The Washington DC Department of Health leverages a variety of data sources—including Emergency Department (ED) records, Emergency Medical Services (EMS) repositories, biospatial by ImageTrend (a platform that aggregates and standardizes EMS data in near real-time), and National Emergency Medical Services Information System (NEMSIS)—to identify overdose clusters and monitor trends across the city. Due to DC’s dense population, city-wide alerts have proven less useful for outreach. In response, DC Department of Health analyzes clusters, such as three overdoses within 500 feet in 24 hours, and has mapped neighborhood-level hot spots to share with partners to help target prevention resources where they are most needed. While the primary responsibility for direct overdose response falls to the Department of Behavioral Health, the Department of Health supports the city through surveillance, data sharing, and funding harm reduction programs. The data they have shared with community partners has informed DC Department of Health’s approach to emphasize harm reduction, outreach, and connecting people to wraparound services, helping residents stay safer and receive care through Live Long DC. They have developed strategies to share actionable information through geomapped alerts, dashboards, and partner communications via email list serv. By combining robust surveillance with strategic partnerships, DC Department of Health continues to improve prevention efforts and inform city-wide and community-level overdose interventions.