Nearly 400 North Carolina citizens died from an opioid overdose last year. In 2014, 45 North Carolina counties had overdose death rates higher than the national average of 9 per 100,000. The state continues to exceed this national average, and has been steadily increasing over the past 10 years.

There have been efforts to reverse the opioid epidemic in North Carolina. Naloxone is now widely available. It’s a drug that can reverse the effects of an opioid overdose and works within minutes of injection.

“Now it’s at a place where insurance companies will pay for it,” said Robyn Jordan, clinical assistant professor of psychiatry at UNC. “And we can prescribe it and pharmacies carry it. In addition, it’s available over-the-counter. So anybody can walk into a pharmacy and just get a naloxone kit without a prescription. So it’s certainly become more accessible for patients.”

Jordan said physicians are also being more cautious about prescribing opiates, but it isn’t enough. The UNC Extension for Community Healthcare Outcomes for Rural Primary Care Medication Assisted Treatment, or UNC ECHO for MAT, has partnered with the University of New Mexico Project ECHO to help provide rural counties with the resources to then provide new medicines to treat opioid addiction.

Jordan said one of those medicines is Suboxone.

“The goal we have is trying to train more physicians one, about the stigma and about what it means to treat these patients and also how to prescribe Suboxone so we can get better care out into the rural communities.”

Suboxone is a type of MAT drug that can be prescribed to addicts. It’s like an opiate but doesn’t affect the body in the same way. It can prevent withdrawal and cravings, and can be used to transition someone off the drug altogether.

Doctor Sherri Green is a research fellow at the Sheps Center for Health Services Research at UNC. She said many rural counties don’t currently have doctors who can prescribe Suboxone. That’s where the initiative comes in.

“So while we have a lot of our urban centers that have some of the highest overdose rates, we have quite a few of our counties–our rural counties, where we don’t have full access to evidence-based care,” she said. “And this initiative is meant to help determine, assess and reduce the barriers for rural primary physicians who may want to provide medication-assisted treatment for people who have opioid-use disorders.”

Jordan said there’s also a stigma that surrounds mental health and addiction regarding evidence-based care. And the initiative will also seek to break it.

“The biggest difficulty that we have is that physicians are not trained to prescribe Suboxone, and so a lot of physicians don’t know how,” she said. “There’s also just the stigma of mental health and the stigma of addiction and people just not wanting to do that. They don’t want those patients in their clinics.”

Green said there are supporters all over the state from community members to government leaders and that the goal at the end of the day is to save people.

“We do have people from treatment to medical providers who are committed to trying to find some answers and we want to save lives and we want folks to reduce the harm to their families and to communities.”

The UNC ECHO for MAT will work to expand access to MAT in 22 under-served counties and will serve as a venue for Project ECHO capacity building in North Carolina.

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