The Collective Response Initiative York (CRIY) evolved out of a nearly decade-long effort to unite the York County community to address the negative consequences of substance use. Initially started in 2014 by county government officials to address a spike in heroin-related overdoses, the effort evolved in 2017 with the creation of a non-profit organization called the York Opioid Collaborative (YOC). YOC was created to coordinate and create collaborations that raise awareness and advocate for support to collectively implement solutions and programs for substance use disorders. “Collective impact” is a framework for uniting a community to transform outcomes by altering the conditions that hold an intolerable status quo in place. The York Opioid Collaborative is now working with community leaders to design the key elements and structures of the initiative.