Opioid Disorder and Overdose | Impact

Collaborating with State and Community Partners

Prevention for States: A partnership with the North Carolina Division of Public Health

The goal of this CDC-funded partnership is to conduct surveillance and evaluation activities to inform opioid overdose prevention strategies implemented in North Carolina. The IPRC partners with the Injury and Violence Prevention Branch (IVPB) at the NC Department of Public Health (NC DPH) to identify research questions that can directly inform the ongoing development and evaluation of prevention efforts in North Carolina. Examples of this work include quantifying the risk of opioid overdose among formerly incarcerated individuals, evaluating the impact of naloxone distribution on opioid overdose deaths, and analyzing emergency medical services (EMS) data to examine EMS responses to opioid overdoses. Additionally, as state and community partners frequently consider innovative strategies to address the opioid crisis, the IPRC is well-positioned to respond to time sensitive inquiries from the IVPB regarding the utility of opioid overdose surveillance and prevention activities and provide critical analyses of the evidence regarding their effectiveness. The IPRC works closely with the IVPB to share results from this work to key stakeholders, as well as the broader NC community. The results of every surveillance, evaluation, and critical analysis project are summarized in a 2-3 page brief report that can be disseminated to individuals within NC DPH, NC Department of Health and Human Services, and the broader community. The IPRC also presents the results to individuals from state and community agencies, as well as at NC Opioid and Prescription Drug Abuse Advisory Committee meetings. Additionally, to reach an audience beyond NC, the IPRC presents results at academic and practitioner conferences, on webinars, and in academic journals. PI: Meghan E. Shanahan, PhD, MPH | Co-Is: Rebecca B. Naumann, PhD, MSPH | Shabbar Ranapurwala, PhD, MPH

Evaluation of North Carolina’s Medicaid “Lock-In” Program

Medicaid beneficiaries are a particularly high-risk population for prescription drug overdose, having prescription opioid overdose rates six times that of non-Medicaid beneficiaries. One strategy that nearly all states use in an attempt to reduce misuse of prescription drugs is the implementation of Medicaid “Lock-In” Programs. “Lock-in” Programs identify beneficiaries demonstrating potential overutilization of prescription opioids, as well as other controlled substances, and restrict their access to these drugs. Little research has examined the impact of these programs, leaving policymakers without comprehensive evidence to inform program design. Through a CDC-funded project, the IPRC conducted a unique linkage of NC Medicaid claims to the state’s Prescription Drug Monitoring Program to gain a more complete picture on all controlled substance prescriptions dispensed to Medicaid beneficiaries, regardless of payment source. Utilizing this innovative linked data source and advanced methods, the IPRC researchers have conducted several studies examining the impacts of the “Lock-In” program, notably finding that the program was associated with increased use of cash payment to obtain controlled substances. Results from these evaluation efforts have been shared widely with researchers and practitioners through publications and many other outreach activities via conferences and professional meetings with public health agencies. PI: Asheley Cockrell Skinner, PhD (now at Duke University)

Click here to view the IPRC’s core and affiliate faculty publications