California Opioid Safety Coalition

A statewide network of 16 local coalitions in 23 counties focused on safe opioid prescribing, expanding use of medications for opioid use disorder, and wider access to naloxone

In response to the opioid crisis, the California Health Care Foundation (CHCF) launched the California Opioid Safety Network (COSN): 16 community coalitions with the objective of supporting three main strategies:

  • educating providers on the safe prescribing of opioids
  • expanding use of buprenorphine as a medication for opioid use disorder (MOUD)
  • increasing the availability of naloxone for reversing opioid overdoses

CHCF provided technical assistance to form coalitions and support implementation of the strategies.

At its website, COSN provides informational resources and tools on:

  • safe prescribing
  • alternative treatment for pain
  • MOUD
  • naloxone distribution
  • harm reduction
  • building sustainable coalitions
  • measuring and communicating outcomes
  • planning for sustainable partnerships

Participating coalition counties have built unprecedented partnerships and engagement across sectors.

Continuum of Care
Type of Evidence
Report with evaluation
Response Approach
Cautious Opioid Prescribing
Medications for Opioid Use Disorder
Overdose prevention
Peer-reviewed Article

Evidence of Program Effectiveness

In the peer-reviewed literature:

"Having a county coalition was associated with a 2% decrease in the opioid prescribing rate; receiving Initiative support was associated with an additional 2% decrease...county coalitions were associated with a 21% decrease in prescription opioid overdose deaths." (Henry et al., 2021)

In an evaluation report:

  • 90% of coalitions developed and/or promoted safe prescribing guidelines that were adopted by primary care and emergency department facilities
  • >50% of coalitions sponsored buprenorphine waiver trainings, conducted outreach to primary care offices to encourage buprenorphine prescribing, or worked with community clinics to integrate addiction treatment into primary care. 80% of coalitions also promoted other addiction medications such as naltrexone
  • >75% of coalitions worked with providers to co-prescribe naloxone with opioids and/or supported pharmacies in ensuring naloxone availability. More than two-thirds of coalitions also worked closely with first responders to carry naloxone

Program evidence found here