State Attorney General Josh Stein told a group of local health directors Wednesday that a growing opioid drug crisis is killing four people across the state each day.
A key strategy to saving some of those lives, Stein said, is House Bill 243, the Strengthen Opioid Misuse Prevention, or STOP, Act. The bill would target the prescribing of pain killers such as Oxycontin, which Stein says has resulted in an increase in addiction.
The proposal would limit doctors to prescribing no more than a five-day supply of opioids such as Percocet during an initial visit to treat a patient’s acute pain, or a seven-day supply following a surgical procedure. Doctors could prescribe a bigger supply during follow-up visits, and the limit wouldn’t apply to cancer patients and others being treated for chronic pain.
The measure passed the House unanimously in April, and remains in a Senate committee. Stein noted that $20 million that had been earmarked for drug treatment over the next two years was taken out of the Senate’s version of the budget, while $10 million was added to the House version.
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“It’s nowhere near adequate to meet the crisis, but it’s a start,” Stein said to the group of public health administrators and attorneys assembled at UNC-Chapel Hill’s School of Government.
Stein noted that the rate of fatal opioid overdoses in the state has exploded from 150 in 1999 to 1,110 in 2015. Synthetic opioid deaths quadrupled between 2003 and 2015, to 288. Preliminary numbers show that fentanyl alone killed 332 people last year, with the number dying projected to be even higher this year.
Stein was joined by his wife Anna, an attorney who works with the state Division of Public Health’s chronic disease and injury section. The Steins both think the state has taken meaningful steps toward reducing the number of drug overdoses, including measures such as the 2013 Good Samaritan Law that allows people to seek medical help for an overdose by offering limited immunity for some drug, alcohol, and probation or parole violations. It also grants civil and criminal immunity to anyone who administers the overdose antidote naloxone in good faith and allows community-based organizations to distribute naloxone through a special prescription from a medical provider.
“It’s a step forward,” Anna Stein said. “It encourages people to call the police, but whether it offers protection – that’s another question.”
The Steins also praised the state’s new syringe exchange program that was signed into law last summer by former Gov. Pat McCrory that allows drug users to exchange used syringes for sterile ones.
House Bill 243 would also allow local health departments to set up syringe exchange programs and distribute naloxone.
“The STOP Act represents a significant broadening of local health departments’ authority,” Anna Stein told the group. “The division of public health stands ready to help local health departments set up syringe exchange programs.”
The attorney general said that while traveling the state in recent months he’s spoken with residents who over and over have told him about “my child, my spouse, myself” and the “personal hell” they have endured struggling with addiction.
Stein said the state’s public health officials need to find new ways to reduce demand for opioids by educating and engaging young people about the dire consequences of substance abuse. He pointed to the deadly synthetic opioids such as fentanyl and furafentanyl, which are exponentially more powerful than heroin. Furafentanyl killed 77 people in North Carolina last year, while fentanyl killed four people over one weekend in Cary, Stein said.
In addition to reducing the number of people who end up addicted, Stein said only one out of 10 people suffering from opioid addiction were treated last year in North Carolina. He said it was akin to 90 percent of people with chronic heart disease being left untreated.
“The lack of resources is tragic,” he said.
When it came to law enforcement, Stein mentioned an oft-repeated phrase he’s heard from members of law enforcement: The state can’t arrest its way out of this epidemic. And while he promises to come down hard on drug trafficking rings that are profiting from the suffering of others, he also supports drug diversion programs that have cropped up across the state and other programs such as drug courts.
Stein said he regularly talks with sheriff across the state whose entire workload has been taken over by the drug crisis.