LILLINGTON — Opioid overdoses account for more deaths across the country than car crashes or gun violence. Unintentional opioid overdoses killed nearly five people a day in North Carolina last year and were responsible for more than 6,700 emergency room visits, according to statistics from the North Carolina Department of Health and Human Services.
In Harnett County, the number of opioid-related deaths and overdoses has continued to climb as well. County health officials are partnering with local agencies and churches to combat the threat, but many obstacles stand in their way.
Decades of medical facilities treating pain and a rise in synthetic forms of powerful chemicals fueled an explosion in opioid addiction that seems to spare no community.
“It’s a societal problem,” John Rouse, health director with the Harnett County Health Department, said. “People got to where they thought every medical procedure they had was supposed to be pain free. It’s not. We think we’re not supposed to deal with any kind of pain or suffer any kind of discomfort after a medical procedure or an accident. That’s where a lot of that came from.”
A focus on treating pain through medication gained traction in the 1980s, Rouse said, and resulted in patients receiving excessive amounts of prescriptions following sometimes routine procedures or mild injuries.
“Does pain need to be treated and managed? Yes,” said Rouse. “But just because you stub your toe doesn’t mean you’re getting a free ride for the next week. There is going to be some discomfort. Giving somebody a 90-day supply of pain medication for that is a little much.”
Legislation on the state and federal levels, targeting illegal possession of opioids, has made an impact on the availability of prescription meds, Rouse said, but a rise in synthetics such as fentanyl are taking the epidemic to dangerous new levels.
“A lot has been done to reduce the number of legal opioids that are in the system,” Rouse said. “But you can buy heroin cheaper than you can buy a 5-pound bag of sugar. It’s being cut with these real powerful synthetic forms of heroin that are killing people. Fentanyl, as a drug, has a legitimate purpose. It’s a very powerful painkiller, but now it’s being made synthetically.”
Mikkel McKinnie, 31, of Fuquay-Varina was in November after he admitted to selling a drug cut with fentanyl to a man found dead of an overdose in 2016. A white residue found on a spoon near the victim tested positive for the drug that is 50 times more potent than heroin, according to prosecutors in the case.
Local health officials say that happens a lot.
“A lot of times people don’t know what’s in there,” said Debra Hawkins, a Harnett County public health administrator. “That one dose can kill you.”
Harnett County health officials have partnered with other area agencies such as Campbell University and religious institutions to combat the crisis. A critical challenge for local officials trying to treat people struggling with opioid addiction is limited access to care. Once a person decides to get help, Rouse said, the issue is finding somewhere to treat them.
“Where are you going to send them?” Rouse asked. “Good Hope Hospital is full and they have a waiting list. They’re trying to add 16 more beds, but I guarantee the week they open that, it’ll be full. Where else do you go? You’ve got to go outside the region and hope you can get into a facility. How do you pay for that service? A lot of these treatment centers are privately run and they’re not cheap. We don’t get money specifically for that. We don’t have enough family practice providers in Harnett County. Campbell University and the hospital are trying to build that up, but that takes time.”
Once someone completes a rehabilitation program, keeping them clean is yet another challenge. A person struggling with addiction often returns to their socio-economic circle and ends up relapsing, Rouse said.
Statistics show white males, between the ages of 20 and 50, make up the largest affected demographic of opioid addiction.
“Individuals come back from a treatment facility, they’re clean for six months, they take the same amount of drugs (they did) when they left and it’s killing them,” said Rouse. “It really affects white males. Not that it doesn’t affect people across the whole spectrum but white males are the predominant ones.”
Harnett County Emergency Medical Services personnel administered naloxone (Narcan), a medication designed to reverse opioid overdoses, 221 times since last November, which is up from 197 over the year before. More than 690 EMS units responded to reports of a possible overdose in the past year, marking a substantial jump from the 662 responses in the previous 12 months.
“Unfortunately, the epidemic continues to increase in the county,” West Barefoot, HCEMS assistant chief, said. “Our folks are prepared and trained to respond in the event someone faces an overdose. Hopefully, we can treat it and reverse it and give them another chance to get themselves clean. You’ve got a lot of people who take prescription medications who revert back to illegal drugs because they’re cheaper. Unfortunately, when you go that route, a lot of times your tolerance level can’t handle the amount you’re ingesting.”
DHHS stats report Harnett County suffered 23 opioid poisoning deaths in 2018 compared to 14 in 2016. Stats from the NIDA show that deaths involving synthetic opioids like fentanyl spiked from 116 in 2013 to 1,285 statewide in 2017. Heroin-involved deaths in the same time period rose from 189 to 537 cases.
Eliot Duke can be reached at 910-230-9038 or firstname.lastname@example.org.
In 2017, the Tar Heel state exceeded the national average of opioid overdose deaths per 100,000 people with 19.8. The opioid overdose death toll in North Carolina jumped from 1,407 in 2016 to 1,953 people the following year, according to the National Institute of Drug Abuse. the number of deaths and overdoses has continued to climb in the state and in harnett county.