Overdoses were finally on the decline in NC. The pandemic reignited the crisis.

Fatal overdoses in North Carolina had finally started to decline.

After steadily rising for years, deaths dropped by 7% in 2018, despite the growing prevalence of fentanyl, an opioid even more potent and deadly than heroine.

The state had aggressively invested in fighting the opioid crisis — it expanded access to evidence-based treatment, sent Narcan to at-risk areas and reduced medical dispensing of opioids.

Low overdose numbers in 2019 seemed to confirm the efforts were paying off.

People in the NC Department of Health and Human Services started believing it was possible to meet a goal they had set back in 2016: to cut the expected overdoses in 2024 by 20%.

“There was a lot of hope in those two years before the pandemic,” said Mary Beth Cox, a substance use epidemiologist DHHS.

Then COVID-19 hit.

“Who knows where we would have been if the pandemic hadn’t happened?” Cox said.

INCREASED ISOLATION, DISAPPEARING TREATMENT AND SUPPORT GROUPS

Loneliness and social isolation became more common. It became harder to send Narcan out into the community. Support groups and treatment centers transitioned online.

“You can do group therapy on the phone or in video, but it’s still not true connection,” said Ellen Stroud, who directs addiction and management operations for the state’s opioid response. “And that’s really a huge part of recovery.”

Disturbing data began emerging.

In the first year of the pandemic, fatal overdoses in the state shot up by 40%. In 2021, deaths increased by an additional 22%.

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