The ONE Program
Project name: Community and Clinical Collaboration for Opioid Misuse and Overdose Prevention
Investigators:
- Jayme Steig, PharmD
- Mark Strand, PhD, CPH
- Amy Werremeyer, PharmD, BCPP
- Heidi Eukel, PharmD
- Oliver Frenzel, PharmD, MPH
- Elizabeth Skoy, PharmD
- Lisa Nagel, PharmD
Timeline: September 2018 – present
Collaborators: North Dakota State University, North Dakota Department of Human Services, Community Pharmacies, Paramedics, Nurses, Correctional Facilities, Tribal Communities
Purpose:
The Opioid and Naloxone Education (ONE) Program is a community pharmacy-based initiative aimed at improving population health by screening patients for opioid misuse and accidental overdose and applying interventions. The mission of the ONE Program is to “proactively help patients and communities by providing resources to pharmacists and patients to educate them about opioid misuse and accidental overdose” It integrates community pharmacy practice into public health initiatives, aligning pharmacy with preventative care. It has led to improvements in pharmacy procedures, a decrease in patient stigma, an increase in naloxone delivery, and notable effects on population-level evaluations.
The ONE Program also includes the provision of opioid risk reduction efforts to home health programs, correctional facilities, North Dakota colleges and universities, collaborations with local public health units, tribal communities, and evidence-based data collection and dissemination.
Find Us
The ONE Program was recently described in an Research Features publication: 
Using opioid riskscreening to combat the opioid epidemic.
What is already known on this topic?
Opioid misuse and overdose continue to be persistent public health challenges. Enhancing safe opioid use for all patients involves identifying those at risk of opioid-related harm and offering preventative services before harm can occur. Community pharmacists, who engage with every patient receiving an opioid prescription, are uniquely positioned to implement interventions to ensure safe medication use and prevent opioid misuse.
What is the impact of this project on collaboration and advancement in pharmacy?
The ONE Program has demonstrated the crucial role community pharmacists play in preventing opioid misuse and overdose. It has also highlighted the importance of incorporating community pharmacy practice into public health initiatives throughout North Dakota, aligning pharmacy with preventive care efforts.
What is the impact of this project on improving population health?
The ONE Program tackles a major patient safety issue and has the potential to reduce the high-cost burden associated with medication safety. It includes a sustainable and evidence-based tool/process that can be easily transferred and adapted to meet the needs of individual pharmacies. The ONE Program has led to positive changes in pharmacist practice-based behaviors, reduced pharmacist stigma towards patients, increased naloxone dispensing to those at risk, and shown significance in population-level evaluations.
Publications
A PharmD Program Curricular Approach to Addressing the Opioid Crisis, DOI: 10.1016/j.cptl.2019.02.026
Preparing Student Pharmacists to Identify Opioid Misuse, Prevent Overdose, and Prescribe Naloxone. DOI: 10.1016/j.cptl.2019.02.013
A Primary Prevention Approach to the Opioid Epidemic, DOI:10.2105/AJPH.2019.305060
Changes in Pharmacists’ Perceptions After a Training in Opioid Misuse and Accidental Overdose Prevention, DOI:10.1097/CEH.0000000000000233
Evaluation of a Program to Screen Patients in Community Pharmacies for Opioid Misuse and Accidental Overdose, DOI:10.5888/pcd19.220028
Examining Attitudes and Beliefs that Inhibit Pharmacist Implementation of a Statewide Opioid Harm Reduction Program, DOI:10.24926/iip.v11i4.3446
Implementation of a Statewide Program within Community Pharmacies to Prevent Opioid Misuse and Accidental Overdose, DOI:10.1016/j.japh.2019.09.003
Improving Community Pharmacist-Delivered Care for Patients With Psychiatric Disorders Filling an Opioid Prescription, DOI:10.1176/appi.ps.202100592
Longitudinal Evaluation of Pharmacists’ Social Distance Preference and Attitudes Toward Patients with Opioid Misuse Following an Educational Training Program, DOI:10.1080/08(897) 077-2022.2060449
Nurse Delivered Medication Safety Screening Program for Home Care Visits, DOI:10.1111/phn.13178
Opioid Risk Stratification in the Community Pharmacy: The Utility of the Opioid Risk Tool, DOI:10.1016/j.sapharm.2022.07.009
Patient Acceptance of Naloxone Resulting from Targeted Intervention from Community Pharmacists to Prevent Opioid Misuse and Accidental Overdose, DOI:10.1080/08(897) 077-2020.1827126
Pharmacists Stigma Toward Patients Engaged in Opioid Misuse: When “Social Distance” Does Not Mean Disease Prevention, DOI:10.1080/08(897) 077-2021.1900988
Program Evaluation of the Opioid and Naloxone Education (ONE Rx) Program using the RE-AIM Model, DOI:10.1016/j.sapharm.2019.11.016
Patient Experience and Satisfaction with Opioid-Related Screening and Intervention in Community Pharmacies, DOI: 10.1177/08971900221109528
Impact of Implementing Screening and Interventions to Target Prevention of Opioid Misuse and Accidental Overdose in the Inpatient Setting, DOI:10.1177/08971900221144183
A Longitudinal Comparison of Pharmacy Documentation Platforms Using the Technology Acceptance Model, DOI:10.1177/87551225221128207
Implementation of a Pharmacy Follow-Up Program for Dispensed Opioid Medications, DOI: 10.3390/ijerph20176628
Availability of Buprenorphine/Naloxone Films and Naloxone Nasal Spray in Community Pharmacies in 11 U.S. States, DOI: 10.1016/j.drugalcdep.2022.109518
Opioid Risk Screening: Program Evaluation from the Community Pharmacists’ Perspective, DOI: doi.org/10.1016/j.japh.2021.12.003
Opioid Misuse and Overdose: Changes in Pharmacist Practices and Outcomes, DOI:10.1097/CEH.0000000000000317
Assessing a Medication Safety and Disposal Program Using the Health Belief Model, DOI:10.24926/iip.v14i3.5546
Moving Opioid Misuse Prevention Upstream: A Pilot Study of Community Pharmacists Screening for Opioid Misuse, DOI: 10.1016/j.sapharm.2018.07.011.
A Call to Develop Opioid Risk Assessment Programs for Implementation in the Pharmacy Setting Doi: 10.1016/j.japh.2023.10.018
Grants
Eukel H, Strand M, Skoy E, Steig J, Werremeyer A. Community and Clinical Collaboration for Opioid Misuse and Overdose Prevention. North Dakota Department of Human Services. October 2020 – September 2021. $283,935
Eukel H, Strand M. Public Health Nursing Supporting Safe Opioid Use through ONE Rx $15,000
Strand M, Eukel H, Werremeyer A, Skoy E, Steig J. Primary prevention of opioid misuse and accidental overdose across North Dakota. North Dakota Department of Human Services. September 2019 – August 2020. $221,887
Eukel H, Strand M, Werremeyer A, Skoy E, Steig J. Opioid Misuse and Overdose Risk Prevention Expansion. North Dakota Department of Human Services. January 2019 – September 2019. $141,000
Strand MD, Eukel H, Werremeyer A, Skoy E, Steig J. Community Pharmacy Opioid Misuse Risk Prevention toolkit project. Alex Stern Family Foundation. May 2018 – December 2019. $15,000
Strand MD, Eukel H, Werremeyer A, Skoy E, Steig J. Community Pharmacy Opioid Misuse Risk Prevention toolkit project. North Dakota Department of Human Services. May 2018 – December 2019. $116,468
Strand MD, Eukel H, Werremeyer A, Skoy E, Steig J. Community Pharmacy Opioid Misuse Risk Prevention toolkit project. Blue Cross Blue Shield of North Dakota Caring Foundation. May 2018 – December 2019. $19,000
Strand MD, Eukel H. Pharmacist Engagement in the community to Target Opioid Abuse Prevention. FM Area Foundation and the North Dakota Board of Pharmacy. June 2017. $11,078
Skoy E, Eukel H. Expansion of the ONE Program with West Virginia Drug Intervention Institute, Inc. May 2024-September 2024. $10,482
Strand O, Frenzel O, Eukel H, Skoy E, Werremeyer A. Opioid Harm Prevention in Tribal Communities. North Dakota Department of Health and Human Services. February 2024 – August 2025. $83,536
Eukel H, Skoy E, Werremeyer A. Expansion of Opioid Overdose Rescue Kits and Opioid Safety Education Across North Dakota. North Dakota Department of Health and Human Services. January 2024 – March 2024. $75,000
Eukel H, Skoy E, Steig J, Strand M, Werremeyer A. Preventative Opioid Risk Mitigation in North Dakota. North Dakota Department of Health and Human Services. October 2023 – September 2024. $589, 867
Eukel H, Skoy E, Werremeyer A. State-wide Community and University Opioid Safety Education and Opioid Overdose Rescue Kits. North Dakota Department of Health and Human Services. October 2023 – September 2023. $59,968
Eukel H, Skoy E, Werremeyer A. Opioid Overdose Rescue Kits and Opioid Safety Education Across North Dakota Communities and Universities. North Dakota Department of Health and Human Services. May 2023 – September 2023. $118,000
Eukel H, Strand M, Skoy E, Steig J, Werremeyer A. Opioid and Naloxone Education: A State-wide Approach to Prevention, Education, and Interventions. North Dakota Department of Health and Human Services. October 2022 – September 2023. $632,000
Steig J, Nagel L, Eukel H, Skoy E, Werremeyer A. Opioid Drug Safety Risk Evaluation and Mitigation Strategies (REMS) Development. MMB Healthcare. January 2022 – December 2022. $80,170
Steig J, Eukel H, Hursman A, Skoy E, Strand M, Werremeyer A. Opioid Drug Safety REMS Planning. MMB Healthcare. October 2021 – December 2021. $5,000
Eukel H, Strand M, Skoy E, Slevin A, Steig J, Werremeyer A. Preventative Care Collaboration – Opioid and Hepatitis C Risk Prevention. North Dakota Department of Human Services. October 2021 – September 2022. $444,717
Eukel H, Strand M, Frenzel O, Nagel L, Skoy E, Steig J, Werremeyer A. ONE Program: Opioid Risk Mitigation In North Dakota.. North Dakota Department of Health and Human Services. October 2024 – September 2025. $500,000