5 The Plays The word “play” in this document refers to a specific idea, initiative or strategy that a community, jurisdiction, government and/or organization might select to bolster collaborative efforts to prevent opioid use disorders. The play descriptions attempt to define purposes, goals and objectives, theories of change, ways to implement the strategy, evidence of the previous success or lack thereof, and resources for further study/examination. These plays are intentionally short synopses of current knowledge, designed to be a starting point for group discussion and further exploration of how each might benefit the population served. This list is not exhaustive. Many strategies have been proposed and many trials have been conducted as the entire nation seeks answers to the question of how to cope with this historic epidemic. We selected the plays below because they appear to have traction by virtue of their perceived or actual positive value/impact. Research to provide concrete evidence of the success of various strategies (plays) has been emerging over the past decade, but there are still many that have not been exposed to evidentiary evaluations.28 Inclusion of the plays on this list was based either on demonstrable evidence of their value or actual impact. 1. Remove the stigma Addiction is a disease. Educating the public, health care professionals, health care systems and plans, community organizations and law enforcement about that reality – and, as a result, about the need for prevention, detection and treatment with a comprehensive team approach – may be the most important component of any program to stem the tide of opioid use disorders. There is considerable research about the extent to which the stigma of drug use or misuse impedes the prevention or treatment of the problem. In a paper on this topic, SAMHSA explores the extent to which words matter in the effort to address misuse.29 In addition, the negative effects of the stigma associated with substance use disorder have been documented, as has discrimination in employment and social relationships.30 Substance use disorders are often treated as a moral and criminal issue, rather than as a health concern. This is especially true of illegal substances, which are perceived more negatively than legal ones. The use of particular substances (e.g. heroin) has not only been deemed deserving of social disapproval and moral condemnation, but has