The opioid crisis is complicated. Its potential impacts are broad and far-reaching, it has no single root cause, and it is not confined by geographic boundaries or socio-economic classes. To succeed, any attempts to mitigate the damages inflicted by this scourge cannot be made in isolation. Instead, they must be guided by the principle of collective impact, which has been defined as “the commitment of a group of important actors from different sectors to a common agenda for solving a specific social problem.” (Kania & Kramer 2011)



There are five elements necessary to achieve collective impact. (ibid) The first requires that participants working toward a specific goal share a common agenda for change. They do not have to begin their collaboration with a shared understanding of the solution(s) needed to achieve their goal, but they should come into the process knowing that a joint effort is necessary to be successful. Second, to evaluate whether goals are achieved, shared measures must be developed to track progress. Each participant in the collective action will undertake different efforts to reach the shared goals. Third, while each actor’s role is different, their activities should be mutually reinforcing—that is, coordinated with the activities of other participants and aligned with the common agenda and pre-established measures of success. Fourth, throughout the process, continuous communication is essential to building trust and motivating participants. Finally, to keep the process moving forward, there must be a backbone organization, described by Collaboration for Impact as “a separate organization dedicated to coordinating the various dimensions and collaborators involved in the initiative.” The backbone organization provides expertise, planning, and coordination to keep the participants on task and offers advice and support during the initiative.


The Opioid Response Project team at the UNC School of Government serves as the backbone organization for the ten collaborative teams participating from communities across the state by:


  1. guiding participants’ visions and strategies;
  2. supporting the aligned activities of the community teams and ensuring they are consistent with the shared agenda (i.e., mutually reinforcing);
  3. working with the teams to establish shared measurement practices;
  4. building up public goodwill for the project;
  5. advancing policy developed in collaboration with participants;
  6. mobilizing funding to achieve established goals; and
  7. keeping the lines of communication open and flowing among all participants.