One Rx

A project training North Dakota pharmacists to screen and talk to patients about opioid use disorder

Many patients prescribed opioids don't fully appreciate the risks of opioid use. Started in 2018, the ONE Rx (Opioid and Naloxone Education) program in North Dakota trains pharmacists to screen patients for opioid use disorder (OUD) and educate them on the safe use of opioid medications. This puts pharmacists on the front lines of preventing OUD as well as early intervention, should warning signs of misuse come to their attention during conversations with patients. Naloxone is distributed to individuals who are identified as high risk for overdose. 

One Rx is a joint project of the North Dakota (ND) State University School of Pharmacy, the ND Department of Human Services, the ND Board of Pharmacy, and the ND Pharmacists Association.

An evaluation found that the program has been successfully implemented as planned. Thus far, the program has enrolled 67 pharmacies and trained over 240 pharmacists, who in turn found that nearly 20% of patients they counseled were at high risk for an accidental opioid overdose. Pharmacists engaged 18% of patients in interventions to encourage safe opioid use. 

ONE Rx is a tool for pharmacists to facilitate crucial conversations with patients using opioid medications...helping them identify and manage risks.

Continuum of Care
Harm Reduction
Type of Evidence
Response Approach
Cautious Opioid Prescribing
Early Intervention
Overdose prevention
Peer-reviewed Article

Evidence of Program Effectiveness

"The ONE Rx training was completed by 240 pharmacists and 41 registered pharmacy technicians. Thirty community pharmacies implemented the program between October 2018 and May 2019, and more than 1700 patients were screened for the risk of opioid misuse and accidental overdose." (Skoy, E. et al.)

" Approximately 16.9% of all patients receiving opioid prescriptions were screened for risk of opioid misuse and accidental overdose. Of the patients screened, 97.1% of patients at risk for opioid misuse or accidental overdose received a pharmacist-led intervention. Additionally, 44.8% of the pharmacist that enrolled in ONE Rx completed at least five screenings and of those, 80.0% maintained the program three months later." (Strand et al., 2020)