Plymouth County is located in southeastern Massachusetts, between Boston and Cape Cod. The county has more than 500,000 residents and is made up of a diverse array of 27 communities, ranging from small affluent New England towns to urban impoverished commercial areas. Originally conceived as a post-overdose crisis response program, the Plymouth County Outreach (PCO) has expanded far beyond its initial conceptualization to become a more comprehensive countywide recovery support and harm reduction initiative.

PCO has been recognized as innovative because it represents a substantive countywide partnership of specially selected and trained officers from all 28 police departments in the county (including one state university police department), recovery coaches, and hospitals committed to sharing information about overdoses and working collaboratively to support this important work. The program has been effective at breaking down the silos and even mitigating the periodic antagonism that had previously characterized the relationships between these stakeholders. PCO represents an authentic effort by forward-thinking police chiefs, health care professionals, the district attorney, sheriff, community providers, and members of the recovery community to reject the traditional excuses for not collaborating and to do something meaningful about the mounting overdose crisis that was devastating communities across Plymouth County. Perhaps most importantly, PCO has been successful in reducing both fatal and nonfatal overdose incidents throughout the county as evidenced by a 46 percent decrease in nonfatal overdose incidents between 2017 (1,529) and 2022 (822); and a 15 percent decrease in fatal overdose incidents between 2017 (147) and 2022 (125). Data from 2023 (as of November 2023) suggest the decline in overdose events is continuing with a 20 percent decrease in fatal incidents and a 17 percent decrease in nonfatal incidents so far between 2022 and 2023.