ASHEBORO — Josh Stein told the Randolph County Opioid-Drug Community Collaborative that “North Carolina is leading the country in addressing the opioid problem … and you are on the front line.”
North Carolina’s attorney general was at the Randolph County Emergency Services building to address the Sept. 26 meeting of the collaborative, which was launched by Randolph County Public Health in 2017.
Stein called the opioid crisis “the deadliest drug epidemic in US history.” Drug overdoses, he said, increased by 40 percent in 2020 and the next year registered more than 100,000 deaths across the country. “Randolph County had 81 overdose deaths in 2021,” he said.
He said the cause of the epidemic was “human greed,” when pharmaceutical companies were claiming that opioid painkillers were non-addictive. “But the pills are highly addictive,” Stein said.
He said a bipartisan lawsuit against the drug companies resulted in a $26 billion judgment against them. Of that settlement, $750 million goes to North Carolina and nearly $10 million to Randolph County over an 18-year period.
The settlement money has to go toward attacking the opioid problem, Stein said. “We want the money to make a difference. So much exciting work is being done. These folks are absolutely dedicated,” he said. “Because of people like you, augmented by the state, more people will be healthy and alive next year and the year after. I’m eager to keep doing this work.”
Stein said North Carolina is one of just a few states that haven’t expanded Medicaid as part of the Affordable Care Act. With 89 percent of addicts without health insurance, Stein said expanding Medicaid “could save lives.”
Stein had been introduced by Darrell Frye, chair of the Randolph County Board of Commissioners. Frye said he works part-time with an Archdale funeral home and they recently buried a 58-year-old, a 35-year-old and a number of youth, all of whom died from overdoses. The 58-year-old, Frye said, was his brother-in-law, who died from heroin laced with fentanyl.
Frye said Stein “understands this issue and his focus is on how North Carolina families deal with crime” and the resources available to them.
After Stein listed what the state is currently doing to address opioids, Randolph County Sheriff Greg Seabolt took the podium to tell what his agency is doing. So far in 2022, he said, there have been 513 overdose calls, 64 of which were deadly. That’s an average of nine calls per week, he said.
“My deputies have to respond to those calls,” Seabolt said, and they are able to use Narcan to revive patients until emergency medical technicians arrive.
“We’ve had a record number of arrests” for drug charges, he said, and the amount of drugs confiscated is enough to kill everyone in Randolph and six neighboring counties.
“These drugs come from the border (with Mexico),” Seabolt said. Addressing Stein, he said, “Please send a message to Washington” to protect the border.
Seabolt said 44 percent of the inmates of the Randolph County Detention Center are drug abusers or addicted to drugs. “We’re working hard to get a program to fix the problem, to bring people back to where they need to be.”
He said drug problems “can hit anyone. I have seen it in my family. We’re trying to keep drugs out of jail but it’s almost impossible.”
After seeing the same people come and go at the detention center, and often seeing their obituaries, Seabolt said, “They’re crying for help. We need mentors to keep them on the right path.
“We want it to be better tomorrow than it was today.”
Andy Gregson, Randolph County district attorney, told the group that “Randolph County is awash in illegal drugs, especially fentanyl and methamphetamines. Meth is driving a lot of violent crime, especially against children.”
Gregson also asked Stein to take the message to Washington to control drugs coming across the border. “We have to cut the flow off,” Gregson said.
The District Attorney Office will “prosecute death by distribution,” Gregson said, targeting those who sell drugs to overdose victims. He said shutting down the border with Mexico will eliminate supplies to traffickers.
“We’re going to get this solved with a holistic approach,” said Gregson, and thanked the members of the collaborative.
During a question-and-answer session, Susan Hunt of Keaton’s Place, said, “We’re the fourth recovery resource center in the state. Everything we do is free.”
Keaton’s Place, which is headquartered on Worth Street, transports addicts to detox and treatment centers. That involves driving to distant cities, including to houses for pre- and post-treatment.
Hunt said they’re trying to raise funds for a transitional house in Randolph County. It would be used to house people waiting for a bed at a rehabilitation center or, after completing treatment, to stay while waiting for permanent housing, jobs and/or school.
The next meeting of the Randolph County Opioid-Drug Community Collaborative is at 2 p.m. on Monday, Nov. 28, at the Randolph County Office Building.
Randolph County Opioid-Drug Community Collaborative timeline
Randolph County’s 2016 strategic plan set a goal to save lives from overdoses as a result of substance use disorders. To achieve that goal, the county appointed Randolph County Public Health to serve as the lead to develop a community coalition to develop and implement an action plan.
In 2017, Randolph County Public Health assembled a large number of representatives spanning many industries to launch the Randolph County Opioid-Drug Community Collaborative.
Between 2017-20, the coalition implemented numerous strategies to address the opioid crisis, including:
• Held informational community events to raise awareness and reduce stigma
associated with substance use disorders.
• Assured material availability at the local library highlighting opioid use disorder, prevention and treatment.
• Implemented various overdose prevention campaigns utilizing multiple venues such as billboards and social media (e.g., Lock Your Meds).
• Established medication take back events and sites.
• Increased access to naloxone.
• Secured grants to enable uninsured patients to receive behavioral health services.
• Expanded access to substance use disorder treatment services and medications for opioid use disorder via local management care organization Sandhills Center.
• Launched a syringe service program.
• Trained public sector employees on recognizing presence of opioids.
• Offered Crisis Intervention Team training to local law enforcement.
• Piloted a post-overdose response team.
During that time, Randolph County’s overdose death rate increased.
Rate of Overdose Associated Deaths, Randolph County, 2017-20
2017: 39.1 per 100,000
2018: 32.1 per 100,000
2019: 40.4 per 100,000
2020: 57.8 per 100,000
Despite an increase in the overdose death rate, Randolph County’s reported community naloxone reversals sharply increased. This metric reflects the number of overdose reversals using naloxone reported by community members and does not include administration of naloxone by first responders.
Rate of Reported Community Naloxone Reversals, Randolph County, 2017-20
2017: 65.6 per 100,000
2018: 63.5 per 100,000
2019: 287.5 per 100,000
2020: 427.4 per 100,000
During the same time frame, Randolph County residents diagnosed with opioid use disorder receiving services from treatment programs steadily increased.
Rate of Uninsured Individuals and Medicaid Beneficiaries with OUD Served by Treatment Programs, Randolph County, 2017-20
2017: 610.7 per 100,000
2018: 630.6 per 100,000
2019: 648.7 per 100,000
2020: 645.2 per 100,000
The collaborative reconvened in fall 2021 to build on the many successes. As the collaborative has resumed, three workgroups have launched — prevention, harm reduction and connect to care. These workgroups are in the process of developing a new action plan adhering to evidence-based practices and improved measures to assess impact over time.
The collaborative includes representation across many sectors including the justice system, law enforcement, education, human service organizations, primary care providers, behavioral health providers and citizens. By including a wide array of representatives, the collaborative is able to develop and implement a comprehensive approach to substance use disorders which will ensure success over time.
-Notes provided by Jennifer Layton, assistant director of Randolph County Public Health