The PROTECT Protocol is Pathway Systems’ flagship framework for integrating neurocognitive vulnerability into overdose prevention and response. It reframes non-fatal overdose events as cumulative neurological injuries with long-term implications for recovery, disability, and system cost.
The challenge
Most overdose response models treat substance use as a behavioral or pharmacological issue alone, overlooking the hypoxic and traumatic brain injuries that frequently occur during non-fatal overdose events. This omission contributes to recurrent overdoses, impaired decision-making, and a revolving-door pattern in emergency care.
The PROTECT approach
The PROTECT Protocol (Protocol for the Recognition, Observation and Treatment of Emerging Cognitive Trauma) provides a structured, implementable framework for embedding neuroprotective care into existing harm reduction, emergency response, and recovery systems.
The protocol is designed for policymakers, health systems, and community organizations seeking scalable interventions that reduce repeat overdoses while producing downstream savings in healthcare utilization and long-term support services.
Download the full report
Complete evidence base, implementation framework, and references (PDF · 53 MB)