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Opioid-Related ED Visits Down In NC - But Only Barely

Fayetteville Police Department Captain Lars Paul demonstrating how police use a naloxone injectable kit to reverse opioid overdose.
Raul Rubiera

North Carolina emergency departments saw 5,343 opioid overdose related visits in 2018. That's down eight percent from the high of 2017, but still well above any other year in recent history.

The data show that although programs to tackle the opioid crisis show early signs of paying off, the state still has a long way to go before the epidemic is in the rearview mirror.

Emergency department directors cautiously praised the numbers, but didn't want to take too much away from just one year.

"It's better than seeing the opposite," said Dr. Graham Snyder, who is board-certified in emergency medicine and has practiced full-time as an emergency physician at WakeMed Health and Hospitals since 2002. "(But) the rate of growth of the problem, and the pervasiveness of the problem was so severe that I would be a little surprised if we are already cresting."

Opioid related Emergency Department data for 2018, from the N.C. Department of Health and Human Services.
Credit N.C. Department of Health and Human Services
Opioid related Emergency Department data for 2018, from the N.C. Department of Health and Human Services.

The growth of widespread dependence on opiates coincided with the rise of prescription pain killers like oxycodone and others. There has recently been increased scrutiny on the role that drug manufacturers and sales reps played in the sharp rise of prescriptions. Purdue Pharma, the maker of OxyContin, and the Sackler family behind it have faced lawsuits and been implicated – most recently by the Massachusetts attorney general – for the deadly epidemic.

Snyder implored policy makers, health providers, and patient advocates to not rest in the fight. He again said he was glad that numbers for 2018 were slightly better than the year prior, "but still, the staggering total numbers in terms of loss of life, as well as broken families, unemployment, violent crime – it's still one of the biggest threats to public health that we have in the United States," he said.

Meredith College professor of sociology and criminology Lori Brown said she worries that a prolonged government shutdown could interfere with some of the positive steps made recently.

"Drug use, especially this opioid issue, is often associated with economic, employment and family stress. All of these issues are clearly intensified right now for many families and the general unease with how things are going may affect these trends," she wrote in an email. "People... use drugs to self-medicate for mental illness or to deal with other major issues in their lives. The way to fix this is not to punish people but rather to offer treatment and full integration in American society. This is not rocket science."

On this point, Snyder agreed and said some positive steps have occurred.

He said that compared with even just five years ago, "productive compassion" among physicians, paramedics, and police has greatly improved and that where opiate addiction was taboo just a few years ago, the health system and law enforcement have now tackled the problem directly.

"We see that it's a widespread problem that affects all levels of society, and we have attacked it head on," he said.

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