A community coalition in Wilkes County, North Carolina developed the Chronic Pain Initiative (CPI), a multi-pronged strategy to reduce opioid poisoning deaths. This evaluation investigated the changes in physician practice resulting from one of the CPI strategies - dissemination of a 'physician toolkit' containing various guidelines and templates to apply in assessing and managing chronic pain. The toolkit was delivered by the county medical director, who also provided education on the use of the tools as well as background on the scope of substance use problem within the county. Interviews with health care providers indicated that the intervention increased the use of Pain Agreements and the Controlled Substances Reporting System (CSRS). A review of publicly avialble health statistics showed a decline in the average number of narcotic prescriptions filled by local residents, as well as a decline in poisoning deaths concurrent with the intervention. #2011Conference #HealthEvaluation