Strength & Numbers

Lived Experience

What we are doing

Strength and Numbers is a partnership between the North Carolina Survivors Union and the UNC Injury Prevention Research Center. Our team is conducting a series of health needs assessments and research projects, while developing a framework for drug user-led research partnerships in academic and community settings. Some of our projects include:

Treatment Needs for Skin and Soft Tissue Infections (SSTIs)

SSTIs pose serious health concerns to people who use drugs (PWUD), particularly if these infections are left untreated. Traditional healthcare treatment settings are often times unwelcoming and inaccessible to PWUD, potentially leading to delays in getting necessary care. In order to reduce harms associated with SSTIs, it is critical to identify safe healthcare settings offering quality care for PWUD. Our work is describing treatment needs for PWUD experiencing SSTIs and identifying non-traditional SSTI treatment strategies used among PWUD, such as the use of non-prescription antibiotics.

Methadone Access During COVID-19

Methadone maintenance treatment (MMT) is a type of opioid treatment that typically requires participants to take prescribed doses at their clinic. While methadone can be a lifesaving medication for people with opioid use disorder, the requirement of daily in-person clinic visits can be an extremely challenging barrier to access for MMT participants.

In response to the COVID-19 pandemic, the Substance Abuse and Mental Health Services Administration issued guidance to Opioid Treatment Programs which expanded participant eligibility to access methadone doses, specifically loosening regulations surrounding take-home doses. Our team is conducting a needs assessment to describe the perceptions about, and changes to, MMT access in the Piedmont region of North Carolina during COVID-19.

Our work was recently published online pre-print, meaning it has not completed the peer review process in a scientific journal. The contents are preliminary and subject to change. However, we are providing the information back to the community given the urgent nature of this topic area.

To learn more about our work, watch this video about drug user-led research:

Why it matters

Drug use research has substantially increased recently. While there have been advancements to better understand the complexities of health and drug use, efforts to involve PWUD in research design, implementation, and dissemination have been limited. Smaller studies at service providing sites have helped answer specific questions, but the preponderance of researcher-initiated studies involving “big data” (electronic health records, public health surveillance) represent a new paradigm for drug user participation, with unanswered questions about representation. As the nuances in PWUD experiences cannot be easily captured in administrative data, involvement of persons with lived experience is critical to contextualizing findings. Conversely, PWUD may not be aware of being included in medical encounter data. Our collaboration targets these power and knowledge imbalances.

How we are studying it

Our team is using multiple strategies to address our questions related to drug user health. We are building upon existing research and informing harm reduction practice by incorporating lived experience as an essential mechanism of the research process.

NCSU is conducting a community health needs assessment to capture information about MMT access and treatment for SSTIs. To supplement this assessment, our team is exploring the use of healthcare claims data to describe SSTI treatment on a larger scale.

How to use the results

The Strength and Numbers team will use these results to inform harm reduction practice and promote future areas of research. Our primary responsibility is to ensure these results are shared with the communities being studied. Results will be posted on

Who is conducting and supporting the project

Key partners for this effort include the North Carolina Survivors Union (NCSU) and the University of North Carolina Injury Prevention Research Center. NCSU is a self-support group of people with lived experience of drug use, operating within a drop-in center and harm reduction program in Greensboro, North Carolina.

Funding for this project comes from the United States Food and Drug Administration. Studies at the Opioid Data Lab are conducted by independent researchers and do not necessarily represent the views of funders or partners. We are grateful to generations of taxpayers in North Carolina for supporting public universities. We are also grateful to US taxpayers for safeguarding public health by supporting FDA and this research project. These projects are being registered with the University of North Carolina Institutional Review Board.