North Carolina

Overdose calls in Raleigh top more than 500 so far this year but fatal ODs are down, data shows

Fewer people have died from overdoses in Raleigh at this time of year than in the past two years. But the community is still in the grip of the crisis.

“By that point, we were all overdosed,” said Dr. Jennifer Carroll, an NC State University medical anthropologist and harm reducer. “It’s something that none of us in our families, friends and communities have been able to escape. Every single death is a life lost.”

As of this week, Raleigh Police say they have responded to 520 overdose calls. That’s more than one a day and almost twice as many as in five years. It’s almost identical to the number of calls they responded to at this point last year. However, compared to 2020, it increased by 35%, while fatal overdoses in the city fell by more than 20% over the same period.

“The biggest thing for me is that people are calling 911,” Carroll said. “Because people don’t like to do that.”

Policies, such as the Good Samaritan Laws, are one of the reasons those who work with people living with addiction believe there is an increase in calls. Another reason is the prevalence of fentanyl in the drug supply.

“I find it more helpful to think about overdose than something that happens when your margin for error decreases,” said Dr. Jennifer Carroll, an NC State medical anthropologist who is also a harm reducer. “Fentanyl is a really powerful drug. We know people who use fentanyl regularly and have built up their tolerance, but the margin for error is much less. So if you need to go to a new supplier in case there has been a drug market disruption or anything has changed for you which can create unpredictability and put you at risk of overdose.

While overdose service calls have increased, prescribing practices have changed. Last year, the number of opioids distributed in North Carolina hit its lowest level on record — from 2.1 million pills in 2016 to 1.3 million pills.

dr Michael Baca-Atlas, a UNC primary care physician who specializes in addiction medicine, says he sees many patients who still become addicted after being prescribed painkillers, but less frequently now.

“We know that reducing opioid prescriptions is not enough to truly contain the opioid crisis that we are having,” Baca-Atlas said. “We know this is really related to other diseases of desperation.”

Baca-Atlas said its patients often face other issues, such as mental and physical health issues, and turn to substances to help cope.

“I really think that some kind of addiction or developing an addiction has a lot to do with the breakup,” Baca-Atlas said. “What we’re really trying to do for people in addiction treatment is reconnect them with social support. Whether it’s peer support or mutual support groups, it’s really about bringing people back rather than isolating them.”

Isolation is one of the reasons addiction experts believe there has been a spike in fatal overdoses in 2020, as people were using alone and there was no one around to call for help or administer naloxone.

According to the Raleigh Police Department, 48 people have died from drug overdoses so far this year. That’s the fewest since 2019, even as the police respond to more calls for overdoses.

While there are laws that expand access to narcan and offer protections to those who call for help, experts believe more can be done. According to Carroll, a recent proposal is to extend the Good Samaritan’s protections to everyone at the scene of an overdose, not just the person calling the authorities — as required by the current law.

Both Carroll and Baca-Atlas were surprised to hear that Raleigh Police Department has responded to fewer fatal overdoses this year, but cite end-to-end services and a holistic approach as possible reasons the city is seeing improvements.

“We can keep bringing that number down, we can do it,” Carroll said. “We know the loved ones behind these numbers whose lives are being saved.”

And those dealing with the crisis say a multi-faceted approach to managing the crisis is needed.

“We really need to meet people where they are,” said UNC’s Baca-Atlas. “Rather than expecting people to necessarily show up at traditional centers where people are cared for.”

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