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STR-TA Steps in to Assist North Carolina Counties in Prevention and Treatment of Opioid Use Disorder

1. Photo of Jeff Pruett, Opioid Safety Coordinator, requested assistance to address opioid crisis in 10 mostly rural communities
Jeff Pruett, Opioid Safety Coordinator, requested assistance to address opioid crisis in 10 mostly rural communities

The Request

Jeff Pruett, Opioid Safety Coordinator for Partnership for Community Care and Northwest Community Care networks for Community Care of NC, a nonprofit organization that works to improve healthcare and outcomes for underserved communities, was tasked with working with 10 mostly rural North Carolina counties to improve their responses to the opioid crisis. It was an enormous task and he quickly realized he needed help. It was good luck that his project coincided with the launch of the STR-TA grant, which was created to assist in projects just like his. "This looked like a great opportunity to have someone from outside the community come in and address this," he said.


Many of the counties already had programs in place, some had none, but Jeff recognized that to truly make an impact on the opioid healthcare crisis, the counties needed to work together, share resources, and expand the availability of MAT (medication assisted treatment) services. "I saw this as an opportunity to get more people involved," Jeff said. The job of STR-TA was to assist Community Care in better coordinating, collaborating, and communicating across prevention, treatment and recovery for the ten county area, as well as addressing expansion of OUD treatment to underserved counties and rural areas.

"The first task was to determine who was following evidence-based practices," said Deena Murphy, PhD, the Technical Transfer Specialist who is working with Mr. Pruett on this task. After inventorying what is happening within the counties, the next step was to invite the major stakeholders from all 10 counties to get together to discuss ways the counties could work together to reach a common goal. It's important, Dr. Murphy said, that STR-TA not dictate what direction the counties should go, but rather give them the various resources that can help them reach their goal. "Most of the counties had opioid programs in place, but they were not aware what the other counties were doing."

Education the Key

Mr. Pruett said the most important aspect of both prevention and treatment is educating citizens and the medical community about evidence-based practices. As in many parts of the country, stigma is a factor. Patients, law enforcement, first responders, clinicians all need to understand how addiction is treated and why MAT is the most effective way to treat OUD. "We have to convince local providers that this is something that's needed," Jeff said.

The Vision

Ideally, once the project reaches completion, the counties will work together, learn from each other, share resources and examples of best practices, expand MAT treatment, and increase the referrals from emergency departments to treatment centers. Currently, a person who ends up in the ER, is often sent home with little or no counseling regarding treatment. That will soon change, Mr. Pruett said. "It's critical that we bring these communities together so that we're not working in silos," he said.

The Work

This request is still early in this process, and the needs assessment for the counties is ongoing. Initially, the request included the seven most rural counties, but that was expanded to 10 when it was determined that many of the most rural counties were using resources from the more populous counties. A key to success is not duplicating efforts and to share resources, Dr. Murphy said. A meeting was scheduled for mid-November with the major stakeholders to lay out each county's needs. A further meeting of hospital and treatment administrators and clinical leaders is planned for mid-December to discuss expansion of MAT into underserved areas.

Graph of Substances Contributing to unintentional Medication and Drug overdose deaths for North Carolina residents 1999-2016