This CDC-funded project examines the impact of state-mandated opioid prescribing guidelines for acute and post-surgical pain. The outcomes being studied are: 1) physicians’ opioid prescribing behaviors; and 2) opioid safety outcomes among patients, including fatal and non-fatal overdose. This project includes a process evaluation of the state law mandating opioid prescribing limits for acute and post-surgical pain, including recommendations to inform and improve future legislative initiatives. PI: Shabbar Ranapurwala, PhD, MPH | IPRC Co-Is: Stephen W. Marshall, PhD | Nabarun Dasgupta, PhD, MPH | Rebecca B. Naumann, PhD, MSPH | Meghan E. Shanahan, PhD, MPH
This project uses group modelling and other systems sciences tools to assist North Carolina’s Opioid and Prescription Drug Abuse Advisory Committee (NC OPDAAC) to formulate effective cross-agency initiatives in response to the escalating opioid overdose problem.
PIs: Stephen W. Marshall, PhD |Kristen Hassmiller Lich, PhD |Co-I: Rebecca B. Naumann, PhD, MSPH; Administering Department and School: Epidemiology and the Research, Innovation and Global Solutions office at Gillings School of Global Public Health
Supported by the UNC Collaborative Sciences Center for Road Safety (CSCRS), this pilot project funded by the US Department of Transportation explores how linked databases can be used to explore the role of impairment from opioids in motor vehicle crashes on public roads. PI: Christopher Cherry, PhD | Co-Is: Rebecca B. Naumann, PhD, MSPH | Stephen W. Marshall, PhD
Randomized Controlled Trial of an Emergency Department Care Coordination Program in Thirteen Emergency Departments of the Carolinas HealthCare System
This CDC-funded project involved identifying individuals who frequently used emergency departments to treat their non-cancerous chronic pain (NCCP). A total of 411 patients were randomized to either the intervention or control group. The intervention consisted of placing an alert in the medical record and letters sent to patients and their community providers. The alert informed physicians that the patients had made multiple visits to emergency departments to treat their NCCP and suggested that the physician refer the patient to a community-based provider for treatment. The researchers found that the intervention reduced the number of emergency department visits and opioid prescriptions among the intervention group. PI: Christopher L. Ringwalt, DrPH, MSW
Evaluation of a Community-Based Initiative to Prevent Opioid Overdose
This CDC-funded collaborative project between the IPRC and the Pacific Institute for Research and Evaluation involved an evaluation of Project Lazarus, a state-wide initiative to prevent opioid overdose and strengthen provider education and policies to limit emergency department opioid dispensing, which are associated with lower overdose mortality. Project Lazarus is a model of community engagement that has been successfully adopted in rural communities throughout North Carolina and in other states. The program is intended to help communities prevent overdoses, promote responsible pain management practices, and support substance abuse treatment. The program addresses and prevents drug overdose deaths through a variety of methods, including providing Project Lazarus Rescue Kits for individuals, families, health departments, and law enforcement personnel. The kit contains two doses of nasal naloxone as well as educational information on how to revive someone who has overdosed. Evaluation results (“A Statewide Evaluation of Project Lazarus: Seven Strategies to Reduce Opioid Overdose”) were shared at the Society for Advancement of Violence and Injury Research conference in September 2017 in Ann Arbor, Michigan. PI: Christopher L. Ringwalt, DrPH, MSW