Combating the Opioid Crisis from the Inside Out
Personal passions drive Carolina pharmacy faculty and students to find new solutions to the opioid crisis
Story by Carrie Creasy| Graphic by Ryan McDaniel | Published December 6, 2022
Until a few years ago, Delesha Carpenter, PhD, MSPH, had a research program focused on asthma and pediatric communication. Then, within the span of two weeks, she lost two dear friends to opioid overdoses. Within a year, Dr. Carpenter shifted her entire line of research toward increasing naloxone access and suicide prevention. She now uses her public health background to do interventions that make large impacts affecting population level health in the opioid space. She is developing trainings for community pharmacists to improve patient-provider communication about sensitive issues, like opioid abuse.
“Even people who have been out there, boots on the ground, for 20 years, are still uncomfortable having this conversation,” Dr. Carpenter admits. By addressing community providers directly, she reaches the patient population about which she is most passionate. Recently, Dr. Carpenter was awarded a $2.4M grant from the NIH to increase naloxone access.
In documenting where there are geographic or racial disparities in naloxone access across North Carolina, her team aspires to develop useful tools that can be replicated in other states. Dr. Carpenter sees a growing opportunity to affect positive change at the UNC Eshelman School of Pharmacy, especially given the increasing number of pharmacy students interested in her work.
Dr. Carpenter teaches pharmacy students early in their training how to recognize and respond to suicide warning signs. As they settle into their coursework, students often connect with faculty advisors whose research is aligned with their own research interests and desired careers. Dr. Carpenter has noticed a growing number of students interested in opioid centered research.
“A lot of the students who have worked as pharmacy technicians already, and students on early immersions, have reported wanting to get more involved in harm reduction activities in the pharmacy setting,” she notes. Dr. Carpenter is encouraged by this uptick of interest: “I am really glad pharmacy students are passionate about this because pharmacy has a huge role to play in tackling the opioid epidemic.”
The state’s devastating numbers crystallize the opioid crisis as an overwhelming problem draining both North Carolina communities and healthcare professionals. According to the Office of the Chief Medical Examiner, fentanyl-positive overdose deaths increased 212% from 2019-2021 in North Carolina alone. Still, the undeniable prevalence is not the primary motivation for much of the incredible work being done. Like Dr. Carpenter, many who are striving to address this problem professionally have their own personal connections driving them, too.
Grace Trull Marley, PharmD Candidate ’23, is intimately familiar with the stigma surrounding opioid misuse. She watched her older brother battle his addiction throughout her own adolescence. She volunteered at a rehab facility during her undergraduate years before pursuing pharmacy school to be an integral part of significant change.
Grace remembers a lecture during her first year of the PharmD program when substance use disorders and harm reduction efforts were compared to diabetes and insulin. “Something hit me,” she recalls. “I really wanted to make a difference and learn more about what causes someone to have this physiological addiction.” Grace emphasizes that, “Real lives are being lost – people with dreams and aspirations. We don’t talk about it enough.”
Her own experience makes Grace comfortable, confident, and capable in the extremely polarizing conversation. Throughout her four years at the School, she has sought opportunities to contribute personally to work on this subject. Grace devoted her first year of graduate school to research on Medicaid’s coverage of naloxone and barriers to access in all 50 states. She spent her second year conducting a secret shopper study looking at pharmacists’ willingness to dispense buprenorphine, an FDA-approved medication to treat Opioid Use Disorder. She joined the work of Dr. Carpenter to create a training for community pharmacists to overcome DEA limitations and other barriers to buprenorphine.
Grace also engaged with Auburn University in research exploring how the general public perceives naloxone and what effective naloxone education would look like to a community. Her extensive extracurricular efforts have helped make a difference. She notes, “People are beginning to understand this is not just other people’s problem as it starts to more directly affect everyone across the board.”
Tia Belvin, PharmD Candidate ’23, was in her first month of pharmacy school when she lost a close friend to an overdose. Tia was drawn to the Student Taskforce Against Opioid Misuse (StOMP) on campus immediately, and sought a leadership role with their annual naloxone kit making event in her first year. She hit her stride participating in APhA’s student chapter at the School, where she served as President from March 2021-2022. Currently Tia is on their National Committee, as the Liaison for Operation Substance Use Disorders, one of the six APhA patient care projects supported nationally.
Tia is a resource for local APhA chapters pursuing their own unique community outreach projects. “It is inspiring to see students that are a part of this at their local chapter, doing unique events to educate their individual communities,” she says. “The people who are passionate about this reinvigorate it in me.”
Tia has volunteered in a number of medication take-back events, raises awareness for naloxone, and works to encourage community pharmacists to push local policies. During July 2022 Tia completed APhA’s Association Management Externship in Washington DC where she practiced intentional communication with external government entities like the CDC and FDA. She understands that more discourse is necessary in forums where higher-level impact takes place. Tia is interested in legislation and policy and is making plans to pursue administrative pharmacy.
“My personal relationship with this issue made me expect the conversation to be more integrated at pharmacy school,” explains Tia. “Throughout my four years, the conversation has become louder within the classroom.” Grace agrees that sometimes the work feels siloed and points out that “the realities of the opioid crisis have been overshadowed by Covid.” Tia and Grace will launch into their own careers upon graduating this spring, but have paved the way for students in their wake to continue with progress.
As this conversation accelerates, work continues around the School and the University to combat the opioid crisis. Dr. Carpenter is preparing to present at the Prescription Drug Abuse Summit, one of the more opioid-focused conferences in the nation, in April 2023. She says, “I expect to see the School doing even more in this space in the coming years, from drug development to outcomes research.” Dr. Carpenter, Tia, and Grace are each grateful for their platforms and as they strive toward more pathways to connect people with similar interests at the School and beyond. The issue is gaining attention and momentum – positive outcomes are on the horizon.
This story highlights just one of the School’s initiatives to combat the opioid crisis. Read about other initiatives here:
First In Venture Studio Takes Aim at the Opioid Crisis
Pursuing Safer Pain Relief Without Addiction