The United States is in crisis when it comes to drug overdoses, particularly related to opioids like fentanyl and heroin.
Our figures in Fayetteville and Cumberland County are sobering and a call to action for the community. One part of the rescue plan? Naloxone, also known by the brand name Narcan, a medication that public safety personnel and others carry that can reverse an opioid overdose. It is a bonafide lifesaver.
Cumberland County, post-COVID-19 pandemic, saw a spike in overdose deaths. In 2021, the overdose death rate in the county was 64 out of 100,000 people, above the state average of 39 of 100,000 people, according to dashboard data from a search engine by North Carolina Opioid Settlements.
It was part of longer term trend. Between 2015 and 2019, opioid-related deaths in the county doubled, according to figures from the North Carolina Department of Health and Human Services.
Whether overdoses in Cumberland County are up or down presently depends on what metric you are looking at, says Greg Berry, who is the project coordinator for the Cumberland-Fayetteville Opioid Response Team, a collaborative of organizations and individuals with 160 stakeholders. Cherry is also the county's lead program coordinator for North Carolina Harm Reduction Coalition, a grassroots advocacy organization on the front lines of the opioid fight. In that role, he helps steer people with substance abuse issues into diversion programs and away from lockup.
"It is in a better place than we were two or three years ago for sure," he said about overdoses in our county. "Over the last six or seven months, we've seen a steady decline in the amount of people who are presenting in the emergency room for overdose."
"We noticed in October last year that we were down to where we were the year before, and ever since, then we've been ticking down. Now, that's great news,and that tells us that our naloxone distribution efforts are working and the naloxone we're putting in the community is working as keeping people from going to the emergency room."
However, a July report based on stat figures showed that two more people had died from overdoses compared to the same point last year, the toll rising from 33 to 35, he said, citing figures from the NC Injury and Prevention website, operated by the DHHS.
"The danger is still real," he said, noting they had lost two on the recent International Overdose Awareness Day last Saturday.
A naloxone dose works similar to an EpiPen auto-injector for severe allergic attacks; it is relatively easy to administer and is compact. There are also nasal spray versions.
So should we all be carrying it?
My wife brought me a little white Narcan box with the nasal spray the other day. She had attended a meeting of fellow clergy and heard a counselor on the front lines of the opioid crisis in Robeson County and who distributed the Narcan.
The idea is that I carry the Narcan in my car, in case I am out somewhere and someone is in crisis. Carrying naloxone and knowing how to use it these days can be compared, I suppose, to learning how to do CPR for a person in cardiac arrest or knowing how to do the Heimlich maneuver if we see someone choking.
Berry noted that state law provides limited immunity for anyone who responds to an overdose in good faith in case they give someone naloxone "and they wake up and want to sue you."
"It also provides limited immunity for people who are reporting an overdose," he said. "The messaging is 'Yes' we do want folks to carry naloxone because overdose can occur to anyone and anywhere."
He also said CFORT partners offer overdose response training.
"We've probably trained 600 Cumberland County personnel, school personnel. We've trained Board of Elections, Justice Services, librarians, we do community trainings at the library that are open to the public. We got kind of robust training that goes on with the naloxone distribution."
"Then there's another naloxone distribution that goes directly to people who use opioids," he said.
Berry said the distribution and screening process also helps identify additional dangers related to opioids -- such as a finding two years ago that an adulterant, xylazine, was added to the drug supply that has been circulating in Cumberland County and "causes a lot of different adverse health effects."
In May, a Raleigh high-school girl quickly retrieved Narcan from her car to help a man who was OD'ing by the side of the road.
"It takes anywhere from 30 seconds to two minutes to work," the teen lifesaver, Victoria Taton, told WRAL. She clearly knew something about it. "In about 30 seconds to 60, still with the EMS on the phone, he comes out of the state of response that he was in. He throws up. He's coming in and out of consciousness. The EMS are telling us that."
In 2018, a Fayetteville police officer's life was saved by naloxone after he had suffered effects from exposure to fentanyl.
Last Saturday was International Overdose Awareness Day, and the city of Fayetteville marked the occasion by lighting up City Hall downtown in purple colors through Monday.
A news release noted that personnel with the Fayetteville Fire Department and Fayetteville Police Department carry Narcan.
"The FFD reported a total of 499 overdoses from August 2023 to August 2024 and had 263 instances where Narcan was administered," the release states. "FPD provided 38 administrations of Narcan in the same time period."
The city's public safety departments routinely partner with Cape Fear Valley Health System "to educate residents in an attempt to lower the number of overdose related incidents across the community," the release also says.
City and county officials seem to be on the same page in that they want to make Narcan available to anyone who wants it.
Narcan is available at the county Department of Public Health and in vending machines at the county jail. In August 2023, the nonprofit (and excellent community partner) North Carolina Harm Reduction Coalition donated $9,000 worth of Naloxone to the Fayetteville Police Department.
Lars Paul, a retired police captain who is with NCHRC and coordinates with law enforcement, said he hopes the donation "better equips officers who respond to overdoses," a police news release said.
As for whether, "lay people" should carry Narcan, the experts seem to lean heavily on "yes."
"It should be like ... the EpiPen of our generation," Dr. Dan Ciccarone, a professor of addiction medicine at the University of California-San Francisco, told the San Francisco Chronicle last September.
Dr. Beth Mulchachy, a hospital emergency room physician, told the same publication: "Everyone should be aware this is something they can carry if they feel they might come into contact with someone -- if they have teenagers in the house or relatives who are on multiple medications -- who might potentially accidentally overdose."
"It's hard," Berry acknowledges from the opioids front lines. "I lost family members to this. You know, I've worked with people on Monday and came back on Wednesday with the stuff that we talked about doing, and they're no longer there you know? It's tough work.
But he says he tries to keep his focus on the work he and other partners are doing and success they achieve: He cited as an example Cumberland County's move to open a recovery center in the next couple of months.
"I try to keep my focus on the big picture," he said. "We're monitoring this, we're seeing real impact in the community. I look for all the folks that we're able to connect, all the folks that were able to to help, all the folks that were able to save. I just try to focus over there and not on who we're losing."
Columnist Myron B. Pitts can be reached at [email protected] or 910-486-3559.