This study compiled and detailed recommendations from Maryland Local Overdose Fatality Review Teams (LOFRTs) to provide state and local health departments with innovative strategies to address the worsening opioid epidemic and overdose-related deaths. LOFRTs consist of jurisdictional multiagency, multidisciplinary teams that share data to critically examine drug overdose cases. Goals include identification of risk factors and intervention opportunities to inform overdose prevention programs and policy. The authors qualitatively analyzed reports from Maryland LOFRTs case reviews to categorize outcomes and assess using frequency analyses. A total of 9 macro-level categories emerged from the review of approximately 361 recommendations from LOFRTs. Most recommendations related to Prevention Education, Integrated Care, and Harm Reduction strategies. Overdose fatality review is an effective means of understanding the opioid epidemic, strengthening coordinated interventions, and informing local and state health department overdose prevention strategic planning. Teams have a unique vantage point from which to view systems-level gaps and policy issues because of their collaborative nature and the quality of data provided by agencies that directly served decedents.
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