From 1999 to 2016, more than 12,000 North Carolinians died from opioid-related overdoses. More treatment programs, not more jails, are crucial if North Carolina wants to reduce the human costs from abuse of opioids and other drugs, speakers said at a recent substance abuse forum said.
“A growing number of law enforcement officials are telling us we cannot arrest our way out of this problem,” said Steven Mange, senior policy and strategy counsel with the N.C. Department of Justice. Only one in 10 people with addiction get the treatment they need, “and unfortunately, that is a shortcoming with our health care system,” Mange said.
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Durham County Commissioner Brenda Howerton related how drug abuse affects the African-American community. While Durham has some good programs to get people into treatment, “when we look at our jails, we see a lot of people of color,” who cannot contribute to the community, Howerton said. “Instead of incarcerating our folks, we should have been rehabilitating,” she said.
Mange and Howerton spoke at a leadership forum at the Health and Human Services Building. Wendy Jacobs, chairwoman of the Durham County Board of Commissioners, moderated the forum. The N.C. Association of County Commissioners asked counties to hold forums on the opioid crisis, but Durham expanded the forum to include all drugs, Jacobs said. “We need to be inclusive about the problems we are having in our community,” Jacobs said.
Participants at the forum received a packet that contained brochures about a variety of legal and illegal drugs – methamphetamines, cocaine, tobacco, oxycontin, heroin, marijuana and binge drinking.
Durham County will use the ideas generated at the event to create a task force about substance abuse, Jacobs said. “The work today will serve as a foundation for creating a comprehensive, collaborative, integrated Durham County plan and approach to address substance and medication misuse,” she stated in an email.
Mange said he often cites Durham’s STARR (Substance Treatment and Recidivism Reduction) and Drug Treatment Court as models for other communities. Recently, Durham law enforcement and government have taken other steps to fight drug abuse. The Durham County Public Health Department is creating a safe syringe program, and Durham County Sheriff’s Office school resource officers carry naloxone, an overdose reversal drug.
More prevention is needed, and the first step is removing the stigma and dissolving some myths about drug addiction, speakers said. “We need to reduce the stigma around substance abuse disorder,” said Donald McDonald, director of Addiction Professionals of NC, during a panel discussion. There are decades of evidence that drug addition is a disease and not a moral failing, and yet the latter view often prevails, McDonald said.
One myth that persists is that addiction “is a behavior that can be easily controlled,” said Ashwin Patkar, professor of psychiatry and community and family medicine at Duke University. That myth ignores the many factors, including genetics and environment, that make some people addictive, and others not, he said.
Paktar joined other speakers calling for a greater public commitment to treatment and prevention. “We need tremendous resources” for treatment and recovery, McDonald said. “You as a community member ... you need to say, We deserve adequate support and recovery services,” he said.
Every dollar spent in treatment saves four dollars in health care costs, and seven dollars in criminal justice costs, McDonald said. “But you have to ask for it.”
Overdose emergency visits in Durham County
▪ Of 138 emergency department visits for opioid overdose in 2017, 82 overdoses were for heroin
▪ Durham had 57 emergency department visits for benzodiazepine (tranquilizer) overdose in 2017
▪ Durham had 35 emergency department visits for cocaine overdoses in 2017