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For all the national media attention it has attracted, the opioid crisis remains a local problem, demanding that local governments try innovative strategies to fit their communities’ unique needs. Many do this through the Opioid Mapping Initiative (OMI), a coalition of 17 local governments, universities, and nonprofits who meet monthly to swap insights, share best practices, and test their theories of change. This report documents the efforts of the Opioid Mapping Initiative through its first year. On the following pages, case studies are included from a variety of the participating local governments, as well as maps showing a national perspective on various aspects of the opioid epidemic.