Are you or someone you know addicted to prescription painkillers? For many of you reading this, the answer, unfortunately, is yes.
According to data published by the N.C. Department of Health and Human Services, there were more than 1,110 opioid-related deaths in 2015 – a 640 percent increase since 1999. Wilmington has the highest opioid misuse rates in the country, with a little more than 11.6 percent of residents misusing opioids. Hickory, Jacksonville and Fayetteville are also ranked among the top 20 cities for opioid misuse in the country, according to a national report released last year.
The sharp rise in heroin-related deaths in North Carolina is even more alarming – up 871 percent since 2010.
Until recently, efforts to curb the opioid epidemic seemed encouraging. Last year, for example, then-Gov. McCrory signed a bill into law that implemented a standing order for naloxone – a lifesaving medicine that reverses the effects of opioid overdose – making North Carolina only the third state to implement such a program. Naloxone is now available at every pharmacy in the state without a prescription from a doctor, no questions asked.
Gov. Cooper also promised to fight the opioid epidemic during his campaign. Since being elected, he has joined a bipartisan commission of governors from across the country to support better access to addiction treatment services and criminal justice reform.
Despite such bipartisan support in the past, however, the current state budget passed in June by the General Assembly takes a huge step back. Perhaps most shocking is the $53.2 million in cuts to mental health and addiction services. I am frightened to think about the impact this will have on the worsening opioid epidemic in our state. How many more people will fall through the cracks because they do not have access to care? How many more people will die? North Carolina, we can do better than this.
Lt. Gov. Dan Forest, state Senate leader Phil Berger, House Speaker Tim Moore and other leaders of the N.C. General Assembly must put patients over politics and vote for Medicaid expansion in the state of North Carolina – a move that, according to the N.C. Poverty Research Fund, would extend health insurance coverage to 463,000 more individuals and secure tens of billions in federal health care dollars for the state.
Individuals suffering from mental health and addiction stand to benefit the most from Medicaid expansion. Across the country, Medicaid accounts for 25 percent of all spending for mental health disorders and 21 percent of all spending for substance use disorders, making it the largest source of financial support for such services, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
Many individuals suffering from addiction are currently uninsured. As such, they are denied access to programs that provide detoxification and rehabilitation treatment, long-term opioid-maintenance therapy, and social support services like group therapy, stable housing, and employment or educational opportunities. This could all change if the General Assembly votes to expand Medicaid.
Access to health care is matter of life and death – it should not be misconstrued as a partisan issue.
Now is the time for all of us to stand up and demand change. Call your elected officials at the local, state and national level. Ask what they are doing to combat the opioid epidemic and demand their support for efforts to expand Medicaid in our state. But more importantly, talk with your family, friends, co-workers and neighbors about substance use and addiction. If you can, be open about how the opioid epidemic has impacted you and your loved ones. To move the needle forward and eliminate the stigma surrounding substance use and addiction, we cannot afford to keep our struggles secret.
And to those suffering from addiction, whether to prescription opioids or otherwise, know that you are not alone. Please do not give up hope. It can and will get better. If you would like help, talk with your doctor. You can also visit the Alcohol/Drug Council of North Carolina website or call its help hotline at 1-800-688-4232.
William Coe is a native of Raleigh. He is currently an MD/MPH candidate at the Johns Hopkins School of Medicine and Johns Hopkins Bloomberg School of Public Health in Baltimore. He plans to pursue a career in child and adolescent psychiatry.