Robeson County’s collaborative effort to fight the opioid epidemic

By Sarah Nagem

As Robeson County officials debate how to spend the nearly $9 million the county will receive as part of an opioid settlement, a big question looms: What is the most effective way to treat addiction? 

Dr. Kennard DuBose, who leads the Southeastern Prevention and Addiction Recovery Resource Center, has plenty of ideas. 

“There’s no one size fits all,” said DuBose, a professional social worker who specializes in addiction and serves as a professor at the University of North Carolina at Pembroke, where SPARC is housed.  

However, DuBose said, successful treatment of opioid addiction most often includes a combination of medication to ease withdrawal symptoms, therapy to deal with underlying mental health issues and community support to aid in long-term goals. 

Robeson County, home to about 127,000 people in southeastern North Carolina, faces plenty of barriers to such a treatment plan, according to DuBose. 

The county lacks a sufficient number of inpatient beds, there aren’t enough providers who specialize in substance misuse, and the community is already devastated by drugs. (Robeson had a fatal overdose rate last year that was more than 2.5 times the statewide rate.)

DuBose is leading a team of health care professionals, nonprofit leaders, law enforcement officials and more to help break down those barriers and get more people the help they need. The group, made up of about 40 organizations, will submit a plan in August to the Robeson County Board of Commissioners with suggestions on how to spend the opioid money.

Soon, North Carolina counties will begin to receive their share of a $26 billion settlement that put an end to several lawsuits that blamed some U.S. drug companies for creating and worsening the opioid epidemic. 

Robeson commissioners will have the final say on how to spend the county’s $8.8 million, which will be distributed over 18 years. 

Working together

The Southeastern Prevention and Addiction Recovery Resource Center was founded in October with a three-year, $950,000 grant from the K.B. Reynolds Charitable Trust. 

The trust, which also funds the Border Belt Independent, approached UNC Pembroke about serving as a hub for organizations and initiatives that were already working to reduce opioid misuse in Robeson County. SPARC is a kind of extension of the Robeson Rural Communities Opioid Response consortium. 

SPARC’s goal was to bring 23 partners on board in the first year, said Project Director Dr. Jacqueline Davis. As of mid-July, Davis said, there were 39. 

“We reached that goal immediately,” she said. “Folks were really excited about joining and becoming a part of and learning about the consortium all over again.” 

Participating organizations receive a $5,000 stipend for program and operational costs, Davis said. They include Colors of Life, a local gang-prevention initiative; Monarch, a statewide provider of mental health services; and Hope Alive, an organization building a drug treatment center in Robeson County. 

Participants also include UNC Health Southeastern, the Robeson County Sheriff’s Office and the local district attorney’s office. 

DuBose said SPARC helped secure grant funding to bring medication-assisted therapy to the Robeson County jail. Under the program, he said, people who are incarcerated who struggle with opioid addiction can receive medication such as Suboxone or methadone to help during withdrawals. 

“That’s a very painful process, if it’s not treated properly – almost borderline inhumane – and they don’t have the resources to do it,” DuBose said of the sheriff’s office. 

When the inmates are released, they will be connected to resources to continue treatment, DuBose said. As part of the program, SPARC will track their recidivism rates. 

“We want to make sure that we’re getting them the immediate services of withdrawal management,” he said. “But the ultimate goal is to get them in recovery.” 

DuBose said North Carolina Attorney General Josh Stein recently visited SPARC and praised its collaborative efforts. 

Eventually, DuBose said, SPARC would like to expand beyond Robeson County to serve more of southeastern North Carolina. That would require more money. The organization could also serve as a template that could be replicated elsewhere.

“(Stein) was very complimentary with what we were doing in Robeson County, and said we’re really positioning ourselves to form a model,” DuBose said. 

What’s available now in Robeson County?

Last year, 88 residents in Robeson County died of drug overdoses, according to the N.C. Department of Health and Human Services. DuBose said Robeson had the highest rate of fatal overdoses in the state. 

According to DHHS, “The overdose epidemic has predominantly been seen as an issue impacting white communities.” 

But Native Americans have the highest rate of overdose deaths in North Carolina, with 83.6 per 100,000 residents in 2020, according to the agency. The rate for white people was less than half that – 36.1 per 100,000 residents.  

In Robeson County, home to the Lumbee tribe, more than 30% of the population is Native American. 

DuBose said Robeson County needs more opportunities for people dealing with substance misuse to get help close to home. 

The Robeson Health Care Corporation, which serves patients regardless of their ability to pay, offers a 24-bed residential facility in Lumberton for women and their children and a 10-bed facility in Pembroke for pregnant and postpartum women. 

It also operates a nine-bed treatment center in Lumberton for men. 

Hope Alive, a nonprofit in Lumberton, secured $10 million from the state to open a drug treatment facility in a former nursing home in Parkton. The organization has faced criticism for its lack of experience dealing with behavioral health, but DuBose said SPARC supports the project. 

“We welcome that initiative,” he said.

DuBose said there is a shortage of substance misuse providers across the country, and Robeson County faces unique challenges in recruiting qualified professionals. He said SPARC wants to focus on training people locally in hopes they will stay. 

“We know that we’re never going to be able to get the folks who have the bright light, big city aspirations to Pembroke or to Robeson County,” he said. “So we want to focus on just growing our own.” 

For now, SPARC is working on getting the recommendations to county leaders by Aug. 8. DuBose said commissioners have made it clear they don’t want to duplicate services, and they want to spend the money on programs that will help people across the entire county. 

“We want to make sure we utilize these dollars for things that can’t be funded elsewhere,” DuBose said. 

Follow Sarah Nagem on Twitter: @sarah_nagem

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