Prescription Drug Overdose Boost for State Prevention | Apply Online

Opportunity Summary:

The Centers for Disease Control and Prevention (CDC) cooperative agreement titled "Prescription Drug Overdose Boost for State Prevention" (Funding Opportunity Number CDC RFA CE14-1404) was designed to help states strengthen and evaluate practical, statewide approaches to reduce prescription drug misuse, abuse, diversion, and overdose, with a particular emphasis on opioid pain relievers. The program’s core focus is on changing the patient and prescriber behaviors that have contributed to the prescription overdose epidemic, and on building state systems that can measure whether those changes are actually happening. Rather than supporting isolated or short-term activities, the intent is to advance comprehensive interventions at the state level and to document outcomes that show real-world impact.

Applicants were expected to implement work that supports at least two complementary prevention strategies. One strategy centers on enhancing and maximizing Prescription Drug Monitoring Programs (PDMPs), which are state-run systems used to track controlled substance prescribing and dispensing. Another strategy focuses on improving and evaluating state health insurance mechanisms that can reduce misuse and unsafe prescribing, such as Medicaid initiatives or workers compensation controls (for example, patient review and restriction programs, formulary changes, utilization management, or targeted interventions for high-risk prescribing). A third strategy involves evaluating state-level laws, policies, and regulations that influence prescribing and dispensing practices, such as legislation regulating pain clinics, policies supporting clinical practice guidelines, or other regulatory levers that shape how controlled substances are prescribed and monitored. The emphasis on combining at least two strategies reflects the CDC’s view that meaningful reductions in overdoses usually require coordinated action across multiple systems, not a single policy change or program.

The opportunity also made clear that evaluation was a central expectation, not an optional add-on. Outcomes could be measured in several ways depending on which strategies were selected. Programmatic outcomes might include increased mandatory registration and use of PDMPs, higher rates of PDMP queries before prescribing, or greater enrollment in patient review and restriction programs. Behavior-change outcomes might include reductions in prescribing that is inconsistent with clinical guidelines, fewer instances of "doctor shopping," or shifts away from high-risk prescribing patterns. Health-related outcomes could include decreases in emergency department visits tied to misuse or abuse of controlled prescription drugs and reductions in overdose death rates. In other words, the grant was structured to support both implementation and evidence-building, so states could demonstrate what interventions were working, for whom, and under what conditions.

Because most of the authority to regulate prescribing, dispensing, insurance controls, and many public health and law enforcement responses sits within state government, state-level engagement was treated as essential to success. The CDC explicitly emphasized multi-sector collaboration, recognizing that no single agency can address the problem alone. States were encouraged (and in practice expected) to work with partners that share responsibility and influence, such as law enforcement, boards of pharmacy, medical boards, mental health and substance abuse service systems, medical centers, and the lead agencies that administer Medicaid programs. To reinforce this requirement, applicants had to submit letters of support from relevant state governmental entities and other partners connected to the strategies in the proposed work plan, signaling that there was real commitment and coordination behind the application rather than a siloed effort.

Administratively, this was a discretionary funding opportunity using a cooperative agreement mechanism, meaning awardees would typically carry out the work with substantial involvement or partnership from the CDC compared to a standard grant. The activity category was health, and the CFDA listing associated with it was 93.136 (Injury Prevention and Control Research and State and Community Based Programs). The CDC anticipated making 5 awards with an estimated total funding amount of $6,000,000, and the announcement indicated no cost-sharing or matching requirement. Eligibility was limited to State Departments of Health or their bona fide agents, reflecting the state-centered nature of the strategies and the need for access to statewide systems like PDMPs, Medicaid policy levers, and statewide legal and regulatory frameworks. The opportunity was posted on April 3, 2014, with an application closing date of June 4, 2014, and it was later archived on July 4, 2014.

Overall, the grant can be summarized as a CDC initiative aimed at helping states deploy a coordinated package of policy, program, and system interventions to curb prescription opioid misuse and overdose, while simultaneously generating credible evidence through evaluation. The defining features were its state-level scope, its requirement to pursue at least two mutually reinforcing strategies (PDMP enhancement, insurance-based controls, and/or policy and regulatory evaluation), its strong emphasis on measurable outcomes, and its expectation of cross-sector collaboration formalized through partner support letters.

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