Elevating lived experience in overdose prevention: a community case study of Arizona's overdose data to action...

Drug overdose remains a leading cause of preventable death in the United States, with persistent inequities among populations that often face stigma and barriers to care. Traditional evaluation models often exclude people with lived and living experience (PWLE) of substance use from meaningful decision-making.

To address this, the Arizona Department of Health Services (ADHS) implemented a community-based participatory evaluation model within its Overdose Data to Action in States (OD2A-S) program by establishing a Community Advisory Board (CAB). The CAB was designed to integrate lived experience into evaluation planning and interpretation, identify community-driven priorities, and guide program improvement. Members were recruited statewide through a nomination process and compensated. A licensed clinical social worker facilitated meetings using trauma-informed and healing-centered approaches. Participatory methods such as journey mapping and logic model development enabled members to translate personal and community experiences into actionable evaluation questions.

Between August 2024 and August 2025, the CAB met quarterly to prioritize evaluation of naloxone vending machines and peer navigation models. Members identified key barriers, including stigma, rural access, transportation, and lack of culturally responsive care, and provided input on equitable evaluation tools and communication strategies. A composition survey confirmed strong representation of individuals in recovery (86%) and people of color (88%), though rural and tribal, medically assisted treatment, and veteran perspectives remain limited or not represented.

Early lessons demonstrate that compensated, trauma-informed engagement fosters trust, accountability, and practical insights that strengthen evaluation quality and relevance. Challenges include administrative delays in payment, limited generalizability due to small membership, and the need for sustainable funding to expand representation.

Arizona's OD2A-S CAB provides a replicable model for integrating lived experience into state-level overdose prevention. By positioning PWLE as co-evaluators rather than participants, this model advances equity, builds system trust, and strengthens the translation of data into action.