Maryland Overdose Fatality Review Program

Widely replicated outside Maryland, local multi-disciplinary teams review data behind overdose deaths to inform programs across the continuum of care

In 2014, Maryland enacted legislation allowing counties to form Local Overdose Fatality Review Teams (LOFRT) composed of a county health officer and staff from social service agencies, law enforcement, EMS, substance use treatment and prevention programs, and other agencies and individuals involved in responding to the opioid overdose crisis. Teams are given authority to access and analyze data from multiple sources to better understand factors involved in overdose deaths and provide timely feedback to improve overdose prevention efforts. Individual fatality case reviews are conducted to identify potential opportunities for interventions, programs, and strategies that, had they been available, may have prevented the fatality. Findings are communicated to the relevant responders and agencies via the participating team members. 

At least five states besides Maryland have implemented LOFRTs, including New Hampshire, Pennsylvania, Minnesota, Arizona and West Virginia (see here for program descriptions in these states), and a model law for establishing review teams has been developed. Detailed guides to implementing teams and their operation are available here and here.

Analyzing data on factors behind each overdose death is key to implementing effective overdose prevention programs.

Continuum of Care
Harm Reduction
Type of Evidence
Response Approach
Early Intervention
Overdose prevention
Peer-reviewed Article

Evidence of Program Effectiveness

"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." (Haas et al., 2018)