Opioid Safety Coalitions -- American Opioid Project
Note: This form is open to opioid safety coalitions and nonprofits, as well as substance abuse prevention coalitions and nonprofits that cover opioids. The responses below may be posted on the American Opioid website and/or social media pages, in whole or in part. Questions may be directed to Jamal Khan at jamalkhan@americanopioid.org.
Email address *
Name *
Your answer
Title *
Your answer
Coalition Name *
Your answer
City or County *
Your answer
State *
Your answer
Briefly, how would you describe the opioid crisis in your region? *
Your answer
What are your coalition's objectives? *
Your answer
What are up to three major challenges your coalition faces in fulfilling its objectives? *
Your answer
How much support have you received from government public health agencies, elected officials, and other nonprofit organizations? *
Your answer
If you had a magic wand that allowed you to make any policy change you wanted to more effectively alleviate the opioid crisis in your area, what would that change be, and why? *
Your answer
Are there any additional thoughts you would like to share? (optional)
Your answer
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