ENC Health Current: Heroin Epidemic Impacts Region

Oct 19, 2016

Addiction to opioids is a nationwide epidemic hitting eastern North Carolina hard – very hard.

The latest figures from the CDC have four eastern counties with drug overdose rate above the state average and a recent study from a major, healthcare provider put multiple eastern cities in the top 25 nationwide for rate of opioid abusers.

Chris Thomas has more.

Communities in eastern North Carolina are among the worst for opiod addiction according to a recent survey by Castle Light Health of San Francisco.
Credit Castlelight Health/WNCN

Three communities east of I-95 have some of the highest rates of opioid abuse in the United States. At the top of the list? Wilmington, North Carolina in New Hanover County.

Carla Turner says she’s never witnessed anything like it. She’s the Personal Health Services Manager at the New Hanover County Health Department.

“People say ‘why is that?’ I don’t know if it’s because we’re a tourist town with a large college. I don’t know if it’s because we have I-40 which feeds into Wilmington. We’re not too far from I-95, we’re a port city. So I think it could be any number of things.”

Jacksonville came in 12th and Fayetteville was ranked 18th in the report on opioid abuse published by Castlelight Health – a San Francisco based, publically-traded healthcare information company.

Beyond addiction, the number of unintentional drug-related deaths in North Carolina has tripled – from just over 300 in the year 2000 to nearly 1,200 in 2014.

“It’s upsetting as a Wilmington native. Of course, I know we are not unique. I know it’s an issue throughout the country.”

There were only thee, unintentional, fatal overdoses deaths in New Hanover County in 1999 and 11 times that amount in 2014.

Things aren’t much better in Pender County where Turner lives.

“My oldest is in high school and it scares me to death that what he’s potentially being exposed to on a daily basis. And I keep telling myself…but my son will say ‘oh, yeah, sure there’s people who deal drugs in town and that type of thing. It frightens me…the best thing I can do is teach my kids to make good decisions.”

This epidemic crosses social lines of all kinds and its causes are complexly interwoven.

Dozens of opioid products are legal through a prescription – but the cost has skyrocketed over the past few years. Doctors have also been more hesitant to write prescriptions for fear of opioid abuse.

That puts an especially heavy burden on working class individuals in rural areas, like eastern North Carolina, who are in chronic physical or psychological pain. To deal with the pain – or just to have a good time, in some cases – some go underground.

Dr. Soyna Longest, Clinical Director at the Walter B. Jones Alcohol and Drug Abuse Center, says opioid abuse has been an ongoing problem in the region but heroin is dominating.

“Heroin is more accessible. It’s cheaper on the streets. And some of our people who are addicted to the prescription pain meds are now switching to use heroin for those reasons as opposed to getting the treatment.”  

Heroin is also powerful – thrice as powerful as morphine, according to the World Health Organization.

Like most opioids, heroin mimics endorphins – the “feel good” chemical in the brain. The initial effects can be euphoric.

“It is a significant rush. The person – they feel a pleasurable sensation initially. With the heaviness and drowsiness that may last for a few hours – some mental cloudiness. They may have decreased heart rate, slow breathing…this is the high that people chase.”

But it doesn’t last. The body develops a tolerance and simulating that first high becomes more difficult with every hit.

Cravings for most are intense and consuming. If more heroin doesn’t find its way into the body, it will start to flush it out of the system. The high caused by heroin – along with the torment withdrawal brings – can make individuals suffering from addiction go to great lengths to keep using.

“Once the addiction takes over, it is a lifelong chronic and relapsing course and the person will engage. The person will engage in drug seeking behaviors no matter what the consequences. It impairs the judgment of someone. They will abandon whatever ethical values they have grown up with just to find the drug and sustain their addiction, even above family and friends.”

It’s made work for addiction and rehabilitation specialists across the region difficult but Dr. Longest sees it, in part, as a sign of something positive.

“It is much less stigmatized than it has been in the past, especially with the heroin and there are many peer support programs out there to help people in their recovery.

The state Department of Health and Human Services has ramped up its efforts to address the issue and are working with local health departments. Turner says her department is also reaching out to local organizations.

“We are trying to address that…not just through law enforcement but through our community partners, our faith based community our substance abuse programs – through those communities – through our school system. It’s not like we don’t know that it’s happening, we know that it’s happening. We’re just trying to wrap our brains around…how to – ‘fix it’ is probably not the right thing to say but how to address it – and how to begin to chip away at it.”

Like many epidemics – opioid addiction has no respect for age, race, gender, sexual orientation, or any other distinction. Tuner believes people are starting to realize that.

“No one is immune. Anybody who thinks they don’t have this problem, to at least a small extent to their surrounding community – I believe is fooling themselves. That’s my opinion – just because it’s not out there in your face.”

Heroin is one of humanity’s oldest narcotics and its’ still one of the most powerful. It has been an ongoing problem elsewhere – the slums, ghettos, and bohemian blocks in the city.

But now it’s that prevalent (pre-ve-lant) on the farms, the fishing docks, and the sub-divisions of eastern North Carolina.

It’s unknown if the region will make a full recovery from the epidemic but despite rising rates of addiction, Dr. Longest believes there’s reason to hope.  

“There are more people who are becoming addicted but the good thing is there’s also more people who are starting to seek treatment.”

I’m Chris Thomas.