142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Rural North Carolinian Appalachian law enforcement and drug users: Engaged, willing and able to use an opioid antagonist to decrease opioid overdose mortality

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 11:30 AM - 11:50 AM

Robert Childs, MPH , North Carolina Harm Reduction Coalition, Durham, NC

Last year over 1,100 North Carolinians died prematurely from an unintentional drug overdose, the majority of which occurred in rural communities. In response to this pressing public health problem in rural communities, the North Carolina Harm Reduction Coalition (NCHRC) successfully advocated for the passage of the nations’ first Republican based comprehensive drug overdose bill (SB20) in 2013. SB20 contains a 911 Good Samaritan provision, ensuring immunity for small amounts of drugs, alcohol and drug paraphernalia at drug overdoses, as well as immunity from criminal and civil liability to prescribers and administrators of an opioid antidote. SB20 also allowed community organizations, such as NCHRC,  to dispense it without the presence of a medical provider through a standing order.


NCHRC conducted 90-minute educational trainings on overdose prevention and response with several dozen Law Enforcement departments. Pre-/post-surveys of trainees were collected. Additionally, NCHRC surveyed, provided naloxone to, and conducted in depth interview with illegal and prescription drug users who don't use their medication as prescribed.


Findings will describe the implementation of overdose prevention measures, including carrying the antidote, in participating Appalachian law enforcement departments (five, as of abstract submission, with >30 anticipated), as well as data from pre-/post-surveys. Partnerships have been arranged with the state’s Appalachian region drug users unions and methadone clinics, providing access to naloxone to their patients and resulting in 45 overdose reversals in a 4-month pilot period.


A combination of Law Enforcement and illegal drug/prescription drug user trainings, with a focus on overdose prevention and antidote use, can be an effective tool to shift knowledge/attitudes, practice in addressing overdose prevention, and overdose mortality in Southern Appalachian states.

Learning Areas:

Administer health education strategies, interventions and programs
Advocacy for health and health education
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Describe harm reduction approaches to overdose prevention, including the use of opioid antagonists Explain essential components of the implementation of an overdose prevention intervention in rural Appalachian communities Name how simultaneous engagement of Law Enforcement and drug users is effective in overdose prevention

Keyword(s): Rural Health, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Robert Childs currently servers as NC Harm Reduction Coalition’s Executive Director and was named one of five people who made a difference in HIV in 2011 and was recognized for running the best Grassroots Campaign by the AAA+ in 2013. Robert is considered an expert in harm reduction and has presented at the UN, US Congress, FDA and multiple State Legislatures. Childs specializes in getting conservatives and law enforcement to buy into harm reduction.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.