Collections > Master's Papers > Gillings School of Public Health > Evaluation of North Carolina Laws SB 20 and HB 850 and Development of Revised Drug Policy for UNC System Schools
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Background: Drug overdoses have reached epidemic proportions, becoming the leading cause of unintentional injury deaths in the United States (U.S.), surpassing motor vehicle accidents in 2009 (Jones et al, 2013). To address this rising problem, North Carolina recently enacted Senate Bill 20 (SB 20), a Good Samaritan overdose prevention legislation that provides legal protection for those who call for medical help in the case of a drug overdose. This law also removes civil and criminal liability for prescriptions and use of naloxone, an opioid overdose reversal drug. Additionally, North Carolina's House Bill 850 (HB 850) was enacted to reduce the spread of blood-borne diseases by providing legal protection for those who declare a clean syringe to a law enforcement officer prior to being searched. The first aim of the Capstone project was to evaluate these policies to understand their impact in the populations they are intended to benefit. Through the second aim of the project, the Capstone team advocated for revision of the University of North Carolina's (UNC) system-wide drug policy to reflect the intent of the newly enacted laws. Methods: To evaluate the policies, we conducted 78 three to five minute interviews with those at risk of experiencing and/or witnessing unintentional overdose at five sites in North Carolina. We analyzed this data to assess individual knowledge of the new laws and how this knowledge may result in behavior change. To advocate for a revision of the UNC system drug policy, we conducted in-person interviews with stakeholders at UNC-Chapel Hill (UNC-CH) using semi-structured interview guides, and telephone interviews with administrative counterparts at other campuses, using a revised and shortened interview guide. Additionally, we conducted a web-based survey about campus drug policy and use to UNC-CH students. We then analyzed data from the interviews and surveys to inform a policy brief and executive summary, which were then disseminated to relevant system stakeholders. Results: Our evaluation findings revealed that a majority of participants were unaware of the components of the newly enacted laws. Additionally, mistrust of law enforcement played a large role in participant's intended behavior during an overdose or police search. These findings were summarized in a manuscript and submitted to the International Journal of Drug Policy. Three key ideas informed the revision of the UNC system-wide policy and the accompanying policy brief and executive summary: support received for the revised policy; information obtained on inadequacies in the current zero-tolerance policy; and methods suggested for implementation of the policy. Discussion: Evaluation results illustrate the need of expanded educational and advocacy campaigns to spread knowledge of SB 20 and HB 850. Additionally, the evaluation results indicate a sentiment that the laws' partial protections make them irrelevant to many individuals at risk of experiencing or witnessing an unintentional opioid overdose. Qualitative data from University stakeholders provided valuable insight into the current policy development and implementation process and informed recommendations for the UNC system Board of Governors. While most stakeholders felt Good Samaritan policies for alcohol could pave the way for these policies to include drugs, the inclusion of Good Samaritan drug policies will require additional efforts.