This report contains data from an environmental scan survey that the National Association of County and City Health Officials distributed in January 2019 to 388 local health departments (LHD) identified from the 2018 Forces of Change survey as respondents who reported conducting activities to address "opioid use and abuse" in 2017. The goal of the scan was to create a foundational understanding of LHD opioid overdose prevention and response efforts to inform priorities at the local, state, and national levels.This sample is not intended to be nationally representative.