ONE Program Aims to Break Stigma of Opioid Use, Save More Patient Lives

Amid the backdrop of drug overdoses topping 100,000 annually, the Opioid and Naloxone (ONE) program at the North Dakota State University (NDSU) School of Pharmacy aims to make a difference and hopes to expand into multiple states, with the first being West Virginia.

Over the next few months, programs such as ONE and NaloxONE West Virginia intend to make legislative inroads into addressing the opioid crisis in the United States.^1,2

ONE is a continuing-education program intended for pharmacy professionals to prevent opioid misuse and accidental overdose with specific tools, such as a follow-up pharmacy technician program, online training, and other resources, according to the ONE program website.²

After seeing how naloxone was taught in academia and its indication of only being used in specific environments in the pharmacy, Elizabeth Skoy, PharmD, director of the Center for Collaboration and Advancement in Pharmacy at NDSU, thought that there was a need to build the ONE program.

The growing use of new devices in the pharmacy with pharmacy teams having little to no education on how to use them was a hurdle to overcome, she said in an interview.

An example of the educational training that Skoy and her colleagues have developed in the ONE program is an introduction to a tool to screen patients for the risk of opioid misuse, the risks associated with accidental opioid overdose, and the science behind addiction.²

The first state on board to include the ONE Program into its pharmacy practice is West Virginia, which recently announced that the West Virginia Drug Intervention Institute would implement the NaloxONE West Virginia program with more than 20 pharmacies across the state.³

The opioid epidemic has swept through West Virginia, and many health care professionals have wanted to bring a program like this to fruition, according to Susan Bissett, PhD, president of the West Virginia Drug Intervention Institute.

She has seen the issue of prescription drugs shift to more illicit drugs, but misuse and accidental overdoses occurring in the home have outweighed these problems recently.

“When you look at the number of prescriptions for opioids, even though they have gone down, we still have a large number of the population on opioids, so I find that the naloxone piece is really important,” Bissett said in an interview.

In addition, a troubling issue arising in West Virginia is the number of children who are being raised by their grandparents as a result of the opioid epidemic, which can have adverse consequences.

“They come from homes where misuse was normalized and are then moved into homes where misuse is not common, but medicine is more accessible, since there is more chance of multiple prescriptions or an opioid script,” Bissett said.

The goal of the ONE Program is to continue its expansion across all pharmacies in the United States.

“There are a lot of different programs out there with pharmacy involvement to prevent opioid related deaths, and I commend all of them; everyone is doing something to help. But the ONE program is really all encompassing, because it is preventative and allows pharmacy to play more of a role in prevention,” Skoy said.

An unintended benefit of the work behind ONE and NaloxONE West Virginia is the education it has provided the public to show how vital pharmacists are, according to Bissett.

“A pharmacist is somebody that most people in their community, especially in rural communities, know and trust. So, if that person is providing them with an additional screening tool and counseling opportunity to engage with them in medication safety, I think that is just crucial,” Bissett said.

Even with these positives, there is still work to be done on the legislative front. The education and pharmacist delivery of naloxone has increased since these programs began, but Bissett hopes that the work with the 30 independent pharmacies as a pilot makes changes specifically through the Centers for Medicare and Medicaid Services.

“As you know, with Medicaid and Medicare, they reimburse, and private insurers follow suit, so that is really what we’re hoping for, in that it becomes a reimbursable expense, secondarily. First and foremost is to save lives,” Bissett said.

References

• Drug overdose deaths in the U.S. top 100,000 annually. CDC. News release. November 17, 2021. Accessed May 2, 2022. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm
• ONE opioid and naloxone education. Accessed May 2, 2022. https://one-program.org/
• Opioid and Naloxone Education program from North Dakota State University expands to more states. North Dakota State University School of Pharmacy. News release. February 16, 2022. Accessed May 2, 2022. https://www.ndsu.edu/pharmacy/news/detail/67388/