Several New England states, including Massachusetts and Rhode Island, are on pace to record fewer opioid overdose deaths in 2017, compared with the year before. This follows years of fast-rising death tolls in the region. State officials say their efforts, ranging from widespread distribution of an overdose-rescue drug to expanded treatment access, are starting to bear fruit. "It's a ray of hope," says Gov. Gina Raimondo of Rhode Island, which reports a 9% decline in accidental-overdose deaths through the first 8 months of 2017. In Massachusetts, authorities estimate a 10% decline in opioid-related deaths through September, compared with the same period last year. New Hampshire’s Office of the Chief Medical Examiner has projected a slight decrease, and preliminary figures in Vermont indicate that state could also trend lower. Joshua Sharfstein, MD, who directs the Bloomberg American Health Initiative at Johns Hopkins University, credits states like Rhode Island, which he has advised, for taking aggressive steps to address the crisis. Measures there include a screening program to spot opioid problems among new prisoners, and then offer them medication-assisted treatment. Another Rhode Island program put peer-recovery specialists in hospitals to guide overdose patients to treatment. Massachusetts' efforts include widespread availability of naloxone while adding treatment beds and putting tight limits on prescription opioids.