North Carolina, as well as the entire nation, is facing a health crisis with the ever -growing misuse and abuse of prescription drugs. In 2014, a group of state leaders representing North Carolina participated in both the National Governors Association Policy Academy on Reducing Prescription Drug Abuse and the Substance Abuse and the Mental Health Services Administration Policy Academy on Reducing Prescription Drug Abuse.

The Prescription Drug Crisis In North Carolina

In the last 15 years, the United States and the state of North Carolina have seen a dramatic increase in the rate of death caused by an overdose of opioid prescription drugs. This increase is running parallel with the ever-increasing rate of prescription of opioid painkillers.

North Carolina has one of the highest rates of opioid prescribing in the US. There is a direct correlation between the rates of prescribing and the rates of overdose (per the CDC, 2014). States that have implemented strong CME programs focusing on opioid use and abuse saw an immediate decrease in their total overdose deaths in just one year while seeing lower dosing rates from clinicians.

In 2017, North Carolina providers wrote 72.0 opioid prescriptions for every 100 persons. The average U.S. rate in the same year was 58.7 prescriptions per 100 persons according to the CDC.

North Carolina's 2010 prescription painkiller death rate of 11.4 per 100,000 residents is just below the national average of 12.4 per 100,000 (per the CDC, 2013). Across the nation, death from prescription pain relievers is nearly double that of the rate of overdose for all other illegal drugs combined according to NIDA.

Because the majority of the prescription drugs being abused are opioids, North Carolina has seen a rise in heroin use, as those individuals addicted to pills find a cheaper, more accessible method to continue their addiction. This is not isolated to North Carolina, but a national problem.

By far, the leading cause of overdose death in the state of North Carolina is from opioids. At the time of death 51% had an active prescription for opioids. In North Carolina, as in the United States as a whole, unintentional opioid overdose deaths have rapidly increased.

They increased from just over 100 deaths in 1999 to over 1,300 deaths in 2016. The increase in the last year was gut-wrenching: from 2015 to 2016 there was an increase of nearly 40%.

Provisional emergency department visit data for 2017 showed over 5,700 visits for opioid overdose this past year, a 40% increase from the 4,103 emergency department visits in 2016. In addition, the economic cost of unintentional opioid-related overdose death in North Carolina in 2015 was estimated to be over $1.5 billion.

In SAMHSA's 2014 report, 53% of people using a prescribed pain reliever for non-medical use reported receiving it free from a friend or relative. An additional 14% reported purchasing it from a friend or relative.

The rate of overdose deaths involving opioid prescriptions was 6.5 deaths per 100,000 persons in 2017 and has not significantly changed in the past several years. The same year, there were 1,953 overdose deaths involving opioids in North Carolina — a rate of 19.8 deaths per 100,000 persons compared to the average national rate of 14.6 deaths per 100,000 persons.

The greatest rise occurred among deaths involving synthetic opioids other than methadone (mainly Fentanyl), from 116 in 2013 to 1,285 deaths in 2017. In the same four-year period, heroin-involved deaths rose from 189 to 537 cases.

Prescription opioid-involved deaths have not statistically changed in the past several years with 659 reported deaths in 2017.

NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. The most recent data on the rate of babies born with NAS/NOWS in North Carolina is from 2014 hospital discharge data.

From 2008 to 2014, the rate of NAS/NOWS increased from 1.8 cases per 1,000 hospital births to 8.2 cases per 1,000 hospital births (per Healthcare Cost and Utilization Project).

Of the new HIV cases in 2016, 1,404 occurred in North Carolina. Among males, 7.1 percent of new HIV cases were attributed to opioid and prescription opioid abuse or male-to-male contact and opioid abuse. Among females, 9.8 percent of new HIV cases were attributed to opioid and prescription opioid abuse.

In 2015, an estimated 29,814 persons were living with a diagnosed HIV infection in North Carolina — a rate of 354 cases per 100,000 persons. Of those, 14.6 percent of cases among males were attributed to opioid abuse or male-to-male contact and opioid abuse. Among females, 19.1 percent were living with HIV attributed to opioid abuse.

There were approximately 82 new cases of acute HCV (0.8 per 100,000 persons) reported in North Carolina in 2016 (per the CDC). In North Carolina, there are an estimated 67,200 persons living with Hepatitis C (per the 2013-2016 annual average), a rate of 880 cases per 100,000 persons. A large number of these cases were attributable to opioid and prescription opioid abuse.

Addiction Treatment In North Carolina

The good news here is that there are numerous centers of treatment and rehab available in North Carolina. There are many types of treatment centers such as long term addiction treatment facilities, short term drug abuse treatment, outpatient detoxification programs, outpatient substance abuse treatment services, inpatient drug abuse treatment and others.

There is a wide range of drug and alcohol rehab facilities available. They include individual psychotherapy, dialectical behavior therapy, couple/family therapy, trauma therapy, trauma-related counseling, cognitive/behavior therapy and others, to name a few. If you need rehab in North Carolina, all you need to do is place a call to any of the available rehab centers.

CITATIONS

https://www.carnevaleassociates.com/our-work/emerging-drug-trends-prevention-issue-brief.html

https://www.dea.gov/resource-center/2016%20NDTA%20Summary.pdf#page=40&zoom=auto,-80,792

https://www.dea.gov/sites/default/files/2018-11/DIR-032-18%202018%20NDTA%20final%20low%20resolution.pdf

https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs

https://www.getsmartaboutdrugs.gov/news-statistics/emerging-drug-trends

https://www.ncbi.nlm.nih.gov/books/NBK234579/

https://www.shadac.org/publications/50-state-analysis-drug-overdose-trends-evolving-opioid-crisis-across-states