UNC researchers find link between life-saving kits and reduced overdose deaths

Researchers at UNC discovered North Carolina’s community-based naloxone distribution program is associated with lower rates of opioid overdose deaths. 

Leading the team was Dr. Becky Naumann, assistant professor of epidemiology and core faculty member of the Injury Prevention Research Center. Researchers found that distributing naloxone kits, which contain a life-saving drug, reduces opioid deaths in North Carolina. 

“We have a close relationship with North Carolina Division of Public Health,” Naumann said. “And with them, we work on evaluating opioid overdose prevention programs and policies across the state. This was one of the programs that was a real priority.”

Naumann and her partners evaluated a naloxone distribution program implemented in August 2013 by the NC Harm Reduction Coalition. The program came in response to rising numbers of opioid-related deaths in the state, which Naumann said is a critical focus of public health experts at the moment. 

“The opioid overdose epidemic is really a crisis right now,” Naumann said. “And what we’re trying to do as a community, as a research community, as a practitioner community, is really try to hone in on and figure out what programs and policies are going to be most effective for us to put our resources behind.” 

According to the North Carolina Department of Health and Human Services, more than 12,000 North Carolina residents died from opioid-related overdoses between 1999 and 2016. In recent years, these deaths have increased at a rapid rate — from 2014 to 2017, the annual number of opioid overdose deaths more than doubled from 962 to 2006. 

Naloxone has proven to be an effective method of preventing these opioid-related deaths. The drug acts as an opioid antagonist, binding to receptors and blocking the effects of opioid drugs. 

The distribution of naloxone kits is one of the best methods of tackling the opioid crisis in North Carolina, Shabbar Ranapurwala, a UNC faculty member who collaborated with Naumann on the study, said.

Ranapurwala said the benefits of a naloxone distribution program extend beyond the prevention of overdose deaths.

“There is a lot of evidence that naloxone distribution can link people to care and other treatment for opioid abuse disorders," Ranapurwala said. "It can connect people to syringe exchange programs so that they can avoid HIV and other infectious diseases that arise from drug use."

Naumann’s study evaluated the association between the number of kits distributed and the number of opioid-related deaths in each county. Her research found that in counties where more than 100 kits were distributed per 100,000 people, the opioid overdose death rate was 14 percent lower than in counties where kits were not distributed.

The study also conducted a cost-benefit analysis of the distribution program, where cost included the price of kits and distribution cost, and benefit was quantified as deaths avoided. The study estimates that for every dollar invested in naloxone distribution, $2,742 was saved by deaths avoided. 

Naumann said she hopes their research findings provide the quantitative estimates and evidence that the NC Harm Reduction Coalition needs to continue providing its services.

“The hope is that they can further get support for additional resources to expand and continue to do the good work they’re doing,” Naumann said.

Ranapurwala is hopeful the study will result in greater involvement by the state in opioid prevention efforts. 

“The state funded a lot of the program, but the organization was very much through Harm Reduction Coalition, who is more of a grassroots organization," Ranapurwala said. "Once we make it more policy-based and organized through the state government, I think there could be a greater impact of such a program.”

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