In 2017, The News Reporter in Whiteville partnered with Scalawag magazine to analyze the effects of narcotics in Columbus County and the impact on an already fragile mental health care system. Five years later, primary writer Ivey Schofield, plus writer Henry Hawthorne and Border Belt Independent Publisher Les High, sought to answer the question: What has changed, if anything?

After interviewing dozens of people, the Border Belt Independent found that some facets of the opioid epidemic have improved (like stricter prescription policies), some have persisted (like continuing arrests for drug possession and distribution), and some have deteriorated even more (like increases in overdoses, overdose deaths and the number of children under state custody). 

Following are takeaways from the seven-part series, which concluded Friday.

Part I: ‘We need to have a reformation‘

• In 2019, Columbus County’s prescribers wrote 76.8 opioid prescriptions per 100 people — which is higher than the state’s rate of 56.7 prescriptions per 100 people and the country’s rate of 46.7 prescriptions per 100 people. However, due to changing prescription practices, this has reduced over the years. There’s greater emphasis on pain management through over-the-counter medications, massage, physical therapy and acupuncture. 
• As a result of these stricter prescription practices — along with the high cost of maintaining a pill habit — many people ultimately turn to the cheaper, more accessible, faster-acting heroin. But heroin is much less safe than a prescribed pill. Dirty and shared needles can lead to HIV and hepatitis C infections, and heroin is often laced with fentanyl, which is around 100 times more potent than morphine. 
• In Columbus County, unintentional deaths due to overdoses increased from 17.2 deaths in 2017 to 28.8 deaths in 2020 per 100,000 residents — or by 67%. 

Quotable

“In Columbus County, it’s everywhere, it’s bad, and people don’t want to see it.” Darren Mills of Celebrate Recovery

Link to the story: https://bit.ly/3GDl4Wm

Part II: Sheriff: Columbus drug crime is a ‘bad situation’

• The court has become more lenient toward people who struggle with addiction but harsher on drug dealers.
• Approximately 70% of newly incarcerated people in the state — or 1,400 a month — need substance abuse treatment, according to the NC Department of Public Safety. That means there are not enough beds or resources to provide this service to everyone, even without pandemic restrictions. 
• Since taking office in 2018, drug arrests in Columbus County for drug violations nearly tripled from 2017 to 2020, according to data provided by the sheriff’s office. Greene has taken a “boots on the ground” approach to addressing drug crime. He’s focused on open air drug markets, which are hotspots for substance distribution.

Quotable

“This is rural North Carolina — this ain’t New York City — and it’s happening here. Somewhere we’ve all dropped the ball.” Sheriff Jody Greene

“You can lock them up, but are we providing treatment? We have to look at what the causes of drug use are.” DREAM Center Director Amber Bellamy

“We need more access to psycho-social treatment than medication treatment.” Dr. Evangeline Gonzalez, CRHS hospitalist

“Why would they want to go work at McDonald’s for an hour when they could stand on a corner and make $600–$700 a day?” Whiteville Police Chief Doug Ipock

“Arresting somebody for marijuana is stupid as hell.” Vickie Pait, director of Families First

Link to the story: https://bit.ly/3A7aOTv

Part III: Hospital, EMS seeing ‘a lot more’ overdose deaths

• Curbs on how providers prescribe synthetic opioids like OxyContin have led to higher use of drugs like heroin, which can be particularly lethal when mixed with other drugs. Unintentional overdose deaths increased by two-thirds in Columbus County from 2017 to 2020.
• The hospital and EMS providers have seen the number of psychiatric and mental crises  cases skyrocket in recent years, which in is part attributed to substance misuse. It has placed a tremendous burden on manpower and resources.
• The pandemic made substance misuse and the mental health crisis exponentially worse.
• Hospital officials say the move toward community-based care has resulted in a desperate need for more in-patient treatment facilities. The hospital is often forced to hold patients in the ER for several days before a facility can be found.

Quotable

“Everybody thinks they’re immortal when they’re using drugs.” Dr. John Penrose, head of emergency department at Columbus Regional Healthcare System

“The number of opioids has been reduced but you’re seeing an increase in other drugs like heroin and others. It’s been a trade-off.” John Young, retired CEO of Columbus Regional Healthcare System

“They couldn’t get out of the house and the walls started closing in.” Shannon Strickland, Whiteville Rescue Unit chief, on the effects of the pandemic on drug use and mental crises

 “It will ebb and flow, but we need more access to psycho-social treatment than medication treatment.” Dr. Evangeline Gonzales, on the need for more treatment options for mental crisis patients

Link to the story: https://bit.ly/3rrIrf5

Part IV: Drug treatment program leads to sobriety, sisterhood

• A drug treatment program in Columbus County uses the Bible to get people struggling with addiction to ask themselves why this happened and how they can reclaim their lives.
• Free inpatient drug treatment programs exist in the county, but there’s a waitlist that has grown since the beginning of the pandemic.

Quotable

• “I was beginning to build the foundations of Christianity back up. When I did that, the enemy came at me really hard, and I allowed it.” April Bell, resident of Rose House, a Whiteville treatment center for women
• “They’ve come further than some could have even dreamed of.” Monique Holenko, director of operations at Rose House

Link to the story:https://bit.ly/3IbVhoi

Part V: Drug treatment options exist, but many don’t know where to find them

• Funding for mental health has fallen over the last two decades, forcing nonprofits and law enforcement to address mental health without adequate training.
• Local prevention and treatment resources (among others): Trillium Health Resources (referral services), Men and Women United (case management and referral services), Community Support Agency (mental health), Christian Recovery Centers (inpatient drug treatment), Coastal Horizons Center (drug treatment for pregnant and postpartum mothers), Hope and Healing Center (methadone and suboxone), Boys and Girls Homes (counseling).

Quotable

“There’s a stigma to getting help.” Devoria Berry, director of Community Support Agency, a certified behavioral health agency with offices in Whiteville and Delco. 

“If we can provide empathy and understanding to reduce that stigma, we could have a much greater impact on helping individuals get the treatment they need and ultimately make that difference for families and the larger community as a whole.” Jessica Canavan, assistant director of community based family services at Coastal Horizons

“I always say that some treatment is better than no treatment. When they’re ready, it’ll be really easy for them to continue.” Gayle Beese, the program coordinator in Whiteville.

Link to the story: https://bit.ly/3KhWJr9

Part VI: Abuse, neglect of children often goes hand-in-hand with parents’ drug use

• In 2020, half of all children in foster care in Columbus County were there due to parental substance abuse, which is higher than the state’s average of 45%. But due to the pandemic, Columbus County doesn’t have enough foster homes to accommodate all the kids who need them.   
• Getting parental buy-in is important, so local nonprofits offer case management and parenting classes that promote healthy communication.

Quotable

“When we start to shift that focus to, ‘What are we doing for the next generation,’ maybe it’ll get more strength.” Selena Rowell, director of Columbus County Partnership for Children

“Addiction cycles become generational. We learn from our parents, what they do and how they cope. It’s very hard for them to break that cycle without help.” Ricky Creech, president of Boys and Girls Homes

Link to the story:https://bit.ly/3KeSJaR

Part VII: Coalition hopes to coordinate efforts to combat opioid crisis in Columbus County 

• The lack of coordination among resources prevents the county from having a cohesive plan to fight substance misuse.
• Grants from the Kate B. Reynolds Charitable Trust and others are providing funding to develop and implement a long-term prevention and treatment plan. Thus far, about $1 million has been awarded, with hope for other grants.
• 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.  

Quotable

“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.” Cynthia Wiford, principal consultant and founder of ACT Associates

“We want to hear from the people, the people who are worried every night that their child is not going to come home.” Lauren Cole, who is working to create an opioid coalition and pursue grants to implement a coordinated response among treatment and prevention providers in the county

Link to the story: https://bit.ly/325oBh5