More than 107,000 people died of drug overdoses in 2021, with deaths rising fastest in Black, Indigenous, and other communities of color. In 2021, the overdose crisis took the lives of North Carolinians at the rate of ten per day, and last month, North Carolina’s Office of the Chief Medical Examiner confirmed that deaths continued at these high levels into 2022. Efforts to reverse course on the overdose crisis are hampered by widespread discrimination against people who use drugs and the routine denial of lifesaving medications for opioid use disorder (MOUD).

In response, the Vital Strategies Overdose Prevention Program and Disability Rights North Carolina (DRNC) have launched two initiatives to protect the right to healthcare and other supportive services for North Carolinians with substance use disabilities, including access to agonist medications for opioid use disorder (MOUD) in jails across the state.

“DRNC is very enthusiastic about launching these new programs with Vital Strategies to improve conditions in North Carolina for people with substance and opioid use disabilities,” said Virginia Knowlton Marcus, CEO of DRNC. “We must build community awareness and end discrimination to stop these tragic deaths. Disability must never be a barrier to accessing care.”

Discrimination in Healthcare and Supportive Services

As part of the partnership, DRNC will leverage data collection, individual legal assistance, systemic litigation, and related strategies to address discrimination in healthcare for people with substance or opioid use disabilities in North Carolina. Discrimination in healthcare against people who use drugs takes many forms, such as substandard care in emergency rooms after an overdose or denial of admission to a skilled nursing facility because someone is taking prescribed medications for opioid use disorder.

The project will incorporate several strategies:

  • Creating Know Your Rights and other materials for directly affected communities
  • Monitoring healthcare facilities and engaging communities to understand where and how discrimination takes place
  • Providing direct legal assistance to individuals experiencing discrimination based on their current or previous substance use
  • Developing a litigation strategy to target systemic drivers of discrimination.

“People who use drugs have a federally protected right to be free from discrimination in the provision of healthcare,” said Derek Carr, Legal Technical Advisor for the Overdose Prevention Program at Vital Strategies. “Yet from recovery homes that deny admission to people taking prescribed medications for opioid use disorder to hospitals that refuse to provide medically appropriate care based on a person’s current or past substance use, discrimination remains a persistent barrier to care. We are thrilled to partner with Disability Rights North Carolina on this important initiative to help ensure that North Carolinians can access the full continuum of evidence-based, life-saving services.”

Denial of Lifesaving Treatment in Jails

In addition to addressing discrimination against people with substance use disabilities in healthcare and other supportive settings, DRNC will investigate policies and practices related to medications for opioid use disorder (MOUD) in North Carolina’s jail and detention facilities. This includes publishing a comprehensive report on the current state of MOUD access in these facilities, developing Know Your Rights and other educational materials for incarcerated individuals, and providing legal assistance to individuals held in jails or detention facilities who seek access to MOUD.

“North Carolinians who have been incarcerated are 40 times more likely than the general public to die from overdose in the weeks following release from incarceration,” said Kate Boulton, Senior Legal Technical Advisor at Vital Strategies. “We know that access to buprenorphine or methadone dramatically reduces the risk of fatal overdose, but these medications remain unavailable or extremely limited in many correctional settings. We are proud to partner with Disability Rights North Carolina as one of several strategies to help ensure that these lifesaving medications are available to people in North Carolina jails and detention facilities.”

The collaboration between DRNC and Vital Strategies builds upon each organization’s work. This includes DRNC’s extensive reporting on overdose deaths in North Carolina jails and Vital Strategies’ joint initiative with the Legal Action Center to enforce and expand anti-discrimination protections for people who use drugs. The partnership also can serve as a model for how state Protection and Advocacy organizations like DRNC can use their specialized legal expertise to address issues of discrimination faced by people with substance use disabilities.

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About Vital Strategies

Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. Our overdose prevention program works to strengthen and scale up evidence-based, data-driven policies and interventions to create equitable and sustainable reductions in overdose deaths. Work across seven U.S. States is supported by funding from the Bloomberg Philanthropies Overdose Prevention Initiative, launched in 2018, and by targeted investments from other partners.

Learn more at

About Disability Rights North Carolina

Disability Rights North Carolina is the federally mandated protection and advocacy system in North Carolina, dedicated to advancing the rights of all people with disabilities, of all ages, statewide. DRNC is an independent, 501(c)(3) nonprofit organization and a member of the National Disability Rights Network. Learn more about Disability Rights North Carolina at


Tony Newman, Director of Communication
Overdose Prevention Program, Vital Strategies

Virginia Knowlton Marcus, Chief Executive Officer
Disability Rights NC