One 26-year-old Cabarrus County woman had an opioid addiction so bad that she risked exposure to HIV/AIDS and other diseases by shooting up with a used needle that she had bleached and sharpened.
Now, because she turned in her needle at a publicly sponsored syringe exchange and enrolled in a methadone treatment program in the county, she is no longer using illegal drugs and is running her own repair business.
In a state where nearly 2,000 people die each year from an unintentional opioid overdose, this is the kind of success story that communities are sharing and learning from through a new project from the School of Government.
The Opioid Response Project, directed by the School of Government’s ncIMPACT Initiative, has Carolina faculty experts on law, social services, nonprofits, child welfare and more partnering with local governments to find some common solutions for the opioid problem. The goal of the project is that the first responders, law enforcement, health care professionals, treatment and recovery providers, judicial workers, local government officials and others from these communities learn from each other and distill these experiences into action plans for their communities.
Ten community teams from 16 counties across the state are participating in the project. One team covers five counties (Beaufort, Hyde, Martin, Tyrell and Washington) and another covers three (Greene, Lenoir and Wayne). The other counties are Cabarrus, Cumberland, Durham, Forsyth, Mecklenburg, Onslow, Transylvania and Wilkes.
“Each of these communities faces its own variation of the opioid crisis,” said Anita Brown-Graham, the professor of public law and government who leads ncIMPACT. “The challenges that these communities have expressed to us won’t surprise you, but it might surprise you how diverse they are.”
Across the state, social workers have seen the number of children in foster care double annually. In Lenoir County, so many parents with addiction have lost custody of their children that the county set up a drug court program that helped with employment and housing to help reunite families. Municipalities that want to add a drug treatment center have to consider how close it would be to a school. The schools have to figure out how to educate the children who live in households made unstable because of parental drug addiction.
‘Cross-pollination’ of expertise
The project is co-led by Kimberly L. Nelson, Albert and Gladys Hall Coates Distinguished Term Associate Professor of Public Administration and Government, and Adam Lovelady, associate professor of public law and government.
The two approached ncIMPACT about the project, which was funded by a $390,000 gift from BlueCross BlueShield of North Carolina. The gift included $10,000 for each team to hire a community project manager and $10,000 for implementation.
Other faculty members with roles in the project include Willow Jacobson, Albert and Gladys Hall Coates Distinguished Term Professor for Teaching Excellence; Jill D. Moore, associate professor of public law and government; Amy Wade, director of MPA Faculty Network; Mark Botts, associate professor of public law and government; and Sara DePasquale, an assistant professor of public law and government. Other School of Government team members include Emily Williamson Gangi, engagement director of the ncIMPACT Initiative, and Patrice Roessler, manager of elected official programming.
“We’ve tried to figure out how to bring that expertise together in a way that not only trains the communities but positions them to train each other. It’s cross-pollination,” said Gangi.
The community teams come from urban, suburban and rural areas.
“These communities have what we call a ‘wicked problem,’” said Jacobson, who designs educational content. “It needs integrated solutions at the root-cause level. We want them to pool their efforts to keep the boats rowing in the same direction without bumping into each other.”
After a summer of advance work, teams met on campus in fall 2018 to learn more about the epidemic, talk with peers from other communities and make plans for their communities. They refined plans at a February forum in Goldsboro and are executing those plans this spring.
The teams will meet five times in all, at forums in different regions of the state. At the forums, the teams will learn from experts on opioid-related issues, from faculty experts and from each other.
Nelson sees great value in bringing individual team members together with their peers, which sparked a desire to continue talking online, by phone and in meetings.
“They may have more challenges working together,” Nelson said. “Part of the faculty’s value is helping them through this process with tools and resources to help them overcome roadblocks they might encounter.”
Wade, an expert in collective impact, agreed. “Our role is helping them create stronger internal infrastructure and capacity and achieve efficiency, effectiveness and better alignment of services in their community. It’s taking a step back to think strategically about how to create a roadmap so that your community can make a more meaningful impact.”
After the project’s fifth forum in 2020, faculty will finish work on a public website and a free guide based on lessons learned and other resources gathered over the two-year program.
“We’re setting them up to effectively move into implementation,” Nelson said. “We want every team to have an action plan that they can operationalize in their community and to be clear on the baseline data for each strategy. They will need to communicate regularly as they move forward and use adaptive strategies for changes along the roadmap they’ve created for their work.”
Some teams have already identified best practices for which they need funding. A team of graduate students from the School of Government, the UNC Gillings School of Global Public Health and the city and regional planning department is helping write grant proposals for the funding.
“We recognize that there are 10 different teams with 10 different compositions and 10 different sets of priorities,” Lovelady said. “There will be some evolution over time, but certainly this spring they’ll have clear action steps and will transition to addressing the challenges in their communities.”