Opioid Disorder and Overdose | Featured Research

Using Data to Fight the Opioid Epidemic

A visionary research and dissemination project funded by the U.S. Food and Drug Administration is advancing the science of studies of opioid analgesics. The Methodological Advances in Evaluating Abuse Deterrent Opioid Analgesics project is leveraging emerging advances in data connectivity and establishing new standards for methodological rigor, with a focus on abuse deterrent formulations.

The overall project goal is to develop and disseminate new “open source” epidemiologic tools to facilitate rigorous evaluation of abuse deterrent formulations (ADFs). The methodologic products from this project will be made available to the research community, in the expectation that researchers will apply them to improve the quality of studies in the area of opioids. PIs: Nabarun Dasgupta, MPH, PhD | Svetla S. Slavova, PhD  | Co-Is: Terry Lee Bunn, PhD | Patricia R. Freeman, PhD | Stephen W. Marshall, PhD

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Evaluation of State-Mandated Acute and Post-Surgical Pain-Specific Opioid Prescribing Guidelines

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

Helping NC Agencies Develop Evidence-Driven Opioid Overdose Prevention Initiatives

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

Chronic Pain Management, Opioid Misuse, and Risk of Blood-Borne Infections

The overall objective of this project is to leverage a unique combination of “big data” and qualitative data to generate high-quality evidence about optimal strategies to taper or end long-term opioids use. This includes using a combination of NC insurance claims, health system, cause of death, and blood-borne infection diagnosis data, supported by enhanced complementary qualitative interviews. PI: Brian Pence, PhD | Co-Is: Shabbar Ranapurwala, PhD, MPH | Christopher L. Ringwalt, DrPH, MSW

Opioid Disorder & Overdose | Selected Prior Research

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 Iowa prescription monitoring program 

This CDC-funded project was subcontracted through the University of Iowa Injury Prevention Research Center and involved using statewide health insurance data and an interrupted time series analysis to examine the impact of Iowa’s prescription monitoring program on physicians’ prescribing practices in Iowa. Results were shared widely with public health researchers and practitioners at the APHA annual conference and the Society for Advancement of Violence and Injury Research conference. PI: Shabbar Ranapurwala, PhD, MPH

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