes from the Field: Trends in Gabapentin Detection and Involvement in Drug Overdose Deaths — 23 States and the District of Columbia, 2019–2020

Lead Agency:
CDC
 

Drug Overdose Deaths in 28 States and the District of Columbia: 2020 data from the State Unintentional Drug Overdose Reporting System

Lead Agency:
CDC
 

Methamphetamine use in the United States: epidemiological update and implications for prevention, treatment, and harm reduction

Lead Agency:
CDC
Partner Agency:
NIH

Characteristics of Adults Aged ≥18 Years Evaluated for Substance Use and Treatment Planning – United States, 2019

Lead Agency:
CDC

CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022

Lead Agency:
CDC

Self-Reported Medical and Nonmedical Cannabis Use: Results from the 2018 Behavioral Risk Factor Surveillance System in 14 States

Lead Agency:
CDC

Trends and characteristics of cannabis-associated emergency department visits in the United States, 2006-2018

Lead Agency:
CDC

Patterns in Nonopioid Pain Medication Prescribing After the Release of the 2016 Guideline for Prescribing Opioids for Chronic Pain

Lead Agency:
CDC

Project ECHO interprofessional telementoring: Using a novel case-based approach for building the U.S. Public Health Service clinical response in pain and substance use disorder

Lead Agency:
CDC
Partner Agency:
OIG

The Overdose Response Strategy: Reducing Drug Overdose Deaths Through Strategic Partnership Between Public Health and Public Safety

Lead Agency:
CDC

Notes from the Field: Overdose Deaths Involving Para-fluorofentanyl — United States, July 2020–June 2021

Lead Agency:
CDC

Estimating Weekly National Opioid Overdose Deaths in Near Real Time Using Multiple Proxy Data Sources

Lead Agency:
CDC

Trends in Concurrent Opioid and Benzodiazepine Prescriptions in the United States, 2016 to 2019

Lead Agency:
CDC

A qualitative assessment of circumstances surrounding drug overdose deaths during the early stages of the COVID-19 pandemic

Lead Agency:
CDC

Risk factors for COVID-19 among persons with substance use disorder (PWSUD) with hospital visits - United States, April 2020-December 2020

Lead Agency:
CDC

Vital Signs: Drug Overdose Deaths, by Selected Sociodemographic and Social Determinants of Health Characteristics - 25 States and the District of Columbia, 2019-2020

Lead Agency:
CDC

Increases in Disparities in US Drug Overdose Deaths by Race and Ethnicity: Opportunities for Clinicians and Health Systems

Lead Agency:
CDC

First Responder Assertive Linkage Programs: A Scoping Review of Interventions to Improve Linkage to Care for People Who Use Drugs

Lead Agency:
CDC

Understanding State-Level Variations in Implementing Academic Detailing for Prescribing Opioids: Findings from 11 States Within the United States

Lead Agency:
CDC

Dose tapering, increases, and discontinuity among patients on long-term high-dose opioid therapy in the United States, 2017-2019

Lead Agency:
CDC

Evidence of the emergence of illicit benzodiazepines from online drug forums

Lead Agency:
CDC

Changes in Opioid Dispensing by Medical Specialties after Release of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain

Lead Agency:
CDC

Clarifying CDC’s Efforts to Quantify Overdose Deaths

Lead Agency:
CDC

Notes From the Field: Overdose Deaths Involving Eutylone (Psychoactive Bath Salts) — United States, 2020

Lead Agency:
CDC

Pilot Case Study: A Framework for Multisector Public Health and Safety Teams Addressing the Overdose Epidemic

Lead Agency:
CDC

From Silos to Synergy: Public Health and Public Safety Collaborations to Reduce Drug Overdose

Lead Agency:
CDC

Improving Partnerships Between Public Health and Public Safety to Reduce Overdose Deaths: An Inventory from the CDC Overdose Data to Action Funding Initiative

Lead Agency:
CDC

Patient-Level and County-Level Trends in Nonfatal Opioid-Involved Overdose Emergency Medical Services Encounters — 491 Counties, United States, January 2018-March 2022

Lead Agency:
CDC

Analysis of trends and usage of ICD-10-CM discharge diagnosis codes for poisonings by fentanyl, tramadol, and other synthetic narcotics in emergency department data

Lead Agency:
CDC

Facilitating Overdose Risk Mitigation Among Patients Following a Clinician Office Closure: A Connecticut Case Study of the Opioid Rapid Response Program

Lead Agency:
CDC
Partner Agency:
OIG

Unintentional ingestion of putative delta-8 tetrahydrocannabinol by two youth requiring critical care: A case report

Lead Agency:
CDC

Associations between prescription stimulant use as prescribed, nonmedical use, and illicit stimulant use among adults evaluated for substance use treatment, 2017-2021

Lead Agency:
CDC

Factors That Affect Opioid Quality Improvement Initiatives in Primary Care: Insights from Ten Health Systems

Lead Agency:
CDC

Change in opioid and buprenorphine prescribers and prescriptions by specialty, 2016–2021

Lead Agency:
CDC

Increases in methamphetamine injection among treatment admissions in the U.S.

Lead Agency:
CDC
Partner Agency:
NIH

Cannabis-Involved Emergency Department Visits Among Persons Aged< 25 Years Before and During the COVID-19 Pandemic—United States, 2019–2022

Lead Agency:
CDC

Characterization of Nonfatal Opioid, Cocaine, Methamphetamine, and Polydrug Exposure and Clinical Presentations Reported to the Toxicology Investigators Consortium Core Registry, January 2010-December 2021

Lead Agency:
CDC

School Connectedness and Risk Behaviors and Experiences Among High School Students — Youth Risk Behavior Survey, United States, 2021

Lead Agency:
CDC

County-level social vulnerability and nonfatal drug overdose emergency department visits and hospitalizations, January 2018–December 2020

Lead Agency:
CDC

Medication-Associated Diethylene Glycol Mass Poisoning – A Preventable Cause of Illness and Death

Lead Agency:
CDC

Drug Overdose Deaths with Evidence of Counterfeit Pill Use — United States, July 2019–December 2021

Lead Agency:
CDC

Trends and Characteristics of Buprenorphine-Involved Overdose Deaths Prior to and During the COVID-19 Pandemic

Lead Agency:
CDC
Partner Agency:
NIH

Suspected Nonfatal Cocaine-Involved Overdoses Overall and with Co-involvement of Opioids

Lead Agency:
CDC

Medical Costs of Substance Use Disorders in the US Employer-Sponsored Insurance Population

Lead Agency:
CDC

Hospitalization Associated with Comorbid Psychiatric and Substance Use Disorders Among Adults with COVID-19 Treated in US Emergency Departments from April 2020 to August 2021

Lead Agency:
CDC

Illicitly Manufactured Fentanyl-Involved Overdose Deaths with Detected Xylazine-United States, January 2019-June 2022

Lead Agency:
CDC

Longitudinal dose patterns among patients newly initiated on long-term opioid therapy in the United States, 2018 to 2019: An observational cohort study and time-series cluster analysis

Lead Agency:
CDC

Achieving Reductions in Opioid Dispensing: A Qualitative Comparative Analysis of State-Level Efforts to Improve Prescribing

Lead Agency:
CDC

Chronic Pain Among Adults - United States, 2019-2021

Lead Agency:
CDC

Scope of, Motivations for, and Outcomes Associated with Buprenorphine Diversion in the United States: A Scoping Review

Lead Agency:
CDC

Supporting Evidence-Based Care Through Informatics Innovation to Address the Overdose Epidemic

Lead Agency:
CDC

HEAL Preventing Opioid Use Disorder: A Vision for Research to Increase Access to Prevention Services

Lead Agency:
NIH