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Researchers Targeting Opioid Epidemic

North Carolina has been outpacing the national average in opioid addiction problems, which have been increasing steadily throughout the country over the past 10 years.

A new research initiative at UNC aims to combat that by reducing barriers to physicians treating opioid use disorders in rural areas of the state.

The project is the first part of an effort that aims to increase access to specialty care in North Carolina, relying on a medical education model that can give rural health practitioners training, experts and resources that usually are not available to them.

The UNC Extension for Community Healthcare Outcomes for Rural Primary Care Medication Assisted Treatment — or UNC-ECHO for MAT — is collaborating with a similar program at the University of New Mexico Project. The program’s goals are to better connect people with opioid-use disorders to primary care providers and to reduce deaths from accidental overdoses.

“There is both a shortage of [medication-assisted treatment] providers, especially in rural counties, and a need to support [these] providers through case-based learning, practice supports, and a collaborative community response with treatment and other social and medical supports for patients” receiving medication-assisted treatment, said Sherri Green ’03 (PhD), a research fellow at the Sheps Center for Health Services Research and assistant professor in UNC’s Gillings School of Global Public Health.

The UNC-ECHO for MAT aims to better understand what prevents primary care providers from offering medication-assisted treatment in their practices, evaluate strategies to overcome those barriers, and work with providers and community and state partners to expand access to medication-assisted treatment with associated community supports in 22 rural and underserved counties.

The three-year, $2.9 million project is funded by the federal Agency for Healthcare Research and Quality, which is part of the U.S. Department of Health and Human Services.

Barriers to physicians providing medication-assisted treatment include:

  • lack of training for primary care providers;
  • concerns about a patient’s ability to follow through with treatment;
  • workload practice resource limitations;
  • isolation or lack of support for the practitioner;
  • difficulties in connecting patients with community treatment resources, and;
  • stigma associated with substance use disorders and use of medication-assisted treatment.

The UNC ECHO team intends to collaborate with local managed-care organizations for mental health and substance use disorder services staff and providers.

The Centers for Disease Control estimated the national opioid overdose death rate for 2014 to be 9.0 per 100,000. In 2014, 45 counties in North Carolina had overdose death rates of more than 9.0 per 100,000. According to the N.C. Division of Public Health, 1,101 people in the state died in 2012 from unintentional poisoning, with 92 percent of all unintentional poisoning deaths being drug or medication related.


 

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