North Carolina has fought the opioid epidemic with an array of public- and private-sector initiatives. In 2017, Governor Roy Cooper released the state’s Opioid Action Plan developed in collaboration with community partners. The plan mobilized state agencies to implement strategies for reducing the number of opioid prescriptions and expanding access to treatment and recovery-oriented systems of care. As part of the plan, the state established the North Carolina Payers Council to bring Medicaid, Medicare and commercial insurers together to collaborate on responses to the epidemic. While there has been a 12 percent reduction in the number of opioid prescriptions since 2013, the rate of opioid-related deaths has not yet plateaued in North Carolina.

A new spotlight analysis, developed by Manatt Health in partnership with the American Medical Association (AMA) and the North Carolina Medical Society, focuses on two agencies—North Carolina Medicaid and the North Carolina Department of Insurance. It provides a detailed analysis of what the state has accomplished and where it could take further action. Of particular note, North Carolina has not expanded Medicaid to low-income adults as allowed under federal law, leaving approximately 150,000 North Carolinians who have a substance use disorder (SUD) without coverage. This is a major missed opportunity that could help North Carolina end the opioid epidemic within its borders.