Building local health department capacity to disseminate naloxone in North Carolina

Background/Purpose: In North Carolina, rates of unintentional drug overdose have increased 333% since 1999. In 2013, NC passed a Good Samaritan/Naloxone law intended to increase community access to naloxone, an effective, safe opioid reversal strategy. Building capacity for Local Health Department (LHD) standing orders may be an effective distribution mechanism for naloxone.

Methods: A resource toolkit was created using: 1) results from an online survey administered to LHD directors (n= 85) to assess knowledge, actions taken, and support needed to implement naloxone standing orders, 2) semi-structured interviews with stakeholders implementing naloxone access programs, 3) literature review, and 4) expert review from county stakeholders who have adopted standing orders.

Results/Outcomes: Stakeholder interviews illustrated the complex coordination between health providers, first responders, and local policymakers that is required to pass a standing order. Survey results demonstrated that about one-fifth (n=18) of LHDs had passed a standing order, and many expressed interest in technical assistance to do so. Based on formative research, resources were organized into five categories: 1) background on naloxone distribution, 2) standing order processes, 3) stakeholder involvement, 4) framing for local partner programs, and 5) standing order implementation and sustainability.

Conclusions: Effectively implementing state policy on a county level is critical to preventing future overdose deaths. Building capacity of LHDs to disseminate naloxone, through the use of standing orders, can increase naloxone access in communities. More research is needed to evaluate the efficacy of standing orders on overall naloxone access especially in populations most at risk.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Analyze the role of local health departments may have in disseminating Naloxone in their community. Discuss examples of standing order language, resources, and other tools that facilitate the implementation of standing orders. Describe the development of a Standing Order Resource Toolkit to build capacity for naloxone distribution among North Carolina's local health departments.

Keyword(s): Drug Abuse Prevention and Safety, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Research team member on evaluating North Carolina naloxone policy and developing resources for local health departments on naloxone policy
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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