Lee County has seen 18 opioid overdoses so far in 2017, and one local health official says the epidemic that has plagued North Carolina and much of the nation is only getting worse.

Ashley Graham, health education supervisor for the Lee County Health Department, oversees the county’s involvement in Project Lazarus, a North Carolina-based public health nonprofit built to educate communities on the epidemic and assist them in the fight against it. Graham says Lee County’s numbers so far this year don’t tell the whole story, because its database doesn’t take into account people who overdosed but were revived — likely with the life-saving drug naloxone, which reverses the effects of opioids immediately — and not taken to a hospital.

“Much of what the state’s done to fight the epidemic has focused on the prescription drug side,” says Graham, who joined LCHD in 2014. “There are new prescription laws, new limits and a controlled substance reporting system — because of all of this, people are definitely turning more to heroin. And the majority of heroin users are former users of opioid medications.”

North Carolina is home to four of the Top 20 cities in the U.S. for rate of opioid abuse, which takes into account both heroin and prescription and illegally manufactured pills. Wilmington leads the nation, followed by No. 5 Hickory, No. 12 Jacksonville and No. 18 Fayetteville.

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Lee County’s numbers, thankfully, fall well short of the problem in those cities. But the local numbers do show a disturbing trend. Of the 18 overdoses in Lee County so far in 2017, 14 of them have been heroin-related and the other four prescription drugs. Seven of those reported overdoses were the result of a “bad batch” of heroin (one laced with fentanyl) that was distributed locally last April.

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Prescription opioids like codeine, hydrocodone, methadone and fentanyl — used by doctors to treat pain — and illicit opioids like heroin and illegally manufactured pills claimed more than 1,200 lives in North Carolina in 2015. Fifteen years earlier, that number was around 300.

Numbers like that were the reason Project Lazarus was formed. The organization was established in Wilkes County in 2008 after Fred Wells Brason II, the nonprofit’s president and CEO, 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.

From Day 1, Brayson believed educating the public was an important step — Project Lazarus achieved this partly through “pill takeback” events where people could drop off their unused prescription medicine to keep them out of the wrong hands. The organization also hammered home this advice when it comes to prescription meds — “Take correctly. Store securely. Dispose properly. And never share.”

The impact in Wilkes County has been astounding. After the first three years, accidental deaths from opioid ovderdoses 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).

Project Lazarus came to Lee County the same year Graham arrived in 2014. Graham oversees the “public awareness” arm of the organization locally, and she’s given several presentations recently for local church and civic groups and at health fairs, schools and the local enrichment center.

Her message has included educating the public on local “drop boxes” for opioid medications that go unused (diversion control). Currently, the Lee County Sheriff’s Office, Sanford Police Department and the Walgreens pharmacy at Dalrymple and Horner are the only three Project Lazarus dropboxes in the county (the boxes must be located where they can be supervised by law enforcement).

She’s also been an advocate for getting naloxone (known as the “Lazarus Drug”) into the hands of law enforcement, first responders and community members. “Initially, Sanford PD felt they didn’t necessarily need it because EMS was usually at the scene, but that changed as the problem grew,” Graham said. “Now they’re carrying it as well.”

Sanford currently does not have an inpatient addiction treatment center — the state as a whole has a shortage of beds for addicts and recovering addicts — but Graham hopes that changes in the future.