Rural Strategies

Rural and small communities have unique opportunities and challenges that shape their abilities to establish, expand, and sustain their overdose fatality review (OFR) efforts. There are resources designed to support and empower rural community leaders and multidisciplinary partners in rural communities to implement and enhance OFRs. Additional rural specific materials are available at Rural - Resource Library - COSSUP Resource Center to aid multidisciplinary teams to develop effective, collaborative strategies to address the drug overdose epidemic.

Opportunities

COSSUP Rural Initiatives
Rural Webinar Series
Rural Resources

COSSUP Rural Initiatives

The Reaching Rural Initiative brings together rural practitioners from different professional backgrounds and areas throughout the country to support them as they grow as leaders and advance solutions to address the persistent challenges of substance use in their communities. Learn more at Reaching Rural Initiative - Reaching Rural.

The Rural Responses to the Opioid Epidemic (RROE) project, co-funded by the Bureau of Justice Assistance, the Centers for Disease Control and Prevention, and the State Justice Institute, was developed to address the substance use crisis in rural America and build upon rural communities’ unique strengths by supporting 21 rural sites across the country to bring together local public safety, public health, and behavioral health stakeholders to address substance use disorder (SUD) and overdoses within their communities. Learn more in the RROE impact report.

Check out the impact report!

download impact report

Rural Webinar Series

This four-part webinar series invites rural jurisdictions to learn from their peers. Each session features multiple sites from rural communities that are demonstrating the innovative work made possible by rural partnerships through OFR.

Please register to reserve your spot for all sessions!

Webinar Session 1:
Developing Strategic Partnerships in Rural Communities

OFRs rely on multidisciplinary partnerships to share information, data, and insight to determine what intervention and prevention strategies are necessary to reduce drug-related deaths and empower a community response to substance use disorder. Hear from rural OFR facilitators and members to learn about their role, specific engagement strategies for diverse stakeholders, and how to develop strategic partnerships across sectors.

April 15th, 2025
Webinar Session 2:
Next-of-Kin Interviews and Grief Support

A next-of-kin (NOK) interview provides an in-depth look at how someone lived, their social supports, and the circumstances that led to an overdose death. NOK interviews are tools OFRs can use to expand their understanding of the life experiences of a decedent and identify nontraditional touchpoints or systems that may not be represented by OFR team members. Learn how rural OFRs utilize and implement their NOK process in their respective jurisdictions.

June 17th, 2025
Webinar Session 3:
Embedding Lived Experience in an OFR

Intentionally including individuals with lived experience allows for a more complete understanding of what effective community change can and should look like. Persons with lived experience can safely participate in and bring valuable insights to all aspects of the OFR process. Hear how these rural communities have meaningfully involved persons with lived experience in the OFR process.

August 19th, 2025
Webinar Session 4:
Data Collection and Dissemination

OFRs utilize aggregate and case-level data to better understand community context, trends, and needs. In rural communities, collecting data can be challenging. Learn how to collect, analyze, and disseminate relevant overdose datasets from rural OFR data managers.

October 21st, 2025

Rural Resources

Resources for Rural Substance Misuse Prevention

Online Resource - 1/23/2025

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A comprehensive library of tools, guides, and research tailored for rural communities addressing substance misuse and overdose prevention. These materials are available to aide multidisciplinary teams to develop effective, collaborative strategies to address the drug overdose epidemic.
A comprehensive library of tools, guides, and research tailored for rural communities addressing substance misuse and overdose prevention.

COSSUP Rural Resources

Online Resource - 12/1/2024

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COSSUP Rural Resources

Overdose Fatality Review Board in Rural Arizona a Blueprint for Success in Combating Substance Use

Article - 12/21/2023

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Rural communities possess the social networks, resourcefulness, and resolve to reduce overdose deaths if they are able to equip local stakeholders with the partnerships and data they need to produce effective responses. Overdose fatality reviews (OFRs) have emerged in recent years as ideal vehicles to deliver those responses sustainably. Learn how the OFR Board in Yavapai County, Arizona, was instrumental in helping to reduce overdose deaths in the county by 18 percent from 2020 to 2022, following a 108 percent increase from 2017 to 2020
Overdose Deaths Decline Among Youth in Yavapai County, Thanks to Naloxone Distribution and Fentanyl Awareness Campaign

Sauk County, Wisconsin OFR Mentor Site Podcast

Podcast - 11/16/2023

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This podcast highlights a conversation with the facilitator from an OFR mentor Site. The Sauk County Overdose Death Review Team is managed by Public Health Sauk County and is a rural county-led OFR team, established in 2018. It is currently funded by the CDC Overdose Data to Action grant.
This is a podcast featuring an OFR mentor site.

Yavapai County, Arizona OFR Mentor Site Podcast

Podcast - 11/16/2023

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This podcast highlights a conversation with the facilitator from an OFR mentor Site. The Yavapai County OFR Board is managed by MATFORCE, a substance abuse coalition, and is a county-led OFR board, established in 2016.
This is a podcast featuring an OFR mentor site.

2021 National Virtual Forum on Overdose Fatality Review: Mock OFR Review 2: Rural Review

Video - 2/25/2021

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A mock OFR team conducts a rural overdose fatality review.
A mock OFR team conducts a rural overdose fatality review.