Two eastern North Carolina counties have adopted a new way of addressing the opioid crisis, which comes in the form of small purple boxes called ONEbox.
Two eastern North Carolina counties have adopted a new way of addressing the opioid crisis, which comes in the form of small purple boxes called ONEbox.
ONEbox is an emergency kit that contains doses of naloxone, a nasal spray that can rapidly reverse the effects of opioid overdose. The kit walks the user through how to administer the medicine in a crisis.
Wilson County was the first to roll out the ONEbox, and they’ve been placed in 78 locations so far to make them accessible to anyone.
Tiffany Hux said Narcan saved her life.
“I’m glad it did. I am so glad. If not, I wouldn’t be here for my two-year-old child,” Hux said.
Hux has been clean for 10 months after using heroin on and off for five years.
She’s overdosed more than once.
“It can happen everywhere,” she said. “You never know who it will happen to, who it will happen with and where it will happen.”
Jeff Hill, executive director of the Wilson County Substance Coalition, said the ONEbox is all about making naloxone, or Narcan, more accessible.
“We are past the point as a community that we can depend on a handful of people who can save lives. We have to be a community full of people who can save lives,” he said.
The Community Paramedic Program in Edgecombe County is also working to roll out the boxes, installing a ONEbox in Larema Coffee House in downtown Rocky Mount.
Larema Coffee’s owner, Kevin McLaughlin, said he hopes it will help prepare his customers and employees in a crisis.
“Instead of thinking, this would never happen here or to someone we know or see,” he said. “It can happen. It does happen. Every day. It is better to be prepared for than not.”
When the box is opened, users first hear a reminder to calm down.
From there, instructions walk users through how to use the overdose-reversing medicine.
“I can train you as many times as I want, but I do not know how you will react in that moment. If I can give you a tool that can walk you through that process and create that sense of calm, you’ve got a better chance of saving that life,” Hill said.
Even though she is now clean, Tiffany said she will keep the tool around just in case.
“I keep Narcan here. Even if I’m not getting high anymore, I keep it here. Just in case I have a friend who calls me and needs it,” she said.
CARY, N.C. (WTVD) — On Tuesday, Wake County school officials took another step toward putting potentially life-saving medicine into public schools — countywide.
Wake County School Board members approved a new policy Tuesday that would require all schools in the county to keep a supply of Naloxone — also known by its brand name Narcan — and train faculty members on how to use it. Families who have been touched by the fentanyl epidemic say that’s a big win.
“The more we say fentanyl out loud without shame, the more people understand that anybody could die,” said Barb Walsh, a Cary mom and founder of the Fentanyl Victims Network of North Carolina.
Someone’s going to die because Naloxone wasn’t in school. And is that a risk they want to take?
Barb Walsh, founder of Fentanyl Victims Network of North Carolina
Barb’s daughter, Sophia, died in August 2021 after drinking from a water bottle that had the dangerous opioid mixed into it. Since then, Barb’s made it her mission to not only support families like hers but also promote life-saving medicine however she can. She founded the Fentanyl Victims Network in August 2022, one year after Sophia died.
“I have a fire extinguisher in my kitchen just in case I have a fire, that’s because I want one,” she said. “Naloxone is the same thing.”
In December, Barb attended a Wake County school board meeting, urging officials to consider requiring Naloxone be put into schools. Now, that’s one step closer to becoming reality, after a new policy was approved — and just needs to be voted on to become official.
“We don’t know where the threat is going to come from. But if we have a tool that can save a life, particularly one of our students’ lives, we want to do everything we can to take those steps,” said board chair Chris Heagarty.
According to state health statistics, Naloxone was used for suspected overdoses 21 times on school grounds statewide last year. Walsh said it’s not worth waiting for more.
“It may not have happened in North Carolina yet. But someone’s going to die because Naloxone wasn’t in school. And is that a risk they want to take?” she said.
Though there’s work to be done — only about 20% of North Carolina’s public school districts have Naloxone policies — the significance of Tuesday’s decision isn’t lost on Walsh.
“It doesn’t take an army. It doesn’t take a lobbyist. It takes a mom who’s lost a child to stand in front of the school board to make this happen. And that’s significant,” she said.
Funding for the new policy is not yet clear. Heagarty said they’ll be targeting possible state and federal funds in addition to county funding out of the superintendent’s budget. The policy will be discussed at a full board meeting in May, and if passed could be in place by next school year.
by Jaymie Baxley, North Carolina Health News April 18, 2024
By Jaymie Baxley
Small purple boxes have become a promising tool in Wilson County’s fight to lessen the deadly toll of the opioid epidemic.
ONEbox is a first aid-like kit that contains doses of naloxone, a nasal spray that can rapidly reverse the effects of opioid overdose. When the kit is opened, a screen embedded in the lid plays a video of a paramedic giving step-by-step instructions for administering the drug.
“Let’s take a deep breath,” says the woman in the video, speaking in either English or Spanish, depending on the language selected. “Step No. 1 is to check to see if somebody really is unresponsive. You can do that by gently shaking them or shouting, or you can use your knuckles against the sternum to see if you get a reaction.”
Dozens of the kits have been placed in strategic locations throughout Wilson County in recent weeks. Jeff Hill, executive director of the Wilson County Substance Prevention Coalition, said he wants the boxes to become so ubiquitous that “any layman will know what it is, know how to identify it and know how to use it.”
“At the end of the day, we understand that anybody in the right place, right time and right scenario can become, or needs to become, a first responder,” he said. “Wherever I can’t be, a ONEbox can — and that could be the difference between life and death.”
Joe Murphy, left, Susan Bissett and Jeff Hill in front of the Wilson County Public Library, one of more than 60 local sites where ONEbox kits have been distributed since February.
‘Community of first responders’
Hill first encountered ONEbox at a conference last year in Washington, D.C. Impressed with the kit’s lifesaving potential, he brought back a sample to show county officials.
“My initial reaction was, ‘Wow, it is so compact and it gives you everything that you need — all the tools that you need — to help save a life,’” said Lori Winstead, deputy manager for Wilson County. “With this system, you kind of avoid that fear of not knowing what step comes next. It puts you at ease, and that’s important in an emergency situation.”
At the time, Winstead was working on a spending plan for Wilson County’s first tranche of funding from a landmark settlement with the pharmaceutical companies that stoked the national opioid epidemic. Money from the settlement, which brings $7.5 million to the county over the next 18 years, can only be spent on services and strategies that address the crisis.
ONEbox fit the bill. In April 2023, the Wilson County Board of Commissioners agreed to buy 200 kits for $40,000. Hill’s coalition received the kits in February and began distributing them to local nonprofits, government agencies and businesses such as Casita Brewing Co. and Thomas Drug Store.
He said the demand was “greater than we expected.” The coalition ran through its initial supply within three weeks, prompting the county to order another shipment of 200 kits.
“I think it caught on so fast because the community bought into being a resource,” said Hill, adding that Wilson is the first county to deploy the kits in North Carolina. “Our quote here in Wilson County is ‘we’re a community of first responders, not a community dependent on them.’”
Unlike many of the state’s rural counties, Wilson has seen a decrease in fatal overdoses. The latest available data from the N.C. Department of Health and Human Services shows that Wilson County had 30 overdose deaths in 2022, down from 37 deaths a year earlier.
The use of naloxone rose over the same period. The Wilson Times reported that local paramedics administered naloxone to 105 patients in 2022, a 34 percent increase from the previous year. That number does not include doses administered by other public safety agencies and civilians.
Hill said the kits are part of a larger effort to improve community access to lifesaving interventions. He noted that Wilson County’s Board of Education approved a policy last May requiring every school in the district to keep a supply of naloxone.
“That’s very rare because most people would view that as, ‘Oh, no, we have a drug problem,’” he said. “That’s not what our school system is saying. What they’re saying is the same way we have an AED and a first aid kit on site, God forbid, in case of emergency, we want to make sure that we have naloxone to protect the sanctity […] and the livelihood of our students.”
Another example, he said, is Wilson Professional Services, a local medication-assisted addiction treatment center that offers free naloxone to anyone who requests it. The facility also provides training so people know how to properly administer the drug.
Naloxone has been readily available for years at community hubs like the Wilson County Public Library, where a staff member used it to save the life of a man who overdosed in 2022.
The intersection of Barnes and Goldsboro streets in downtown Wilson. Jeff Hill, executive director of the Wilson County Substance Prevention Coalition, said the community has been quick to embrace ONEbox.
“Wilson has certainly been one of the more comprehensive approaches that we’ve seen,” said Susan Bissett, president of the institute. “They’re using the libraries. They have them in bars and restaurants. They’re working with the schools and the local higher education facilities.”
Bissett traveled to Wilson County with a film crew last month to record testimonials from local leaders. The recordings, she said, are meant to show other communities how to successfully implement the kits.
“To see another Appalachian community embrace this has been incredible,” she said. “The fact that it is a more rural community — and how they’re making sure that boxes are in locations strategically placed throughout the community so that bystanders can respond — is incredible.”
Her comments were echoed by Joe Murphy, creator of ONEbox. Murphy said he came up with the idea after seeing his small West Virginia hometown “ravaged by drugs.”
“The way that every single organization we’ve talked to in this community has embraced it, from law enforcement to the public sector, is unbelievable,” he said. “You just don’t see this anywhere in the country.”
Kristen Kinney, circulation manager for Wilson County Public Library, gives an on-camera testimonial for a video about ONEbox.
Hill believes Wilson County could be a bellwether for other communities in North Carolina. He said officials from neighboring counties have already expressed interest in deploying ONEbox kits based on the successful rollout in Wilson.
“The goal is to create a model that can be replicated,” he said.
Dreamville Music Festival organizers are ensuring attendees can have a good and safe time on Saturday and Sunday. On Monday, the festival announced they will have naloxone kits available at the festival.
Dreamville Music Festival organizers are ensuring attendees can have a good and safe time on Saturday and Sunday.
On Monday, the festival announced they will have naloxone kits available at the festival.
Naloxone is a drug that counteracts the effects of an opioid overdose. It is sold under the brand name Narcan.
Dreamville is partnering with This Must Be The Place to help distribute the kits. The group is a non-profit that helps distribute kits for various events, ranging from music festivals like Coachella and Lollapalooza to awards shows like the Grammy Awards.
“It is our goal to normalize naloxone and other overdose prevention tools in every corner of the country, because only then can we curb the deaths that continue to be caused by this unfortunate epidemic,” The charity said on its website.
William Perry with Be the Place said this is the third year the charity has worked at festivals to provide naloxone.
“We have passed out 50,000 of these kits, that resulted in 100 [out of] 100 overdose reversals,” Perry said.
Perry said while they may work out of festivals, they wanted to emphasize festivals are the best places to get the life-saving drug into the hands of people.
“You are going to have folks from all over coming into the Dreamville Festival [and] we can catch them when they are in one place. Due to a lot of barriers, they haven’t gotten the stuff,” he explained. “You’d rather have it and not need it than need it and not have it.”
Dreamville isn’t the only place offering or considering having naloxone.
Perry said he hopes the charity and its presence at Dreamville will help destigmatize the need for naloxone and help access the drug, which can be difficult to find.
“This is normalizing the care of others, which has been so impactful,” Perry said.
Perry said the group will distribute the naloxone near one of the entrances of the festival grounds, and graduate students from the University of North Carolina-Chapel Hill will assist them.
State and local leaders held a press conference Wednesday to highlight strategies to mitigate the fentanyl epidemic in Mecklenburg County.
CHARLOTTE, N.C. — Mecklenburg County Sheriff Garry McFadden, Attorney General Josh Stein and other federal, state, and Charlotte leaders are seeking solutions to the fentanyl crisis.
Sheriff McFadden hosted a press conference Wednesday at the Mecklenburg County Detention Center in order to highlight some of the work done to combat the rise in fentanyl-related deaths.
According to the United States Department of Justice, the number of fentanyl seizures in 2024 represents over 82 million deadly doses.
Around 10 people die in North Carolina every day because of fentanyl, according to Stein.
During the press conference, leaders discussed efforts by the Mecklenburg County Sheriff’s Office to train staff members on administering Narcan. These efforts saved over a dozen lives this past year.
“People are dying from this drug thinking that they’re taking something simple, but it’s laced with fentanyl,” Mecklenburg County Sheriff Garry McFadden said.
Also, in November of 2023, the Arrest Processing Center lobby received a Narcan vending machine, which is accessible to anyone. Additionally, Sheriff McFadden installed 39 Narcan alarm boxes that were placed in resident pods.
“Should Narcan be in schools? Absolutely. In every classroom? Absolutely. At every nightclub? Absolutely, why? Because we are in the business of saving lives,” Sheriff McFadden said.
Barbara Walsh, founder of Fentanyl Victims Network of North Carolina, has efforts underway to put Fentanyl reversing drug Naxolone or ‘Narcan’ in all state schools.
Barbara Walsh, founder of Fentanyl Victims Network of North Carolina, has efforts underway to put Fentanyl reversing drug Naxolone or ‘Narcan’ in all state schools.
What is Fentanyl?
It’s a powerful synthetic opioid that is similar to morphine but 50 to 100 times more potent.
While it is a prescription drug, it also can be made and used illegally.
When used properly, fentanyl treats severe pain like after surgery.
According to the National Institute of Drug Abuse, synthetic opioids like fentanyl are now the most common type of drugs involved in overdoses in the U.S.
Finding Solutions
Wake County resident, Barbara Walsh’s life changed forever in 2021. Her 24-year-old daughter died from fentanyl poisoning after unknowingly drinking a bottle of water laced with the drug.
Because of that unfortunate event, Walsh is now leading efforts to get fentanyl out of the hands of minors and put Naloxone on the shelves of schools in North Carolina.
Walsh’s network speaks and connects with families who have lost loved ones to the fentanyl drug.
Currently, Walsh is pushing for the opioid reversal medication Naloxone, also known by the brand name Narcan, to be available in every school in our state. Her efforts are across all 100 counties of our state.
“We’re seeing a lot of adolescents experimenting or unknown to them or experiencing fentanyl crisis and their lives could be saved if Naloxone which is the antidote to the fentanyl emergency is administered,” Walsh said.
Since Walsh’s efforts began in December 2023, Charlotte-Mecklenburg Schools has added naloxone to its first aid kits at every school. Nurses and at least two first responders at each school are to be trained in how to use it.
The Fent Vic organization will be holding a meetup on April 14 in Winston-Salem. For more information, click or tap HERE.
Fentanyl Crisis in the Triad
Here in the triad, there are efforts underway.
State and local leaders addressed the opioid and fentanyl crisis alongside local leaders in February.
A combined $89 million dollars is going to fight the crisis in the Triad. $47 million dollars of that federal money is coming to Greensboro and Guilford County. Another $42 million dollars heads to Forsyth County and Winston-Salem.
The money is earmarked to help prosecute drug suppliers, and decrease demand thru recovery services.
Over the next 18 years, Wake County will receive $65 million to fight the opioid crisis.
Families who lost loved ones to opioids are helping Wake County plan how to spend millions of dollars to prevent more deaths.
According to Wake County, 219 people died from overdoses in the county in 2022, the last full year of recorded data. That’s one person every 40 hours.
Data from the Raleigh Police Department shows 103 of those deaths — nearly half — occurred in Raleigh, making 2022 the city’s most deadly year on record since police began tracking drug overdoses in 2015.
Over the next 18 years, Wake County will receive $65 million as part of a $50 billion nationwide settlement that forces drugmakers and distributors to pay for their part in the opioid epidemic.
On Friday, Wake County leaders asked for the community’s input on how to best use the money.
Wake County’s Opioid Settlement Community met Friday inside the McKimmon Center at North Carolina State University. The committee brought together more than 100 people, including families who’ve lost loved ones to the opioid crisis.
Cheryl Stallings, a Wake County commissioner, said the county has already received about $4.85 million.
“This is significant, and this is historical,” Stallings said. “We really want to use these funds wisely, and we think one of the best ways to do that is to plan with as many people as involved as how we want to use those funds moving forward.”
The funds have helped expand treatment for people with opioid use disorder and provided resources for survivors of an overdose.
Now, Wake County must create a plan to spend more settlement funds over the next two years.
“We have these funds that can actually do something in stopping that trend and building an infrastructure of health and well being for our community moving forward,” Stallings said.
Cary resident Barb Walsh said moving forward is how she honors her daughter, Sophia, who died of fentanyl poisoning in 2021.
“She stopped at an acquaintance’s house and grabbed a bottle of water, and in that bottle of water was diluted fentanyl,” Walsh said.
Walsh now runs the nonprofit Fentanyl Victims Network of North Carolina to help shape the response to the opioid crisis in Wake County.
“These folks are compassionate,” Walsh said. “They’re committed to saving lives, and so am I.”
Walsh said she hopes there can be easier access to the drugs Naloxone or Narcan, which can reverse an opioid overdose.
Wake County is currently trying to expand where people can get the life-saving drugs, including working with the Wake County Public School System to make Narcan available on all campuses.
RALEIGH, N.C. (WNCN) — Wake County wants the community’s input on how to spend more than $65 million. The county will receive the money over the next 18 years as part of a national opioid settlement.
The county says it wants people directly impacted by the opioid epidemic to help make these decisions, and they hosted a community meeting Friday, bringing together several different groups sharing their stories.
“She died immediately. Naloxone was not administered and 911 was not called,” said Barb Walsh, executive director of the Fentanyl Victims Network of NC.
In August 2021, Walsh’s daughter Sophia was 24, applying to grad school and getting ready to buy a house, but one day, she stopped at an acquaintance’s house.
“She grabbed a water bottle out of the fridge,” Walsh said.
Walsh said the bottle had fentanyl in it, killing her daughter.
“You go into a black hole when your child dies,” Walsh said.
She joined nearly 150 people at Wake County’s community meeting Friday to discuss how the county should spend money from the national opioid settlement.
“This will really help us define how to make these investments over the next two years,” said Alyssa Kitlas, Wake County’s opioid settlement program manager.
Overdose deaths in Wake County have increased since 2019. In 2021, state health records show 240 people died of of an overdose.
“We’d like to slow that trend and really support people with their most immediate needs,” Kitlas said.
The county wants to keep investing in treatment, early intervention and housing support.
Other groups, like the North Carolina Harm Reduction Coalition, also want to make sure people with firsthand experience are part of making decisions.
by Jennifer Fernandez, North Carolina Health News March 4, 2024
By Jennifer Fernandez
LEXINGTON — On a recent Saturday, family members gathered in a circle at a church here to share stories of loved ones lost to fentanyl.
“Our whole world is turned upside down,” said Michelle, a Forsyth County mother who lost her 19-year-old son to fentanyl poisoning. She didn’t want to use her full name for this story or go into details about his death, as authorities are still investigating.
She doesn’t think her son knew he had taken fentanyl, which has become more common as drug dealers add it to everything from heroin to fake prescription medications.
Just a few grains of the highly potent opioid — about 2 milligrams, an amount that’s barely enough to cover the date on a penny — can be fatal. In 2021, fentanyl was involved in 83 percent of fatal medication or drug overdoses in the state, according to N.C. Department of Health and Human Services.
“If this can happen to him, this can happen to anybody,” said Michelle, who has made it her mission to help educate other parents about the dangers of fentanyl.
She’s not alone in her fight.
Barbara Walsh, whose Fentanyl Victims Network of North Carolina organized the recent Lexington meeting, is pushing for North Carolina to require that the opioid reversal drug naloxone be available in all schools. Her 24-year-old daughter died from fentanyl poisoning in 2021 after unknowingly drinking a bottle of water laced with the drug.
The North Carolina Child Fatality Task Force also is looking into the role fentanyl has played in the deaths of not only teens, but young children who likely are getting exposed through trash from illegal substance use left within reach.
“We were floored when we started seeing the deaths of the infants and the toddlers, and that’s really what started our prevention efforts,” said Sandra Bishop-Freeman, the state’s chief toxicologist who works in the Office of the Chief Medical Examiner.
In North Carolina, fentanyl contributed to the deaths of 10 children age 5 or younger in 2022. Just seven years prior, the state recorded only one death in that age group.
For children ages 13 to 17, fentanyl deaths increased from four to 25 in that same time period, according to data shared with Child Fatality Task Force members.
“Having one child or infant death related to fentanyl or other drugs is …, is too much,” Michelle Aurelius, North Carolina’s chief medical examiner, told task force members in November.
During that meeting, Bishop-Freeman read from investigators’ notes about child deaths due to fentanyl poisoning.
The decedent’s mother reported seeing the deceased pick up a baggie and put it in her mouth.
During the autopsy, a small piece of folded paper was recovered from the baby’s stomach.
Law enforcement stated there was a plastic bag and loose pills on top of a 4-year-old brother’s bed.
Another report focused on 22 cases in 2021 where a single substance was linked to the child’s death. Pathologists determined that fentanyl was the single substance in 15 of the fatalities. Only one other single substance killed multiple children that year — carbon monoxide, which killed two children. Also that year, fentanyl was one of the substances attributed in six out of seven deaths where pathologists determined more than one substance caused the death.
“These are startling stories to hear. They’re awful stories to hear, but we need to talk about them so we can prevent them,” Aurelius said. “I don’t want to have to do another autopsy on an 8-year-old who … died of (a) fentanyl overdose with (a) fentanyl patch on her skin after she was left alone.”
Counterfeit pills
For older children, fake pills laced with fentanyl are a rising concern.
In 2021, authorities seized 77,000 counterfeit pills in North Carolina alone. Eight in 10 pills contained some fentanyl.
Data from the U.S. Drug Enforcement Administration shows that of the fake pills tested by the agency, seven out of 10 contained potentially lethal doses of fentanyl.
Many fake pills are made to look like prescription opioids such as oxycodone (Oxycontin®, Percocet®), hydrocodone (Vicodin®), and alprazolam (Xanax®); or stimulants like amphetamines (Adderall®).
The fake pills have become easier to obtain, with sales taking place online and on social media.
Further evidence of the impact of these fake pills comes from a recent study by the North Carolina Office of the Chief Medical Examiner. Officials looked at a sample of 75 toxicology reports from deaths between 2020 and 2022 and compared results to what investigators learned about the deaths.
The study showed that 50.7 percent of those who died thought they were taking Xanax (an anxiety/depression medication), and 54.7 percent thought they were taking a form of oxycodone (a pain reliever). However, the toxicology reports were most often positive for fentanyl with no traceable amounts of the medications the victims thought they were getting.
Last year, the DEA seized more than 79.4 million fentanyl-laced fake pills in the country, according to a tracker on the agency’s homepage. So far this year, more than 19.8 million pills have been seized nationwide, which is on pace to be one and a half times last year’s number.
Barb Walsh is executive director of the nonprofit Fentanyl Victims Network of North Carolina.Two women hug while sharing stories of loved ones lost to fentanyl poisoning at a meeting of the Fentanyl Victims Network in Lexington, N.C., on Feb. 10, 2024.Information on fentanyl poisonings in North Carolina sits on a table at a Lexington church that hosted a meeting for families of fentanyl victims on Feb. 10, 2024. A woman shows support for another woman who broke down while telling the story of how she lost a loved one to fentanyl at a meeting of the Fentanyl Victims Network in Lexington, N.C., on Feb. 10, 2024.
Finding solutions
Walsh says the opioid reversal medication naloxone, also known by the brand name Narcan, should be available in every school. It should be treated like any other emergency item that schools stock, like epinephrine pens for allergic reactions or automated external defibrillators to shock a heart back into rhythm.
Some North Carolina school systems are starting to do that.
Charlotte-Mecklenburg Schools is adding naloxone to its first aid kits at every school. Nurses and at least two first responders at each school are to be trained in how to use it.
Wake County Schools, which already allows school resource officers to carry naloxone, may soon follow Charlotte’s lead. District officials plan to recommend that naloxone be placed in every school and a policy be created for staff on training and using it, WRAL-TV reported last week.
Last school year, school nurses, staff or SROs administered naloxone 21 times on school grounds in the state, according to the annual School Health Services Report Brochure. The year before, it was used 14 times. According to the report, 84 school districts last school year reported having the opioid reversal drug available on school grounds through SROs and 22 through a districtwide program.
As of September last year, eight states have passed laws requiring all public high schools to keep naloxone on site in case of overdoses at the school or a school-sponsored event, according to data compiled by the Legislative Analysis and Public Policy Association.
“Studies show that naloxone access can reduce overdose death rates, that its availability does not lead to increases in youth drug use, and that it causes no harm if used on a person who is not overdosing on opioids,” Gupta and Cardona said in the letter.
They also noted that most states have Good Samaritan Laws that protect bystanders who help someone who is overdosing. North Carolina passed a limited Good Samaritan law in 2013 that permits people who are “acting in good faith” to seek medical help for someone who is overdosing without fear of being prosecuted for possessing small amounts of drugs or drug paraphernalia.
“Our schools are on the frontlines of this epidemic, but our teachers and students can be equipped with tools to save lives,” Gupta and Cardona wrote.
Limited resources
One of the big frustrations that family members expressed at the Lexington meeting was how long it took for them to learn that fentanyl killed their loved one.
“We didn’t know for six months it was fentanyl,” said Michelle, the Forsyth County mother whose 19-year-old died. “They just said, ‘Your son is gone.’”
The Office of the State Medical Examiner has faced an increasing workload due to the rise in opioid-related deaths while struggling to retain new forensic pathologists who can make tens of thousands of dollars more for doing the same job in neighboring states.
Last year, legislators took steps to address that wage disparity in the budget by adding $2 million in recurring funds for each of the next two fiscal years to help increase the state’s autopsy capacity.
Lawmakers also added two toxicology positions, however, those jobs were in response to the expected increase in workload due to the new requirement of comprehensive toxicology on all child deaths investigated by a medical examiner. While those new positions will help address that expanded workload, they do not help with the existing work where the department still needs additional positions, the Office of the State Medical Examiner said in an email to NC Health News. The two new jobs have not yet been posted.
One strain on the office is that 45 percent of the workforce is made up of temporary or time-limited employees, “which creates a very unstable workforce,” according to the medical examiner’s office.
The toxicology lab performs more than 36,000 analytical tests each year, performing analysis on 90 percent of medical examiner cases, the office said. On average, the toxicology lab issues reports on about 15,000 cases every year.
That work won’t let up any time soon, as the number of overdose deaths continues at a steady clip in the state.
In January, the medical examiner’s office identified 332 suspected overdose deaths, down from 368 in January 2023. While some will be classified as non-poisoning deaths after further investigation, most will end up being confirmed overdoses, the medical examiner’s office said.
At last week’s meeting of the Child Fatality Task Force, members talked about the difficulty of seeing so many child deaths from overdoses.
Pediatrician Martin McCaffrey told the task force that the child fatality review committee he is on just reviewed three infant/toddler fentanyl overdoses. Jill Scott, president and CEO of Communities in Schools North Carolina, shared that a 17-year-old had died not too long ago.
“He got a hold of something,” she said. “He didn’t know what it was.”
They are part of a much larger picture of the toll that the opioid crisis has had.
In Arlington, Va., pictures line the walls at the DEA’s offices as a memorial to those who have died from fentanyl. There are so many victims, they ran out of wall space for photos, Michelle, the Forsyth County mom said.
“It kind of takes your breath away,” she said, “when you see face after face after face.”
Move will allow school employees to administer overdose rescue drug
In a unanimous vote at its May 8 meeting, the Dare County Board of Education passed a new policy allowing school personnel to administer Naloxone. The so-called rescue drug that can reverse the effects of an opioid overdose, Naloxone has become an important tool in the battle against the opioid epidemic.
Dare County School Board Member Matt Brauer asked if school nurses and school resource officers should be the primary administrator of Naloxone.
School personnel are not required to train to use Naloxone, but the policy establishes guidelines for the storage, procurement, administration and other details related to Naloxone on campus. Students and parents or guardians will be notified annually of the policy.
According to the draft policy text in the meeting agenda packet, Naloxone will be stored in the school nurse’s office or another location designated by the school nurse or superintendent, and it “shall be made available to those trained to administer it in the event of a suspected drug-related overdose.”
The school nurse will ensure that all trained staff are aware of the Naloxone’s storage location and will periodically check the expiration date, notifying administration prior to its expiration, according to the policy.
Lists of school district employees who have completed Naloxone administration training will be maintained in the school district’s administrative office and in the head nurse supervisor’s office. Anyone who administers Naloxone “in accordance with North Carolina law is immune from any civil or criminal liability,” the policy notes.
“The Dare County Board of Education makes no representation regarding the availability of Naloxone in the school system at any given time,” the policy states.
The policy also says law enforcement will be notified of the possession or use of illegal substances and that students using illegal substances will be disciplined in accordance with board policies.
Other district policies that were revised or added at the May 8 meeting were done so at the recommendation of the North Carolina School Boards Association, according to Dare County Board of Education Attorney Rachel Hitch.
“But this is one [policy] that came up in conjunction with your local health department,” Hitch said, adding that Assistant Superintendent Steve Blackstock worked on the draft policy in conjunction with school nurses before it was brought to the board for adoption.
During a roughly 10-minute discussion on the topic, School Board Member Matt Brauer asked several questions, including whether the policy came from a standing order from the state. The standing order since August 2017, signed by the North Carolina State Health Director, allows anyone at risk of experiencing an overdose, anyone who may be able to assist someone experiencing an overdose, or anyone who requests naloxone, to receive the medication.
“The standing order from the state removes hurdles for you to have the medicine in the school system if you need it…so that you may [have this policy],” Hitch responded.
“Why wouldn’t we just…lay it off on the school nurse, who is a healthcare provider, or even the school resource officer, who’s a first responder? Shouldn’t they be the primary person to administer” Naloxone? Brauer asked.
Dare County Schools Superintendent Steve Basnight responded that the goal is to make Naloxone available where it’s needed, in accessible locations. Blackstock agreed, adding that many activities take place in school buildings after school hours when the school nurse is not onsite.
The Dare County Department of Health and Human Services distributes Naloxone at no cost to community members, so Hitch noted that teachers and students may already have the medication on hand.
“We figured if it’s in your schools, then we need to make sure that we’re telling people how it needs to be handled,” Hitch said.
In response to Brauer’s question about potential civil litigation, she said that she’d learned from a Dare County Health Department presentation that if someone were not overdosing and received Naloxone, “there are no implications,” meaning they wouldn’t suffer harm.
“The idea was: The administration is easy, the risk is very minimal…and the possibility that the issue finds its way to your schools is unfortunately very high; so that was the thinking behind the policy,” Hitch said.
Board Member Mary Ellon Ballance said that some teachers and substitutes are also trained first responders or volunteer first responders who may have used Naloxone in that role to treat overdoses. “I know that Hatteras has several that are also members of the rescue squad and work at the rescue squad in the summer, so they would have access [to Naloxone].”
Board Member David Twiddy asked about what might happen if a student experienced an overdose while on an activity bus away from campus and no one there had the medication.
Basnight said that the policy doesn’t require Naloxone to be available in “every aspect of school life. What we’re saying is, if it’s going to be in the building, here’s where we want it.”
“It’s similar to the AEDs [Automated external defibrillators], Hitch added. “We don’t have them everywhere, but we know that if we have them somewhere, that we have a chance of helping a kid.”
