By Henry Hawthorne IV

While overdoses underscore the opioid crisis in Columbus County, county leaders still have a long way to go to understand the core causes and provide effective prevention programs, says Lauren Cole.

“The first two weeks of April we had 14 overdoses at Columbus Regional,” Cole said. “One mother overdosed and left three preschool children sitting in the emergency room. No one knew where the children would go. What happens to the children? A lot of people don’t realize the turmoil they will suffer for the rest of their lives having witnessed that.” 

Cole, a contract employee with Columbus Regional Healthcare System, the CRHS Foundation, and liaison with the Southeastern North Carolina YMCA, said examples like this demonstrate some of the many severe and complex opioid-related problems that face Columbus County, in part because the county’s relief and prevention efforts are disjointed. 

“We don’t know what is going on in this county. The left hand does not know the right hand,” she said.  

A grant from the Kate B. Reynolds Charitable Trust worth more than a quarter of a million dollars over the next three years hopes to change this.

In July, Cole put a group together consisting of representatives from the hospital, housing, sheriff’s department, police department, municipal officials and the health department, among others. 

“You name it, we had them at the table. We started talking about, ‘Who even knows what’s going on in this county?’” Cole said.

Columbus County will have more resources to fight the opioid crisis with the grant, which will be used to conduct a needs assessment, develop a report and call to action, plus provide technical assistance over three years to implement it.  

Columbus County has an 18% higher rate of overdose, a 29% higher rate of opiate deaths, and a 39% higher rate of opioid prescribing compared to the rest of the state, according to the North Carolina Institute of Medicine.  

Cole said Columbus County continues to struggle because it lacks a collaborative, unified approach to enact change. 

“There is no real progress,” Cole explained. “You have several agencies but you don’t have a coalition that says, ‘You do this, you do that.’”

 Cole said some key leaders and organizations aren’t aware of opioid crisis relief and prevention initiatives. 

This lack of a unified effort illustrates another key problem: without coordination, Columbus County struggles to effectively collect data and identify the source of problems, Cole said. “No one really knows how many doses of Narcan get out, and we don’t know to which areas.”

As Cole sees it, the first and foremost goal of the grant is to create a group that serves as an oversight agency to discover where the key causes of Columbus County’s opioid crisis lie.

The coalition will be comprised of a core leadership group with subgroups that study areas such as housing or medical care, Cole said.  

A consulting company, Addiction Consultant Trainers (ACT), will assist local efforts.

A key component is talking to people who have been affected by the opioid crisis, Cole said.

Cynthia Wiford, Principal Consultant and founder of ACT Associates, said the best way to understand the problem is to talk to people. 

 “We have been identifying the key players. We will not only identify them, but we will interview groups of people within those key players’ arenas,” Wiford explained.  (To take the survey, which will be anonymous, click here https://tinyurl.com/7tjzba46)

Among a variety of focus groups will be workers in Columbus County’s publicly funded services, as well as families and individuals who have directly experienced or been impacted by substance abuse. 

The process will require patience. 

“I’m fearful that if we don’t have immediate results, people will think it is not worth it,” Cole said. “It could take years to stem the flow, to get the rehab going, to find out the repeat offenders, to find out who is bringing it in.”

“It could very well be 10 years before we see real results,” she added. 

  It takes time to start to see change because substance abuse causes so many separate issues, Wiford said. 

“Typically, what happens when you come in and start to do a needs assessment, you identify all kinds of needs. It’s not just, ‘We need more treatment.’ It’s law enforcement that needs help, jails need help, the school system needs help. There are many missing pieces that need to be linked together,” Wiford said. 

With such varied and vast issues at play, ACT and county leaders will need to come up with solutions specially designed for Columbus County. 

“What you start out with is not necessarily what you end up with,” Wiford said. “Hopefully, everything we do in that community will make it stronger, make it more resilient, more responsive, and the problems will start to get addressed.”

Cole and her team are working on follow-up grants and have hopes of developing a long-term project. In addition to the grant from the Kate B. Reynolds Charitable Trust, Columbus County is in the running for a grant from the Substance Abuse and Mental Health Services Administration. 

“If we get this other grant in May, it’s $400,000 per year over three years for specific activities.  That is where you don’t talk about it anymore … it is implementation,” she said.

Wiford said she is optimistic about Columbus County.

“I was really struck by the sincere interest,” she said. “People really want to come together to make something happen. I found a lot of people wanting to step up. It was refreshing to hear people say, ‘We know we have a problem, we just don’t know how to solve it. We need some help figuring this out.’ We hope to provide this help.”

For now, Columbus County must focus on finding the roots of the problem,  plus supporting, helping, and learning from those who have been affected, Cole said. 

“We want to hear from the people, the people who are worried every night that their child is not going to come home.”