The opioid epidemic has been ravaging communities across the United States for years, negatively impacting friends and families, contributing to the mental health challenges that first responders struggle with, and straining health care systems’ resources. Fire departments, as first-line responders, see the impact of opioid use disorder (OUD) firsthand. Both Anne Arundel County, a suburban county in Maryland on the outskirts of Baltimore and Washington, D.C., and Tucson, the second-largest city in Arizona, have experienced the challenges of opioid use in their communities and have implemented first responder deflection programs in their fire departments to support individuals with opioid and/or other substance use disorders (SUDs).