By Mark Shiver
Heroin is responsible for a death a week in one North Carolina community, and in some communities the toll is even higher. On May 6, Nash County Sheriff Keith Stone told the Freedom Action Network radio program “What Matters in North Carolina” that heroin is fast becoming the drug of choice in the state, particularly among young people, and he warns that its use takes a heavy toll.
Stone said, “Young people need to understand this is not like a cigarette you can smoke today and stop tomorrow. If you start heroin you are going to be addicted to it, and there’s a high likelihood you’re going to overdoes and die.”
Once a drug that in the 1970s was often featured in movies and television crime dramas, heroin seemed to fall out of the mainstream. In the ‘90s it was cocaine and crack that filled the big screen, and that was also the cause of much violence and death across America. The addictive nature of crack made it particularly destructive to the user. Heroin is no different, and it’s back in North Carolina and is sweeping across the country with a vengeance.
Stone said that the widespread abuse of prescription pain medicine has led to this resurgence in the abuse of heroin. Dr. Randall Williams, North Carolina’s state health director, told “What Matters” on May 13 that heroin is on the rise and in many ways is the public health crisis of our time. Williams said, “We’re on track now to do the most autopsies we’ve ever done, and that’s largely because of the rise in opioid overdose.”
John Temple, author of American Pain, told “What Matters” on May 26 that, from a drug addict’s standpoint, opioid pain medication and heroin are very similar. Temple said, “To an addict it’s not that heroin is a better high, it’s just cheaper.” Temple’s book recounts the explosion of the illegal selling of pain medication in Florida and how it launched the current epidemic of opioid and heroin addiction in our country.
Williams said it’s not so much a resurgence as an evolution, noting that out of a world population of over 7 billion people, 80 percent of the world’s oral opioid use is in the United States, a country with around 350 million people. Williams said, “We think there are around 77,000 narcotic prescriptions out there for every 100,000 North Carolinians right now.”
The route to heroin abuse and addiction can occur innocently enough, starting with a medical procedure. Williams said, “As I travel around the state, I hear story after story about people going to the hospital for very simple surgeries, and they’re given 60 Lortabs or 90 hydrocodone. And then what happens is that people who are having very basic surgery are in many cases becoming addicted. It’s an incredibly sad fact now that as they run out of ways to get those prescription drugs, they find that heroin is much cheaper and in some ways easier to get.”
Stone’s commentary that young people are dying from heroin was echoed by Williams, who said, “It breaks your heart because I think we’ve had 25 deaths this year, mostly from young people throughout the state who when they went to get their heroin, unbeknownst to them I imagine, they got Fentanyl, or Fentanyl-derivatives, which is 20 times more potent than heroin. By the time that happens they die. It’s incredibly sad when you think about it, to go from taking a prescribed drug to taking heroin to taking a drug that’s incredibly lethal.”
On Friday May 20, U.S. Rep. Robert Pittenger (R-9th) told “What Matters” that a person in his neighborhood died recently who had started with opioids and went on to heroin from there. Pittenger said, “Right now there are 6.5 million Americans with prescription drug issues, and 78 Americans die every day from opioid overdose.”
The Centers for Disease Control states on their website that deaths from prescription opioids –drugs like oxycodone, hydrocodone, and methadone – have quadrupled since 1999. Pittenger added, “Be careful about taking pain medications. Just take your Advil and move on. This is really a very serious problem.”
Pittenger has sponsored several pieces of legislation in the U.S. House to combat the opioid epidemic. The 18 bills include giving law enforcement more tools to fight drug trafficking, educating people on the dangers of opioid addiction, and helping addicted mothers to defeat their opioid addiction by funding treatment programs.
The North Carolina General Assembly is taking a step to try to save the lives of potential heroin overdose victims. Senate Bill 734 (HB1000) would authorize the state medical director to have a standing prescription that allows anyone in the state who suspects that someone is having a heroin overdose to go to a pharmacy and anonymously obtain the drug naloxone hydrochloride.
Otherwise known as “Narcan,” the drug is used to restore the respiratory function of the person having the overdose. It is available as an injection or a nasal spray. Williams said, “It is truly a lifesaving drug,” and likened it to an EpiPen used by those who are allergic to things like bee stings.
Williams also said, “If you’re not breathing – which is how a narcotic overdose kills you – it literally will bring you back to life. The converse is that if you don’t have that drug, you can pretty much do what you want to and you’re not going to live because you have to reverse that not breathing.”
At present there are approximately 70 first responders such as sheriffs across the state that have the drug readily available. Williams said, “They will tell you about literally finding themselves in situations where they’ve saved lives, but if they didn’t have it they would’ve had to watch that person die.”
The bill passed unanimously in the Senate on May 17, and is currently waiting to be heard by the House Judiciary 1 Committee. Most observers predict smooth passage for the bill in the House and that Gov. Pat McCrory will likely sign the bill. Williams said that educating the public about its availability and the fact that a concerned person can obtain it anonymously if they fear someone is in an overdose situation will be crucial to the success of the legislation’s implementation.