March 5, 2025
Dr. Delesha Carpenter is tackling the state’s opioid epidemic one training at a time with support from Dogwood Health Trust
A new initiative aims to equip community pharmacists in Western North Carolina (WNC) with the training and tools needed to improve access to Medication for Opioid Use Disorder (MOUD) and drug test strips, potentially saving lives in the region hardest hit by the opioid crisis. Dogwood Health Trust is supporting this work with a $240,000 grant.
The project, led by UNC Eshelman School of Pharmacy’s Delesha Carpenter, PhD, seeks to address the ongoing opioid epidemic by providing tailored, evidence-based training and technical assistance to pharmacists through coaching. The goal is to increase the dispensing of buprenorphine—a proven MOUD treatment—and ensure that drug test strips, which are legal yet still unavailable in many community pharmacies, are accessible to those at risk.
“Stigma, increased prescribing, and order thresholds are the three things we’ve identified that have created a ‘buprenorphine bottleneck’ in North Carolina,” said Carpenter, executive vice chair of the Division of Pharmaceutical Outcomes and Policy (DPOP).
Carpenter’s work will focus on Rutherford and McDowell counties, both of which report opioid overdose death rates above the state average and have significantly lower-than-average buprenorphine dispensing rates. Despite efforts to expand MOUD prescribing in North Carolina, barriers such as stigma, pharmacy stocking issues, and regulatory challenges often prevent patients from filling their prescriptions. By training pharmacists to overcome these barriers, the project aims to increase access to treatment for individuals ready to start or maintain MOUD therapy.
Building on a successful pilot program with the North Carolina Association of Pharmacists (NCAP), the initiative will offer an updated online version of the Buprenorphine Understanding in the Pharmacy Environment (BUPE) training, which helps pharmacists overcome buprenorphine dispensing barriers.
“Since we had the pilot, there’s been a major policy change in that DEA x-waivers, or training requirements for clinicians to prescribe buprenorphine for opioid use disorder, are no longer required, which can increase the number of buprenorphine prescriptions going out, but it doesn’t change the barriers at the pharmacy level to improve access,” she said.
Virtual one-on-one coaching will also be offered, where a WNC-based pharmacist coach will provide technical assistance to pharmacists, helping them navigate challenges related to buprenorphine dispensing. By offering both live and online training sessions, hundreds of pharmacists can be reached.
Additionally, the grant will allow the team to educate pharmacists on the importance and implementation of fentanyl and xylazine test strips through a training called “Test to Know”. A previous study conducted by Carpenter showed that pharmacists were willing to provide these test strips but needed more training.
Carpenter says empowering pharmacists with the right tools and knowledge is an important step toward reducing overdose deaths and supporting those struggling with opioid use disorder.
Dr. Grace Marley, research assistant professor in DPOP, Stephanie Kiser, executive director of the School’s Rural Pharmacy Health Initiative, and Dr. Bayla Ostrach, adjunct assistant professor in DPOP, are co-investigators on the project.
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