Substance use disorder has taken a tremendous toll in the United States in lives lost, families destroyed, personal incomes disrupted, and the associated childhood trauma causing intergenerational substance use disorder. This has devastating consequences for the health of communities collectively, adding to the structural stress of neighborhoods through the grief of fatal overdoses, lost income, suboptimal parenting, the harms of arrest and incarceration, and the collateral consequences that spin off from the disease of substance use disorder and addiction. From 2010 to 2019, fatal overdoses in Pima County, Arizona, home to Tucson, have increased by over 52 percent. In this same period, there have been increases in costs to health care, criminal justice, and behavioral health systems related to substance use disorder. For the past five years, fatal overdoses in Pima County have eclipsed the number of deaths from homicides and motor vehicle collisions combined.

The opioid epidemic has challenged public health, harm reduction organizations, and the criminal justice system, specifically police, to find alternatives to address this crisis rather than arrest and incarceration. Creative and innovative strategies put forth by thought leaders in policing, social services, and public health have grown in size and scope over the past several years.