North Carolina saw record highs in opioid overdose hospitalizations and deaths in 2022.
Some policies enacted in the middle of the last decade had helped to reverse trends from the opioid epidemic. But the pandemic wiped out those gains and contributed to a worsening crisis that continued through last year.
"People were isolated. They weren't able to use with other people. And so, if you're using by yourself you're at a much higher risk of overdose," said Elizabeth Brewington from the N.C. Council of Churches "The drug supply in North Carolina completely got contaminated. So people were using things that they didn't know had fentanyl or other products in it."
Last year, there were 4,243 suspected overdose deaths, according to preliminary figures from the N.C. Medical Examiner's office, and there were 9,243 opioid overdose emergency department visits, according to preliminary figures from the N.C. Department of Health and Human services. That's nearly 12 deaths per day and more than 25 emergency department visits every single day, on average, last year.
Fentanyl, an extremely potent opioid, has made its way in to many street drugs, not just heroin. While it plays a factor in the increased emergency department visits, prescription pills are also still causing people to overdose.
Brewington and a growing number of faith leaders are advocating for harm reduction strategies to reduce deaths and ED visits. These strategies give drug users the ability to test their drug supply, the proper tools to use drugs safely, and the confidence to call for help in a time of need.
"Harm reduction for the longest time was something that people only learned about through HIV/AIDS activism," said Brewington. "We have this long history, but it wasn't accessible to the broader community. And so there's been a lot of education efforts to get people to understand what harm reduction is."
Syringe exchange programs, for example, became legal in North Carolina in 2016, which brought them above ground. But not every county has a program, so access is still a barrier in parts of the state. In other cases, new laws have contributed to deaths.
"The death by distribution law passed, so people got more afraid to call and ask for help when their friend was overdosing," Brewington said. "And that fear definitely leads to an increase in overdose deaths and people leaving the scene."