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When overdose cases suddenly spike, every second counts. In this episode, Jessica Pough, director of overdose preparedness and response at ASTHO, talks about a new tool designed to help communities prepare before crisis hits. The “Overdose Spike Preparedness Exercise: Tabletop in a Box” gives state and local agencies a structured, customizable way to simulate real-world overdose surge scenarios. From identifying spikes and coordinating across partners to making high-stakes decisions with limited information, the exercise helps teams practice what it takes to respond effectively.