NC’s Border Belt counties will get millions from opioid fund. How should they spend it?

By Sarah Nagem

North Carolina counties will get millions of dollars in the coming years to spend on the treatment and prevention of opioid addiction. 

The money will come from a $26 billion settlement finalized in February that puts an end to several lawsuits that blamed some U.S. drug companies for creating and exacerbating the opioid epidemic. 

The Border Belt Independent looked at how much money could come to four southeastern North Carolina counties – Bladen, Columbus, Robeson and Scotland – and talked to local leaders about how the money could be spent.  

Here’s the breakdown, according to data from the state

Bladen County: $2,765,094

Columbus County: $7,865,482

Robeson County: $8,759,640

Scotland County: $2,893,489

Opioid-overdose deaths have increased significantly in all four counties over the years – from 17 in 2010 to 63 in 2019, according to data from the N.C. Department of Health and Human Services. 

In Robeson County, the number of fatal opioid overdoses more than tripled from 2016 to 2019. 

As county leaders consider how to spend their share of the $750 million that North Carolina is set to get from the settlement, they will likely have to navigate a complex system. That’s because many community organizations are working toward the same goal of reducing opioid misuse, but they often don’t coordinate their efforts.  

“We don’t know what is going on in this county. The left hand does not know the right hand,” Lauren Cole with the Columbus Regional Healthcare System told the Border Belt Independent earlier this year. 

Want to keep up with all the latest news from the Border Belt Independent? Sign up for our weekly newsletter here.

Assessing needs in Columbus County

Columbus County is conducting a needs assessment to determine how best to help people who struggle with addiction to drugs and alcohol. 

The effort, which includes the Columbus Regional Healthcare System, is funded by a nearly $286,000 grant from the Kate B. Reynolds Charitable Trust, said County Manager Edwin Madden. (The trust also funds the Border Belt Independent.) 

As part of the assessment, Columbus County residents can take an online survey found here

Darren Mills co-leads Celebrate Recovery at Western Prong Baptist Church in Columbus County.
Photo by Les High

The findings will be used to create a strategic plan, which could become a guide for how the county spends its money, said Cynthia Wiford, a consultant with Addiction Consulting and Training Associates. 

As part of the process, a series of focus groups this month in Columbus County will include people who have dealt with addiction, their families, law enforcement officials, county commissioners and more, Wiford said in an email. 

“All of this information as well as local data and demographics will be analyzed to create a picture of the scope of the problem, the depth of services as well as identifying the gaps in the service continuum,” she said. “It will be the identified gaps in the services that will most likely be the focus of funds like the opioid settlement funds.” 

Christian Recovery Centers, which operates a six-bed residential treatment center in Whiteville, put in a request last week to get half of Columbus County’s settlement money, Madden said. 

The organization wants to convert its two residential centers in Brunswick County to serve women only and open a 120-bed facility for men in Columbus County, said Executive Director Joshua Torbich. 

One potential location for the center is the now-closed Acme Delco Middle School building in eastern Columbus County, according to Torbich.  

“For the problem that Columbus County has, and even for surrounding areas, a site like that could probably make more of an impact in a shorter period of time,” he said. 

Read the BBI's multi-part series on the opioid epidemic in Columbus County here.

Coordinating efforts in Robeson County

Robeson County could consider putting its money toward a large initiative that is just getting started. 

Using a $950,000 grant from the Kate B. Reynolds Charitable Trust, the University of North Carolina at Pembroke plans to open the Southeastern Prevention and Addiction Recovery Resource Center. 

The center will coordinate with the Robeson County Health Care Corporation and the district attorney’s office, the university said in a news release in December. 

“SPARC will serve as a hub to maximize coordination at local levels,” Dr. Kennard DuBose, assistant professor in the department of social work, said in the release. “By extending an invitation to all county coalitions and service providers treating substance misuse, we will build a greater collaborative effort.” 

Hope Alive, a nonprofit in Lumberton, plans to open a drug treatment facility in a former nursing home in Robeson County. 

The organization faced scrutiny when it received $10 million as part of the state budget last fall to open the center. Hope Alive has no experience in the treatment of substance misuse, as first reported by WRAL

The group is reportedly working with the Robeson Rural Communities Opioid Response Program Consortium, which includes UNC Health Southeastern, UNC Pembroke, the Lumbee Native American tribe and other partners. 

John Lowery, who was elected chairman of the Lumbees earlier this year, has said the tribe might be interested in opening a drug treatment center in Robeson County. 

“Our people need a place that when they’re ready to, (they can) get clean,” Lowery told the Border Belt Independent in January. “They have a safe, livable area to get clean. And it needs to be somewhere near home.” 

Scotland and Bladen

Some Scotland County leaders plan to attend a statewide meeting later this month sponsored by the North Carolina Association of County Commissioners. 

There, they will learn about different strategies and how other counties plan to spend the money, said Scotland County Manager Kevin Patterson. 

Patterson said the county will likely consider partnering with agencies, including the Scotland Health Care System, which has a management agreement with Atrium Health. 

“Outside of some of the major urban counties, I would assume that most every county will have partnerships stretching well outside of their own borders,” he said. 

Bladen County previously got a grant to create a plan for combating the opioid epidemic, said County Manager Greg Martin. 

In Bladen, much of the effort is guided by the local Substance Misuse Task Force. The group has reached out to churches to help inform the community about addiction to drugs and alcohol. 

More information

North Carolina’s 100 counties and some of its biggest cities will get 85% of the $750 million headed to the state. They won’t get it all at once – the payout is set to occur over 18 years, although much of it will be distributed in the next few years. 

Drug companies AmerisourceBergen, Cardinal Health and McKesson will pay $21 billion of the total settlement, and Johnson & Johnson will pay $5 billion.  

N.C. Attorney General Josh Stein helped lead the multi-state coalition involved in the lawsuits. 

More information about the settlement, including a dashboard that will show how counties and cities are using the money, is at

Follow Sarah Nagem on Twitter: @sarah_nagem