








































The Role of Community Coordinated Efforts in Combating the Opioid Overdose Crisis


COMMONWEALTH, Volume 20, Issue 1 (2018). © 2018 The Pennsylvania Political Science Association.  
ISSN 2469-7672 (online). http://dx.doi.org/10.15367/com.v20i2-3.192. All rights reserved.

The Role of Community Coordinated 
Efforts in Combating the Opioid  
Overdose Crisis

The Pennsylvania Opioid Overdose Reduction 

Technical Assistance Center

LYNN S. MIRIGIAN
Program Evaluation Research Unit,  

University of Pittsburgh School of Pharmacy

MARCO F. PUGLIESE
Program Evaluation Research Unit,  

University of Pittsburgh School of Pharmacy

JANICE L. PRINGLE
Program Evaluation Research Unit,  

University of Pittsburgh School of Pharmacy

MONICA F. GAYDOS
Program Evaluation Research Unit,  

University of Pittsburgh School of Pharmacy

The Pennsylvania Opioid Overdose Reduction Technical Assistance Center 
(TAC) was developed by the University of Pittsburgh, School of Pharmacy, Pro-
gram Evaluation and Research Unit (PERU) and funded by the Pennsylvania 
Commission on Crime and Delinquency (PCCD) in response to the need for local 
coordination and supported efforts to address the growing number of opioid 
overdoses in Pennsylvania. This article outlines the TAC’s initiatives to address 
this crisis in 42 counties across the Commonwealth of Pennsylvania, stressing the 
importance of communication and collaboration both within and between com-
munities, such as public health, public safety, first responders, physicians, the 
criminal justice system, and families. The TAC uses the Implementation Frame-
work (IF) developed by Dr. Janice Pringle to achieve accurate data assessment 
and the effective implementation, evaluation, and sustainability of programs.

The increasing number of deaths each year due to opioid drug over-
dose represents an urgent crisis in this country, and more specifically, 
in Pennsylvania. According to the Centers for Disease Control and 



148 Lynn S. Mirigian, Marco F. PugLieSe, Janice L. PringLe, anD Monica F. gayDoS

Prevention (CDC), “In 2014, Pennsylvania had the third- highest number of 
opioid deaths in the country (2,732), behind only California (4,521) and Ohio 
(2,744)” (Centers for Disease Control and Prevention 2016). The Commonwealth 
of Pennsylvania is the sixth largest state by size and population, with a diverse 
range of citizens in urban, suburban, and rural areas. In 2015, Pennsylvania had 
the sixth highest overdose death rate in the United States, and experienced a 
37% increase in overdose deaths from 2015 to 2016 (DEA Philadelphia Division 
2017). Eighty-fi ve percent of overdose fatality toxicology reports included an 
opioid in 2016, and the average profile of a person who has died of an overdose is 
a white male between 25 and 34 years of age (DEA Philadelphia Division 2017).

The Pennsylvania Opioid Overdose Reduction Technical Assistance Cen-
ter (TAC) was developed by the University of Pittsburgh, School of Pharmacy, 
Program Evaluation and Research Unit and funded by the Pennsylvania Com-
mission on Crime and Delinquency (PCCD) in response to the need for local 
coordination and support to address the growing number of opioid overdoses 
in Pennsylvania. Currently engaged with 42 counties, support ranges from 
technical assistance on an as- needed, information- sharing basis to compre-
hensive technical assistance involving local agency coordination, as well as 
data and evidence- based strategies to drive strategic planning, implementa-
tion, and evaluation (Figure 1).

Figure 1. County Map of Engagement with PA Opioid Overdose Reduction Technical 
Assistance Center (TAC) as of December 31, 2017. (Pennsylvania Opioid Overdose Reduction 
Technical Assistance Center [TAC], Program Evaluation Research Unit [PERU], University of 
Pittsburgh School of Pharmacy, 2017.)



The Pennsylvania Opioid Overdose Reduction Technical Assistance Center 149

Since May 2017, the TAC has conducted 316 county meetings to unify 
stakeholders around a unified process. The TAC created a model for opioid 
supply reduction, demand reduction, and overdose reduction at the county 
level using active participation from a coalition of county partners.

The Pennsylvania Opioid Overdose Reduction Technical Assistance Cen-
ter (TAC) strives to serve as a model of and a guide for empowering commu-
nities to address this major public health issue. In looking at other successful 
models, such as Project Lazarus, a community- based overdose prevention 
program in western North Carolina, we learn that “[a]t the center of Project 
Lazarus is the understanding that communities are ultimately responsible for 
their own health and that active participation from a coalition of community 
partners is required for a successful public health campaign” (Albert et al. 
2011, S78).

To be effective, this empowerment must occur as a process of open com-
munication and collaboration both within communities and between com-
munities. To facilitate collaboration within communities, stakeholders must 
begin with an accurate assessment of the problem. The Analysis of Overdose 
Deaths in Pennsylvania, 2016 was compiled to gather accurate data and sta-
tistics on overdose deaths, and to “ensure [that] the Commonwealth’s stake-
holders and citizens receive a professional and accurate analysis generated by 
experts in the law enforcement and public health fields” (Drug Enforcement 
Administration 2017, 3). Communities must work to bridge the traditional 
gap between public health and public safety officials by building effective 
partnerships. One such initiative is Pennsylvania’s Single County Authorities 
(SCAs), which “were established to plan and evaluate community drug and 
alcohol prevention, intervention, and treatment services. The SCAs determine 
a person’s eligibility for service funding, assess the need for treatment or other 
services, and make referrals to appropriate programs to match treatment and/
or service needs” (Miller et al. 2016, 61). In the spirit of collaboration, “SCAs 
are working with law enforcement to implement the community- based rec-
ommendations put forth in the 2015 National Heroin Task Force Report” 
(Miller et al. 2016, 61).

Physicians and first responders must not only be educated on best prac-
tices to assist patients with substance use disorders, but also be engaged to 
become an active part of the solution. One encouraging example of this is 
the DAWN (Drug Abuse Warning Network) program, sponsored by the Sub-
stance Abuse and Mental Health Services Administration (SAMHSA) of the 
U.S. Department of Health and Human Services (DHHS). DAWN is “a public 
health surveillance system that monitors national and local trends in drug- 
related emergency department visits and drug- related deaths investigated by 



150 Lynn S. Mirigian, Marco F. PugLieSe, Janice L. PringLe, anD Monica F. gayDoS

medical examiners and coroners. DAWN tells us where new drug problems 
are emerging, how old drug problems are changing, where public health 
resources might be needed, and which drugs and drug combinations are asso-
ciated with the most severe health consequences” (DAWN 2004).

In a similar vein, the criminal justice system must continue to address 
gaps in services, and work to instill additional treatment programs and effec-
tive education in its facilities. According to a recent draft report of The Presi-
dent’s Commission on Combating Drug Addiction and the Opioid Crisis, “One 
study found that nearly 60% of jail personnel surveyed strongly disagreed 
with the statement that their tax dollars should support methadone treat-
ment” (2017, 74). Clearly, further progress remains to be made in educating 
correctional administrators and practitioners on the benefits of medication- 
assisted treatment (MAT) for individuals at increased risk for overdose fol-
lowing release from jail or prison.

To encourage collaboration between communities, leaders in this field are 
advised to encourage clear communication among stakeholders at the federal, 
state, and local levels, and continue to provide county input to policymakers. 
A recent publication outlines a road map to guide stakeholders at the state 
level to find solutions to the current crisis, and can be used to help facilitate 
collaboration between other levels of government as well (Murphy et al. 2016). 
Families and communities must be continuously educated and made aware 
of the magnitude of this crisis, and programs must remain sustainable to sur-
vive beyond initial implementation. According to Principles of Community 
Engagement, “Community engagement can only be sustained by identifying 
and mobilizing community assets and strengths and by developing the com-
munity’s capacity and resources to make decisions and take action” (CTSAC 
2011, 51).

Organization of Local Efforts

The TAC uses an Implementation Framework (IF) developed by Dr. Janice 
Pringle to engage with counties (Figure 2).

The IF is designed to organize counties to reduce overdoses through 
assessing the local impact of overdose, building capacity, strategic planning, 
developing and implementing interventions with quality and fidelity, and 
evaluating and sustaining efforts. Counties begin with assessment, which 
consists of gathering data to better understand the local impact of overdoses. 
Data is an integral component to local efforts, and the TAC assists coun-
ties in the collection and analysis of data for later use in planning as well as 



The Pennsylvania Opioid Overdose Reduction Technical Assistance Center 151

intervention performance and outcome measures. The TAC has held 10 data 
seminars since May 2017. The TAC maintains a comprehensive list of data 
needed as well as strategies to obtain data for sustained collection and moni-
toring (Table 1).

The TAC offers analysis services to present counties with a comprehen-
sive, objective data report that is actionable.

Next, the TAC may help the county to develop an overdose reduction 
coalition or bring additional stakeholders into an existing coalition (Table 2).

The TAC emphasizes the importance of developing coalitions that work to 
bridge public health and public safety. As these sectors have not traditionally 
needed to collaborate with each other, technical assistance is often needed to 
address coordination of efforts between public safety and public health. The 
TAC provides technical assistance to 22 county recipients of PCCD funding. 

Figure 2. Implementation Framework (IF) Developed by Dr. Janice Pringle. (Pennsylvania Opioid Overdose 
Reduction Technical Assistance Center [TAC], Program Evaluation Research Unit [PERU], University of Pittsburgh 
School of Pharmacy, 2017.) 



152 Lynn S. Mirigian, Marco F. PugLieSe, Janice L. PringLe, anD Monica F. gayDoS

Table 1. Tac List of Data

Data collection Fields

Public Safety 
Overdose Death 
Emergency Medical Services (EMS) 
Emergency Department (ED) 
911 Call 
Trojan Horse 
Naloxone Reversal 
Prescription Drug Monitoring Program (PDMP) 
National Forensic Laboratory Information System (NFLIS) 
DEA Assessment 
Education 
Pharmacy 
Treatment 
High Intensity Drug Trafficking Area (HIDTA)

Source: Pennsylvania Opioid Overdose Reduction Technical Assistance Center (TAC), Program Evalua-
tion Research Unit (PERU), University of Pittsburgh School of Pharmacy, 2017. 

Table 2. county Stakeholders required for effective collaboration 

effective collaboration 

I. 
 
 
 
 
 
 
 
II. 
 
 
 
 
 
 
III. 
 
 
 
 
 
 
IV. 
 
 
 

Health Professionals
a) Single County Authority (SCA)
b) Hospital Professionals 
c) Treatment Providers 
d) Recovery Support 
e) Center of Excellence (COE)
f) Physicians 
g) Criminal Justice 
Public Safety
a) Criminal Justice Advisory Board (CJAB)
b) Coroner or Medical Examiner
c) District Attorney 
d) Probation/Parole
e) Jail
f) Courts 
Community 
a) Schools 
b) Religious Leaders
c) Persons in Recovery 
d) Family Members 
e) Political Figures 
f) Children Youth Services
First Responders 
a) Fire
b) Emergency Medical Services (EMS)
c) Local/State Police

Source: Pennsylvania Opioid Overdose Reduction Technical Assistance Center (TAC), Program Evalua-
tion Research Unit (PERU), University of Pittsburgh School of Pharmacy, 2017. 



The Pennsylvania Opioid Overdose Reduction Technical Assistance Center 153

First, county coalitions are encouraged to have leaders that represent both sec-
tors (e.g., single county authority (SCA) and district attorney (DA)), improving 
buy- in and ensuring that coalition work addresses the scope of opioid over-
dose. Second, barriers in terminology, variability in department goals, and 
differences in values and beliefs amongst different stakeholders are addressed 
through an ideal vision and learning component of each coalition meeting. 
Third, data is discussed openly between public safety and public health to 
eliminate confusion and identify opportunities for coordination. Interven-
tions that bridge the gap between public safety and public health are encour-
aged and shared amongst the TAC counties. For example, law enforcement 
can share nonfatal overdose information with the county drug and alcohol 
treatment authority for follow- up.

Once a county has data to assess overdose and sufficient capacity to get 
work done, the TAC will assist coalitions in the development of an evidence- 
based, data- driven strategic plan used to guide counties in their overdose 
elimination efforts, ensuring interventions are developed and implemented to 
have the highest impact. In 2017, the TAC developed 20 strategic plans. Opi-
oid supply, demand, and overdose reduction efforts are proposed by coalition 
members and implemented by responsible parties through their professional 
responsibilities or volunteers. Because of heightened awareness around drug 
overdose, many organizations and coalitions are responding at the local, state, 
and federal levels. The TAC teaches county entities how to coordinate efforts, 
minimize duplication, and identify and take advantage of outside resources. 
The OverdoseFree PA website, for example, includes content contributions 
from 25 counties and offers a wide range of resources for state and county- 
level entities. This site averages 15,000 page views per month.

Effective implementation and evaluation is accomplished through teach-
ing best practices using an Implementation Guide and connecting counties 
with local evaluators. The Implementation Guide provides structure to the 
county coalitions with respect to how they can implement an activity effi-
ciently and effectively. Second, it provides counties with the information nec-
essary to efficiently obtain additional funds from foundations and state and 
federal sources. Information includes a program summary, initiative cham-
pion, vision, evaluation goals and objectives, literature review, impact model, 
patient pathway diagram, implementation protocol, and evaluation scheme. 
In 2017, TAC aided 11 county applications for federal funding. Given the 
complex relationships and stakeholders that impact opioid overdoses, it is not 
feasible to determine the individual impact of each intervention in isolation. 

Sustainability is pivotal to maintaining interventions beyond an initial 
phase. PCCD recently funded 10 counties to assist with the implementation 



154 Lynn S. Mirigian, Marco F. PugLieSe, Janice L. PringLe, anD Monica F. gayDoS

of strategic planning initiatives, with funding totaling over $800,000, and 
released an additional RFP in 2017 for the same purpose. Furthermore, the 
TAC informs counties when additional funding from federal and local sources 
becomes available and can assist counties with proposal writing and review. 
(The TAC cannot assist with proposals for PCCD funding.)

Interventions

It is beyond the scope of this article to provide details of each intervention 
underway in 42 counties; however, a handful are highlighted below. In total, 
100 programs are currently being implemented by TAC, with an average of 
4.3 new programs being implemented per county.

Supply Reduction

Overdose Investigation Coordination
In partnership with the Drug Enforcement Administration (DEA), local police 
departments are investigating drug- delivery-r esulting-i n- death cases. The 
DEA provides analytical resources to counties, assisting with over 900 state 
and local investigations (communication with Laura Hendrick, DEA). In addi-
tion, all nonfatal overdoses reported to the DEA are subsequently provided 
to the county authority on drug and alcohol, or a local Center of Excellence.

Prescriber Education
County coalitions have expanded training and educational opportunities to 
include health care professionals (e.g., physicians, pharmacists, nurses) and 
first responders. One such program is unique in that physicians are educated 
on opioid prescribing guidelines, the prescription drug monitoring program, 
and alternative strategies to pain management, with emphasis on follow- up 
peer- to- peer interactions. Physician education often lacks an engagement 
piece, especially from other physicians, which decreases the chances of chang-
ing behavior. Peer mentors work with high-p rescribing physicians to plan 
strategies of how to effectively change practice and implement guidelines.

Medication Disposal
Safe medication disposal practices can reduce the supply of opioids avail-
able to a community, and protocols are being developed and implemented to 
limit the potential diversion of opioids from homes of persons who have died, 
nursing homes, real estate agencies, and assisted living facilities (Urie 2017). 
In addition, prescription take- back events sponsored by sheriff and police 



The Pennsylvania Opioid Overdose Reduction Technical Assistance Center 155

departments with support from the DEA occur at least twice a year. Most 
counties also have fixed medicine disposal sites at law enforcement offices, 
with a locator map found on the Pennsylvania Department of Drug and Alco-
hol Programs website. For rural areas, where transportation to a fixed site may 
be problematic, drug deactivation and disposal bags are available (Chandler, 
Fletcher, and Volkow 2009).

Demand Reduction

Increasing Access to Treatment through Criminal Justice Programs
The criminal justice system is a crucial intercept point for individuals who 
have an opioid use disorder. Discharged inmates overdose and die at a much 
higher rate than the general population, and this group is more likely to 
recidivate and commit new crimes (Friedmann et al. 2012; Gordon, Kinlock, 
and Miller 2011; Ludwig and Peters 2014; Timko and DeBenedetti 2007; and 
Welsh et al. 2016). Through the collaboration of county coalitions, county 
SCAs and criminal justice personnel (e.g., wardens, adult probation officers, 
and district attorneys) have begun to address the gaps in services, including 
establishing or expanding treatment programs in jails or prisons. This initia-
tive includes increasing educational opportunities for inmates regarding over-
dose prevention, which could include the provision of naloxone upon release, 
and establishing or expanding drug treatment courts. Treatment interven-
tions provided to jail and correctional facilities anticipate a comprehen-
sive, medically-a ssisted opioid treatment program for incarcerated inmates 
through the implementation of several evidence-ba sed practices. Cognitive 
behavior therapy and other treatment modalities are employed while the 
inmate is still incarcerated in a secure, drug-f ree, controlled environment. 
Prior to release, continued treatment appointments are arranged, and the pro-
gram participant may be induced to start MAT.

Engaging Overdose Survivors with Treatment and Resources
First responders across the Commonwealth have reported experiencing 
burnout related to repeat naloxone administrations to the same individuals 
and knowing that these individuals are not being engaged in treatment. In 
response to these frustrations, county SCA offices have been collaborating 
with local EMS and law enforcement to establish follow- up programs that 
aim to encourage an overdose survivor to enter treatment. Interventions train 
first responders on using naloxone for overdose reversal and training patients 
and families on how to use “leave- behind” naloxone kits (Centers for Disease 
Control and Prevention 2016); using motivational interviewing to conduct 



156 Lynn S. Mirigian, Marco F. PugLieSe, Janice L. PringLe, anD Monica F. gayDoS

referrals and “warm handoffs” to help patients access substance use disorder 
and/or mental health (SUD/MH) evaluation and treatment (DEA Philadel-
phia Division 2017); and/or implementing community- based paramedicine 
and harm reduction follow- up procedures with patients who do not wish to 
pursue treatment (Albert et al. 2011).

For example, one intervention aims to provide follow-u p care and treat-
ment to overdose survivors, through EMS and ED providers working in 
collaboration with the Center of Excellence (COE) and the Single County 
Authority (SCA) to ensure access to drug and alcohol services (Merrick et al. 
2007). This program is designed to expand emergency response duties of first 
responders, resulting in more efficient and ongoing care for the patient and to 
promote collaboration, rather than completion. Upon treatment by emergency 
responders, overdose survivors are informed of the opportunity to speak with 
a care navigator provided by the Center of Excellence. When a survivor is 
interested in pursuing treatment, the care navigator will assist in the entrance 
and completion of an appropriate treatment program. If an overdose survivor 
initially refuses treatment and is transported to a hospital, the EMS providers 
will follow up with the individual the next day to further encourage treatment.

Similar engagement and connection to treatment interventions are under-
way in emergency departments, often referred to as “warm handoffs.” Per-
sons in the emergency departments are screened and identified as needing 
additional follow- up treatment for a substance use disorder. A care navigator, 
patient coordinator, certified recovery specialist, or someone in a similar role 
will engage with the individual and help identify and connect the person to 
treatment. 

Workplace Education
Through workplace education interventions, presentations are conducted 
with a goal to provide educational materials to individuals while promoting 
drug- free work environments (Hartwell et al. 1996; Stoner, Mikko, and Car-
penter 2014). Drug- free work environments include: written drug-f ree work-
place policy, employee education, supervisor training, employee assistance 
program, and drug testing. Resources such as those from PAStop provide a 
worksite toolkit to provide further education regarding the risk of prescrip-
tion painkillers and heroin use, the relationship between painkillers and her-
oin, and how to assist an individual who may need assistance.

Screening, Brief Intervention, and Referral to Treatment
SBIRT (Screening, Brief Intervention, and Referral for Treatment) is an 
evidence- based practice used to identify, reduce, and prevent problematic use, 



The Pennsylvania Opioid Overdose Reduction Technical Assistance Center 157

abuse, and dependence on alcohol and illicit drugs (Agerwala and McCance- 
Katz 2012; Babor et al. 2007). The SBIRT program will consist of three major 
components: (1) screening—a health care professional in any setting will 
use standardized screening tools to assess and identify patients with risky 
substance abuse patterns; (2) brief intervention—a health care professional 
will engage a patient with risky substance use behaviors in a short conver-
sation about their use, providing feedback and advice; and (3) referral for 
treatment—a health care professional will provide a referral to brief therapy 
or additional treatment to patients who screen in need of additional services. 
An outcome from implementation of SBIRT programs is to increase the num-
ber of overdose survivors who enter treatment and sustain treatment, and to 
intervene prior to the overdose. Because of this proactive manner, a decrease 
in the number of overdoses in the emergency department can be expected. 
The combination of early intervention by drug and alcohol staff and timely 
assistance for the patient in obtaining treatment will increase the likelihood of 
a successful discharge from treatment and decrease the likelihood of overdose 
and further substance abuse.

Overdose Reduction

Increasing Access to Naloxone in Pharmacies
The TAC launched a Citizen Science Naloxone Reporting Project, which 
encourages pharmacy customers to engage their local pharmacists in 
discussion about naloxone. Individuals can access an online form on 
 OverdoseFree PA that guides them through conversations with their phar-
macist regarding compliance with the standing order, stocking naloxone for 
same- day purchase, and questions about insurance billing. Individuals can 
fill out the form online and submit it to the website where, once verified, it 
will be added to the Naloxone Finder Map. The Naloxone Finder Map is a tool 
that individuals can use to locate pharmacies in their area that stock naloxone. 
The map also provides information on the formulation that is carried and the 
insurance the pharmacy accepts. Educational materials can be provided to 
pharmacies and pharmacists that do not currently honor the standing order 
and/or stock naloxone.

Increasing Access to Naloxone for Persons at Risk of Overdose
Naloxone priority groups have been identified through data and previously 
published reports. Persons at elevated risk for overdose leaving a county jail, 
treatment facility, or emergency room are offered naloxone with a brief train-
ing on overdose reduction strategies.



158 Lynn S. Mirigian, Marco F. PugLieSe, Janice L. PringLe, anD Monica F. gayDoS

On a broader level, educational interventions are developed for the com-
munity audience that typically include naloxone and addiction education, 
information about treatment resources, and safe disposal of medications, 
including drug take- back days. Educational materials on how to access and 
use naloxone are delivered using a town hall format, through public aware-
ness campaigns, using local newspapers and television stations, by developing 
prevention magazines, through social media, and at the workplace.

Coordination of Efforts Across County Lines

The TAC has assisted multiple agencies in the development and implemen-
tation of various workshops across the Commonwealth of Pennsylvania, 
resulting in over 600 individuals participating with a 99% satisfaction rate. 
The workshops intend to bring together stakeholders from public safety and 
public health to discuss trends regarding overdose deaths, various strategies 
to combat the opioid epidemic, and potential solutions. Subjects may include 
the following: substance use disorder in different populations, evidence- 
based treatment, overdose prevention and harm reduction, bridging pub-
lic health and public safety, prescribing practices and the prescription drug 
monitoring program, addictions 101, and coordinating data between systems. 
Throughout the planning and development stages of each workshop, the TAC 
meets with leadership from each requesting agency multiple times prior to 
the workshops to ensure that content is relevant to the needs of the audi-
ence. Components of each workshop include educational lectures, hands- on 
motivational interviewing skills, keynote speakers, and facilitation of panel 
discussions.

In addition, the TAC is coordinating efforts among federal, state, and local 
stakeholders by communicating programs and initiatives from federal and 
state agencies to county- level entities. Thus far, the TAC has assisted in build-
ing a multitude of partnerships between counties, while providing county 
input to policymakers.

Summary and Future Directions

The TAC strives to improve effectiveness and outcomes through self- 
assessment and is collecting outcome data for programs listed above. County 
meeting evaluations are disseminated and collected following all coalition 
meetings to understand if progress is being made. As a result, the TAC can 
improve using a constant feedback loop with each county, provided by lessons 
learned from weekly meetings. To improve outcomes of county efforts, the 



The Pennsylvania Opioid Overdose Reduction Technical Assistance Center 159

TAC conducts annual key informant interviews with each county. For county 
interventions, detailed evaluation plans that collect process and outcome 
measurements are standard practice for counties working with the TAC. It is 
anticipated that this data will be shared in 2018. Looking to the near future, 
according to a recent report of the TAC, “several counties are projected to 
stabilize their overdose death rates in 2017.”

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ment Providers.” Administration and Policy in Mental Health 43 (January): 105–121. 

Lynn S. Mirigian is the project director for the Pennsylvania Opioid Overdose Reduction 
Technical Assistance Center (TAC) at the Program Evaluation and Research Unit (PERU) 
of the University of Pittsburgh, School of Pharmacy. She manages a dedicated team to fight 
the increasing issue of drug overdose deaths in the Commonwealth. She earned her doc-
toral degree at the National Institutes of Health, where she researched biochemistry and 
cell biology. Previously, Dr. Mirigian worked as a science policy manager in Washington, 
D.C., where she conducted science policy research, marketing and administration of a 
peer- reviewed journal, and scientific task force management.

Marco F. Pugliese is a research specialist for the Pennsylvania Opioid Overdose Reduc-
tion Technical Assistance Center (TAC) at the Program Evaluation and Research Unit of 
the University of Pittsburgh School of Pharmacy, where he manages the organization and 
content of the OverdoseFree PA website. He earned an MA in health, physical activity, and 
chronic disease from the University of Pittsburgh. Mr. Pugliese has prior research experi-
ence with the Centers for Disease Control and Prevention (CDC) and the Physical Activity 
and Weight Management Research Center. His areas of expertise include coalition health 
assessment and evaluation, motivational interviewing, and communication strategies.



The Pennsylvania Opioid Overdose Reduction Technical Assistance Center 161

Janice L. Pringle is an epidemiologist by training, with extensive experience in health 
services research. She is a professor at the University of Pittsburgh, School of Pharmacy, 
and the founder and director of the Program Evaluation Research Unit (PERU) within 
the University of Pittsburgh, School of Pharmacy. Her area of expertise is health services 
research and organizational health. She has developed a framework for assessing organi-
zational health and guiding systems transformation. Dr. Pringle has secured over $140 
million in grants and has developed health care policy research that has been used to 
inform policy development at the state and federal levels.

Monica F. gaydos, MA, is a technical writer for the PA Opioid Overdose Reduction Tech-
nical Assistance Center (TAC) and the Centers of Excellence (COE) projects within the 
Program Evaluation and Research Unit (PERU) of the University of Pittsburgh School of 
Pharmacy. Monica holds a degree in political science from Duquesne University and an 
M.A. in social, therapeutic, and community studies from Goldsmiths College, University 
of London. Her experience in technical writing was gained from positions held at major 
publishing houses in New York City from 1990–2006, and as a freelance writer for several 
nonprofit organizations in Pittsburgh, PA, since 2006. Monica also has research, clinical, 
and teaching experience in exploring mindfulness and somatic approaches to help people 
achieve overall physical and psychological health.




