The Elkin Tribune
DOBSON — Surry County’s new opioid response director Mark Willis hosted the first of what may become periodic community forums on the opioid epidemic in Surry County at Surry Community College on Friday.
“I felt like a new preacher, and maybe no one would show up in the tent,” Willis said in his opening remarks to the capacity audience in the grand hall of the Shelton-Badgett North Carolina Center for Viticulture and Enology.
Willis said that his position as opioid response director for the county is unique in North Carolina and thanked the county commissioners for having the vision to address the epidemic.
Also speaking at the forum via Skype from his home in Sarasota, Florida, was Dr. A. Thomas McLellan, chairman of the board of directors at the Treatment Research Institute and Deputy Director of the Office of National Drug Control Policy from 2009-2012 under President Barack Obama. Hugh Harris, outreach and policy counsel, NC Department of Justice – Public Protection Division, rounded out the panel of speakers.
Willis started off with a graphic depicting the amount of emergency department opioid overdose visits in each North Carolina county, with what he called “a big red blob where Surry County is.”
“Surry has more emergency room visits due to opioid overdose per capita than any other county,” said Willis. In April, Surry had 18 per 100,000 residents, and Cumberland came in second with 11 per 100,000 residents.
“Why is that big red blob in Surry County?” Willis asked. “I don’t have the answer. It’s a confluence of events. Maybe it’s the ‘squeeze the balloon’ theory,” which he defined as problems from more populous areas, Forsyth and Iredell counties, finding their way up U.S. 52 and I-77. “Maybe we have some pharmacies and doctors we need to take care of.”
John Shelton, Surry emergency services director, gave Willis the most recent statistics as of Friday morning, 184 responses and 14 deaths from opioid overdoses this year.
“That’s bad, but it’s better than last year. The only thing that’s saved us in Naloxone,” which is a medication designed to rapidly reverse opioid overdose.
Willis gave a brief history of the opioid epidemic. Starting about 2000, doctors were over-prescribing legal pain-killers. Ten years later, heroin came on the scene. Three years after that, fentanyl became popular. Fentanyl is 100 times stronger than morphine and was responsible for an uptick in overdoses.
“Now we’re in the fourth phase,” said Willis. “We’re seeing heroin, fentanyl, carfentanil (10,000 times stronger than morphine), cocaine and methamphetamine.
“Sometimes the tox screen (of someone who overdoses) is so confusing it’s impossible to know what they died of.”
Willis said that 19 grams of carfentanil could satisfy the medical needs of the entire United States for a year, but it is coming into the country in multi-pound and multi-kilo packages. “Grey death” is the street name of the mixture of drugs that is proving so lethal.
Harris, from the N.C. Department of Justice – Public Protection Division, began his talk by saying, “I like helping people, even though I’m a lawyer,” and commented that where McLellan had referred to Oxycontin (brand name of oxycodone) being called “hillbilly heroin” due to its prevalence among Appalachian mine and factory workers, he was more familiar with the term “hillbilly cocaine” as it was usually snorted by users.
“We all have somebody like that in our community, among our friends, in our family,” he said.
According to Harris, 75-80 percent of incarcerated males are affected by substance abuse, and nearly 100 percent of incarcerated females are.
“We can’t arrest our way out of this issue,” he said.
Harris divided his talk into three topics: prevention, treatment and enforcement.
Prevention includes being watchful of the source, including doctors, dentists and now, veterinarians.
“We should ask our students to come up with programs. Getting youth involved is important.”
Harris emphasized the importance of destroying unused medication. “You’ve got to get rid of them. Don’t flush them down the toilet. We know that’s bad. Turn them in.”
He then added, “You don’t need old prescriptions lying around to tempt your kids or grandkids. And realtors should be aware of addicts posing as clients in order to gain access to medications in medicine cabinets when looking at homes.
“Only one in 10 can get treatment,” said Harris of substance abuse disorder. “What if that was true for heart disease? We wouldn’t stand for that. People would die. People are dying.”
“Of course we want drug dealers locked up,” said Harris, as he began to speak of enforcement, but added locking up users was less effective.
“Someone parties after getting out of jail and drops dead. We don’t want that. Every life is worth saving.”
Everybody can be of value to their community, and while in treatment, they can be, he said. “I don’t care if they have to be saved five, 10, 20 times.” He then told a story of someone who overdosed three times, saved by Naloxone each time. “Now he’s helping others.”
He then described legislative and policy changes aimed at reducing supplies of prescription drugs: limitation of prescriptions for acute pain to a five-day supply, a database to prevent doctor shopping, requiring electronic prescriptions, regulating fentanyl and fentanyl derivatives (noting some of the derivatives were not even illegal at the time they were killing people).
He then spoke of initiatives that would make it a felony for a healthcare worker to steal a patient’s drugs or dilute a patient’s drugs, clarified trafficking, gave appropriate access to databases to law enforcement, and added veterinary drugs.
“We know real solutions come from you. You know your community better than we do. We will help fight this issue. We will reduce the number of deaths.”
By Bill Colvard