Collectively, Randolph County community partners remove barriers to naloxone kits for Randolph County residents at greatest risk of experiencing or witnessing an overdose.  This means providing naloxone kits at no cost to those who request it or participate in programs.  Upon distributing a naloxone kit to an individual, training on overdose symptoms and naloxone administration is provided.  Naloxone kits are offered in two forms - intranasal or intramuscular.  The decision on which form of naloxone to use or carry can depend many factors such as cost, availability, and comfort level.  Both are safe, effective, and can help save a life.  Community partners without the funds to provide naloxone to program participants will refer to local pharmacies to purchase or community partners providing naloxone.

*Randolph County Emergency Services - 911 Communications staff are trained to guide a caller through naloxone administration using intranasal or intramuscular kits.

Reverse Opioid Overdose with Naloxone (Centers for Disease Control and Prevention)

Recognizing the presence of xylaxine and fentanyl in drugs increases the risk for fatal overdose, community partners provide overdose prevention tools.  These include xylazine (XTS) and fentanyl test strips (FTS).  Research has demonstrated these tools to be effective at identifying the presence of these substances and creating behavior change.  To learn more about xylazine and XTS, visit Xylazine Resources.  To learn more about fentanyl and FTS, visit Fentanyl Test Strips.

Community partners target those at greatest risk of experiencing or witnessing an overdose.  Those at greatest risk of experiencing an overdose are listed below.  Family, friends, and peers are also targeted as they are most likely to identify an overdose and can respond quickly.

Populations at risk include:

• People with a history of overdose
• People with a history of substance use disorder
• People who are taking benzodiazepines with opioids 
• People who are at risk of returning to a high dose to which they are no longer tolerant 
• People who are taking higher dosages of opioids (more than 50 morphine milligram equivalents/day)

Equipping people at greatest risk of experiencing an overdose and those who are most likely to identify an overdose with naloxone and training will increase ability of residents to successfully reverse an overdose.  Over time, the rate of fatal overdoses will decrease.

Equipping people at greatest risk of experiencing an overdose with overdose prevention tools (xylaxine and fentanyl test strips) and training will increase the ability of people to be safe.  Over time, the rate of overdoses will decrease.

The Randolph County Opioid-Drug Community Collaborative developed three workgroups aligning with the NC Opioid Substance Use Action Plan – prevention, harm reduction, and connect to care. As the 2022 Community Health Assessment committee selected substance use disorders as a priority, the workgroups participated in five facilitated, Results-Based Accountability strategic planning sessions from September 2022 – to February 2023. The workgroups created a results statement they seek to achieve. It reads, “All individuals in Randolph County affected by substance use disorders and mental health conditions are healthy, safe, and free of stigma”. The workgroups selected several strategies to focus their collective effort.

These included:

• Advocate for recovery-friendly workplace policies with local employers (e.g., fair chance hiring, recovery support)
• Reduce barriers to naloxone access through distribution and training on how to administer

Community Hope Alliance (CHA), a local nonprofit, submitted an application for opioid settlement funds to support naloxone distribution and overdose prevention in Randolph County. In July 2023, the organization was awarded the funding to support the effort.  As the primary distributor of naloxone, CHA serves as the harm reduction workgroup coordinator and includes people with lived experience in the program planning and implementation. Workgroups resumed program planning/implementation meetings in late 2023. In December 2023, Blue Cross Blue Shield NC offered to support naloxone distribution in Randolph County through the purchase of naloxone kiosks. To guide the placement of the kiosks, the workgroup requested data related to distribution of fatal overdoses from Randolph County EMS.  The workgroup reconvened in January 2024 to continue planning.

For most of the performance measures, there is no data to be collected at this time. As part of action plans, community partners intend to report this data for FY2023-24.

Progress in 2024 - Substance Use (Naloxone Distribution)

The Harm Reduction workgroup initiated the planning for the naloxone kiosks in collaboration with Blue Cross Blue Shield NC. Utilizing 2023 data related to distribution of fatal overdoses from Randolph County EMS, the workgroup identified five priority zip codes for placement of naloxone kiosks. To guide placement of naloxone kiosks, the workgroup determined a mixed methods data collection from various stakeholders would be helpful. Quantitative and qualitative data collection tools were developed and a plan to engage stakeholder groups in focus groups was drafted. 

Based on previous studies, the workgroup drafted questions and a facilitator guide for the focus groups. Questions were tailored to specific stakeholder groups, but centered around characteristics of naloxone kiosk placement that would encourage access, assure safety, and reduce stigma. The workgroup received feedback from a qualitative researcher on the focus group questions.

As of September 2024, the workgroup is engaging a potential focus group facilitator and preparing for focus group recruitment. Blue Cross Blue Shield NC continue to partner with the workgroup throughout planning and preparing for placement of the naloxone kiosks.