# Addressing the opioid epidemic through community pharmacy engagement: a multi-state study

> **NIH NIH R34** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $318,151

## Abstract

PROJECT SUMMARY
In 2017, more than 49,000 of the 72,000 estimated drug overdose deaths in the U.S. involved opioid drugs1.
Non-metropolitan rural areas are disproportionately affected by overdose deaths, but often lack access to
naloxone, an opioid overdose reversal agent2. Access to naloxone in rural areas is often limited due to a lack
of community substance use treatment resources and trained health professionals3.
Community pharmacists (pharmacists who work in outpatient ambulatory care settings) are the most
accessible healthcare professional in rural areas4-6 and, due to statewide standing orders that have granted
pharmacists increased prescriptive authority to dispense naloxone to anyone who may benefit from it, are well-
positioned to increase access to naloxone in rural areas7. The release of the Surgeon General's (SG) Advisory
on Naloxone and Opioid Overdose in April 2018, which specifically encourages individuals to talk with their
pharmacists about naloxone10, will likely increase the number of patient and caregiver-initiated requests for
naloxone at community pharmacies. Unfortunately, multiple studies11-12, including our own13, have shown that
even when pharmacies carry naloxone, many pharmacists choose not to offer or dispense it.
Pharmacists' reluctance to offer and dispense naloxone is often associated with discomfort communicating
about the sensitive topic of overdose14-17. Our own work has shown that pharmacists' comfort communicating
about naloxone is significantly associated with how often they offer naloxone13, and existing online naloxone
training resources do not sufficiently address the topic of communication13,18.
The objective of our 4-state collaboration is to develop an online module (Nalox-Comm) to increase rural
pharmacists' self-efficacy to engage in naloxone discussions and, ultimately, increase how often they dispense
naloxone. For Aim 1, we will gather formative data on barriers to engaging in naloxone conversations and
preferences for module content from rural pharmacists, patients, and caregivers (i.e., third parties who obtain
naloxone for someone who takes opioids). We will then analyze formative data and engage in an iterative
intervention development process with a stakeholder development panel and expert consultants to finalize
Nalox-Comm content. For Aim 2, we will conduct a pilot randomized controlled trial in 30 pharmacies to
evaluate whether Nalox-Comm increases the frequency with which pharmacists dispense naloxone (primary
outcome). We will also assess whether the module increases pharmacists' willingness and self-efficacy to
dispense naloxone and improves the quality of their naloxone communication (secondary outcomes).

## Key facts

- **NIH application ID:** 9952357
- **Project number:** 5R34DA046598-02
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Delesha Miller Carpenter
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $318,151
- **Award type:** 5
- **Project period:** 2019-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9952357

## Citation

> US National Institutes of Health, RePORTER application 9952357, Addressing the opioid epidemic through community pharmacy engagement: a multi-state study (5R34DA046598-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9952357. Licensed CC0.

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