The opioid epidemic | Lee and Harnett counties

Editor’s Note: Billy Liggett is editor of Campbell University’s flagship publication, Campbell Magazine. This month, the magazine will publish an in-depth feature on North Carolina’s opioid epidemic and steps medical and pharmacy schools are taking to educate the next generation of health care providers in proper pain management. The following sheds light on the effects the epidemic has on our area — namely Lee and Harnett counties.

---

You’ve heard the numbers by now. But they bear repeating.

More Americans died from a drug overdose in 2016 than from traffic accidents. The majority of those deaths were the result of highly addictive opioid drugs, many of them prescribed by physicians.

In an address before law enforcement officials, physicians, pharmacists and elected officials in Fayetteville last October, former U.S. Congressman Bob Etheridge shared another startling statistic: In 2014, more than 240 million opioid prescriptions were written in the U.S., more than enough to supply every American adult with their own bottle of pills.

And in North Carolina, opioids are killing an average of four people a day. A recent study by Castlight Health, a San Francisco-based health care information company, four of the nation’s Top 25 cities for opioid abuse were based in North Carolina. Wilmington ranked No. 1 in the nation, followed by No. 5 Hickory, No. 12 Jacksonville and nearby Fayetteville, which ranked 18th.

In Harnett County, 47 people died from a drug overdose in 2016, according to the North Carolina Department of Health and Human Services. In Lee County, which has almost half the total population as Harnett, 23 people died as a result of an overdose. For both counties, those numbers more than doubled the previous year’s official “poisoning death” toll. Go back to 2000, and only four people in Harnett and one from Lee died from accidental overdose.

The term “opioid” — meaning “opiate-like” — originated in the 1950s. The painkillers the word is most-often associated with today came on the market with approval from the Food and Drug Administration, beginning with Vicodin in 1984, OxyContin in 1995 and Percocet in 1999.

Taken in these pill forms, opioids are a controlled-release medication — pain control is steady, and the “peaks and troughs” of the medication are much smaller. Longer-acting opioids put patients at a higher risk of overdose, because of the drugs’ effects on the part of the brain that regulates breathing.

Opioid abuse transcends race, gender and socio-economic groups. The most common profile of an opioid addict is someone — most often male and caucasian — in their mid-30s whose initial diagnosis is back pain due to trauma, surgery or degenerative arthritis.

The average time from the first prescription of an opioid to overdose death is 31 months.

•••

Last September, Lee County Sheriff’s deputies began carrying the life-saving opioid overdose reversal drug Narcan on them at all times, joining paramedics and first responders from across the state to help combat the growing number of overdose deaths. The drug was also made available to school resource officers at Lee County and Southern Lee high schools.

Last summer, former Gov. Pat McCrory signed Senate Bill 734 — the Narcan Law — making the life-saving overdose medication available statewide without a prescription.

If North Carolina is considered one of the worst states for opioid abuse, it has to be considered one of the strongest when it comes to fighting it. The 2016 Narcan Law comes three years after North Carolina’s Good Samaritan Law, passed in 2013 to enable law enforcement officers to carry naloxone at all times.

The state says more than 3,300 people in the state have been saved by the drug since that law passed.

North Carolina is also home to the Project Lazarus, a public health nonprofit established in Wilkes County in 2008 after Fred Wells Brason II, president and CEO of the organization, learned Wilkes had the third-highest drug overdose death rate in the nation the previous year.

According to Brason, Project Lazarus’ model is based on two premises — drug overdose deaths are preventable and all communities are ultimately responsible for their own health. The organization’s impact in Wilkes County has been astounding. Within three years of implementing risk-reduce strategies, accidental deaths from opioid overdose decreased by 72 percent there. Wilkes also once had a higher-than-average opioid prescription rate, but in 2011, not one single overdose death could be attributed to prescriptions written in the county (down from 82 percent of the deaths in 2008).

Health care providers in North Carolina are also re-educating themselves on pain management. The state’s medical board now requires continuous pain management and prescription education for North Carolina’s 25,000-plus physicians, 5,000-plus physician assistants and 5,000-plus dentists.