# Creating a novel place-based measure to explain racial disparities in naloxone access to reduce opioid overdose deaths

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2022 · $656,567

## Abstract

PROJECT SUMMARY
From May 2020 to April 2021, more than 100,000 individuals died of a drug overdose, making it the leading
cause of injury death in the United States.[1] The increase in the overdose death rate has primarily been borne
by American Indian/Alaska Native (AI/AN) and Black people, with the overdose rate of AI/ANs (29.8/100,000)
and Blacks (27.3/100,000) now exceeding that of non-Hispanic Whites (23.6/100,000).[4] In North Carolina
(NC) from 2019 to 2020, the overdose death rate increased by more than 75% for AI/ANs and 52% for Blacks,
compared to a 19% increase for non-Hispanic Whites.[25]
Distributing naloxone, an opioid overdose reversal agent, is an effective method for reducing opioid overdose
deaths.[5, 6] The majority of overdose deaths involve opioids, including the synthetic opioid, fentanyl,[26] which
has prompted large-scale national efforts to increase naloxone availability.[5] Naloxone can be purchased at
community pharmacies and is also distributed for free by community-based entities, such as syringe service
programs (SSPs). Unfortunately, recent studies have documented racial and geographic disparities in access
to naloxone, which may contribute to growing disparities in opioid overdose deaths.[7-10, 14, 31]
To our knowledge, no comprehensive measure of naloxone availability has been reported in the literature.
Most studies of naloxone availability assess single sources, such as pharmacies[11-16] or community-based
programs,[17, 18] leaving an incomplete picture of total community-level access. Our objective is to develop a
novel, comprehensive place-based measure of naloxone availability in order to document disparities in
naloxone access. For Aim 1, we will work with an Advisory Board to create a novel, comprehensive place-
based measure of naloxone availability. We will combine primary data collected from a secret shopper study of
community pharmacies and surveys of NC’s naloxone distribution entities with secondary insurance claims
data to comprehensively document sources of naloxone by ZIP code. For Aim 2, we will estimate disparities in
naloxone availability for: (1) AI/AN and Black communities; (2) rural populations; and (3) populations at high-
risk of an opioid overdose.[20, 21] For Aim 3, we will identify how social and community factors, such as
community-level social segregation and drug-related arrests, mediate the relationship between geographic
location and racial disparities in naloxone availability. This study will result in the development of visual tools
and maps that display racial and geographic disparities in availability so that naloxone-distributing entities can
coordinate efforts to ensure equity in naloxone distribution to prevent opioid overdose deaths. We will also
disseminate our measurement development framework so it can be readily replicated in other states.

## Key facts

- **NIH application ID:** 10567710
- **Project number:** 1R01MD018085-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Delesha Miller Carpenter
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $656,567
- **Award type:** 1
- **Project period:** 2022-09-26 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10567710

## Citation

> US National Institutes of Health, RePORTER application 10567710, Creating a novel place-based measure to explain racial disparities in naloxone access to reduce opioid overdose deaths (1R01MD018085-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10567710. Licensed CC0.

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