What do you think is the largest cause of accidental death in North Carolina? Car accidents? Violent crimes? Falls?
Today, for the first time ever, it’s actually accidental drug overdoses?
More people die in North Carolina of an accidental drug overdose — usually an opioid — than any other cause of accidental death. The use of opioids, including prescription painkillers and heroin, is growing with alarming speed, triggering high drug overdose death rates nationwide. In 2015, that equated to 1,460 preventable deaths in our state. And for every person who dies, 16 more make visits to the emergency room and dozens more are addicted.
The opioid epidemic is tearing families apart. As I travel the state, I hardly ever speak to a group without hearing a gut-wrenching personal story about a family member who is struggling with an opioid addiction. That is why I have made addressing this epidemic a top priority as your North Carolina attorney general.
While confronting this crisis won’t be easy, with cooperation among law enforcement, medical prescribers, the public health community and the treatment and recovery community, I think we will make a difference. In my view, a comprehensive and achievable strategy hinges on three key areas: prevention, treatment and enforcement.
Prevention should address educating both the people who might misuse prescription drugs and the doctors and dentists who overprescribe prescription painkillers.
A few years ago, after I had a minor medical procedure and received an opioid prescription with 30 pills, I didn’t end up needing any. I’d wager that many of you have had a similar experience. According to the North Carolina Controlled Substance Reporting System, doctors and dentists wrote an opioid prescription for almost every man, woman and child living in this state in 2016.
Last year, an astonishing 705 million opioid pills were prescribed in North Carolina.
But after just a few days on an opioid prescription, some patients’ brain chemistry begins changing to lead to an addiction. That’s why we also have to educate North Carolinians about the dangers of using these medications unless they are truly needed.
Because addiction can happen so quickly and has become so common, effective treatment is critical. According to experts in this area — health care providers and counselors who specialize in substance use treatment — medication-assisted treatments have proven to manage addiction and promote recovery, particularly when combined with counseling and community support. And research backs them up.
Unfortunately, however, right now, there simply aren’t enough treatment programs around the state. That’s something we need to fix.
Finally, we need to effectively enforce our criminal laws on this issue. It is critical that we aggressively go after the dealers and traffickers who push heroin on people addicted to opioids. Heroin is much cheaper and readily available than prescription opioids, and it’s even more deadly. People who profit off others’ misery and death must be punished.
However, when people are struggling with substance use disorder, jail time may not be the best way to treat their problem. It may be more cost effective and better for our communities as a whole if we help them treat their addiction. That way, they are back at home with their families, working and paying taxes, and contributing to society instead of living on the taxpayers’ dime in jail.
I also want to work with law enforcement to make sure police departments and sheriffs’ offices have access to naloxone, a lifesaving drug that can counteract an overdose. Already, naloxone has been administered 6,000 times in North Carolina to save lives.
Finding smart ways to address this issue is one of my top priorities as your attorney general. That’s why I’ve devoted my first column to this issue. I’m working with the North Carolina General Assembly to address this head-on with new legislation. I’m also traveling to communities across our state over the next several months to learn more from people in the law enforcement, public health, health care provider, harm reduction and recovery communities. Challenging issues take smart ideas and different perspectives. We need as many as we can get.
Turning the tide on this issue won’t be easy, but it’s critically important to keeping North Carolinians safe.
Josh Stein is North Carolina’s attorney general.