One Rx experiences successes; works to combat opioid misuse in North Dakota

The statewide collaborative program ONE Rx recently surpassed its 2000th screening for patients receiving opioid prescriptions in North Dakota. ONE Rx is a program to help address potential prescription opioid misuse from the time a patient picks up their first prescription from their local pharmacist.

Pharmacists and pharmacies enrolled in the statewide collaborative program receive education and tools to help them educate patients on safe use of opioids when prescribed by a physician.

The goal of ONE Rx (opioid and naloxone education), which began in October 2018, is to ensure that patients receiving opioid prescriptions are provided detailed patient education based on their personal need. Pharmacists in the program receive tools to screen for risk of opioid use disorder or accidental overdose and after identifying patient needs, to provide counseling and resources to safely use prescribed opioids.

“No one starts taking a prescription medication expecting to develop an opioid use disorder,” said Professor Mark Strand in the NDSU School of Pharmacy and NDSU Department of Public Health and a ONE Rx program leader. “These tools help pharmacists help their patients identify risks and how to manage them. ONE Rx is a tool for pharmacists to facilitate crucial conversations with patients using opioid medications.”

With more than 2,000 patients screened statewide through the program, Thrifty White Pharmacy #9 in Grand Forks, North Dakota provided the most patient screenings—more than 330 so far.

“The biggest impact ONE Rx has had on patient care is awareness about opioids. Many patients don't understand the full extent of the risks associated with pain medications until they talk to pharmacists,” said Samantha Ketterling, pharmacist in charge of the Thrifty White location on 32nd Avenue South in Grand Forks, North Dakota. “ONE Rx has provided us with the tools to inform and protect our patients from the dangers of opioids. The knowledge and awareness about opioids has also increased immensely among the rest of my pharmacy team.”

ONE Rx benefits communities, as well.

“ONE Rx adds another opportunity for systematic prevention,” said Michael Dulitz, Opioid Response Project Coordinator for Grand Forks Public Health. “Universal screening reduces stigma; ONE Rx empowers pharmacists to identify individuals at risk and select the necessary tools to help address that risk. The program has enabled our local pharmacies to take an increasingly active role in prevention. Our ONE Rx pharmacies have become an important component of our community opioid response,” said Dulitz.

ONE Rx is committed to optimizing the potential of pharmacists to prevent opioid misuse and accidental overdose in their patients, and ensuring safe medication use for each patient every time.

What the numbers show

Thus far, 240 pharmacists have been trained and 67 pharmacies are enrolled in ONE Rx.

  • 19.2 percent of patients counseled identified at high risk for accidental opioid overdose
  • 4.8 percent identified at elevated risk of an opioid use disorder
  • 87 percent of patients were counseled on medication “Take Back” through MedSafe®
  • 18 percent received one or more interventions for safe opioid use
  • 3.6 percent received naloxone

ONE Rx is the effort of multiple partners including North Dakota State University School of Pharmacy, North Dakota Department of Human Services, North Dakota Board of Pharmacy, North Dakota Pharmacists Association, and local public health units. The program received funding from the North Dakota Department of Human Services, the Alex Stern Family Foundation, the Blue Cross Blue Shield of North Dakota Caring Foundation and FM Area Foundation.

For more information about ONE Rx, contact participating pharmacies and local public health units in North Dakota or visit

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