Brittney Lofthouse – Staff Writer

Counties across the state have been holding comprehensive county government leadership forums on opioid abuse, an initiative lead by the North Carolina Association of County Commissioners. Macon County officials joined a growing list of county leadership to hear the presentation of the state of the opioid epidemic in North Carolina and in Macon County. The Highlands Board of Commissioners, the Franklin Town Council, and the Macon County Board of Commissioners, attended a joint meeting last week and were presented an overview of the opioid crisis by members of Macon County Public Health.

“These leadership sessions were an idea put together by the North Carolina Association of County Commissioners and all 100 counties will have a similar exercise,” said Macon County Public Health Director Jim Bruckner. “Macon County is far ahead of most counties in the state in terms of dealing with the opioid problem plaguing our community. We have a task force, which a lot of counties don’t. But just because Macon County is ahead of most, it doesn’t mean that everything in the county is rosy.”

Lynn Baker, Public Health Section Administrator for the Macon County Health Department told county leaders that in Macon County, 37,000 opioid prescriptions were written in 2016, not including prescriptions administered to cancer patients.

“That equated to 1.1 prescriptions for every single county resident… that is an average of 81 pills per person,” said Baker.

On the state and federal level, Bruckner informed county leaders that legislation is being put into place to address the issue. The Stop Act of 2017, sponsored by Senator Jim Davis, was passed with the intent of limiting the number of opioid pills that a doctor can prescribe for certain medical cases.

“The Stop Act, when it’s fully implemented, will limit the supply of opiates to a five- or seven-day supply depending on the case,” said Bruckner. “Doctors will no longer be able to write a ‘scrip’ for 30 days, instead, they will write it for five to seven days, and have to see a patient again in order to provide additional medications.”

On the federal level, the day after Macon leaders met for the forum, Congressman Mark Meadows (R-NC) introduced legislation to address the opioid epidemic. On Wednesday, Meadows and Congressman Jim Renacci (R-OH) introduced the Opioid Abuse Deterrence, Research, and Recovery Act — a bill to combat the rapidly spreading opioid crisis in America.

Meadows’ and Renacci’s bill seeks to address an underlying cause of this issue by placing common sense parameters, with appropriate flexibility, around initial opioid prescriptions for acute pain in order to limit the risks of addiction. Research conducted by the Center for Disease Control (CDC) shows that the risks for addiction to prescription opioids dramatically increase around seven days after prescribed. This bill would place a limit on a patient’s first opioid prescription for acute-pain to no more than 7 days, except in cases of traumatic injury, chronic conditions, cancer-care, end of life care, palliative care, or based on a physician’s recommendation. The limitation to seven days would appropriately mitigate risks of abuse while also providing flexibility for doctors and patients to receive treatment where needed.

“Far too many men, women, and families across the country have suffered from the preventable spread of opioid abuse in America,” Rep. Meadows said. “The effects of this crisis are heartbreaking, and I know for me, they’re felt right at home. My state of North Carolina has four of the top 20 cities in America suffering from opioid abuse, with over 12,000 North Carolinians dying as a result of the epidemic since 1996. This has got to end—and we believe Congress has an opportunity to lead by helping establish standards that benefit doctors, patients, and treatment centers alike. I want to thank my colleague Jim Renacci as well for his efforts. I’m grateful we could introduce this bill to begin a process of seriously addressing this crisis that has impacted so many.”

While the first and foremost negative effect of opioid abuse are the implications it has on individuals and their families, county officials note that there are financial implications on the county level.

“From 2014-16 we never spent more than $100,000 on out-of-county inmate housing and this year, it’s going to be close to $400,000 because of the number of inmates we have currently that are specifically in for drug-related charges,” said Macon County Commissioner Ronnie Beale. “We are having to look at expanding the detention center because it’s at capacity all of the time and the root of that overcrowding is the opioid epidemic.”

Franklin Mayor Bob Scott spoke after the presentation and said that like the North Carolina Association of County Commissioners, the municipal equivalent, the North Carolina League of Municipalities has made addressing the state’s opioid epidemic a priority.

Scott also touted the Franklin Police Department’s efforts to begin carrying Narcan, an opioid overdose reversal medication. In August, the town of Franklin approved funding to supply each of the town’s 18 patrol vehicles with the drug. Since August, Franklin Police officers have completed training, but as of Tuesday, have yet to actually carry the drug.

The Macon County Sheriff’s Office have recently updated the department’s policy and officers have completed training and will begin carrying the drug this week. Going one step beyond having only patrol units carry it, the MCSO plans to have all units carry Narcan including courthouse and detention staff.

“Policies and procedures as well as training takes time,” said Macon County Sheriff Robert Holland, who began the process to carry the drug last month. “We can’t just jump into something without having everything in place. By end of today [Tuesday, Dec. 5] we will enter our next phase and that is dispensing the product to officers.”

The Highlands Police Department has carried the drug since 2015. Full Circle Recovery was the first organization in the county to carry the drug and since they started in 2014. CEO and founder Stephanie Almeida reports the entity has distributed 1,713 overdose reversal kits and personally reversed 70 overdoses, with one fatality.

If Franklin Police Department follows suit and joins Highlands and Macon County Sheriff’s Office in carrying the drug in all patrol vehicles, it will be nearly 200 law enforcement agencies in the state to do so. The Pitt County Sheriff’s Office was the first law enforcement agency to carry Narcan which began in April 2015. Since then, 111 of the state’s 357 police departments carry the drug. In Western North Carolina, police departments in Highlands, Waynesville, Andrews, and Bryson City have carried the drug for the last few years.

In addition to law enforcement agencies, Macon County Emergency Services administered the drug to 16 patents in 2016 and 40 patients so far in 2017. All but one fire department in Macon County carries the drug, and to date, members of the fire department have administered Narcan on two occasions.

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