“The deadliest part of opioids is that people look normal. You can’t tell. It’s happening to regular, everyday kids — not drug-seeking kids.”
As a school nurse and medical professional, Lynn Smarjesse has witnessed the effect of opioid medications first hand.
“Once you’re hooked, it changes your brain’s wiring,” Smarjesse continued. “You can get off of them. You can go through programs where you are put on alternative medications, but chances are, you are going to be on that medication for the rest of your life.”
According to the North Carolina Department of Health and Human Services, more than 12,000 North Carolinians have died from opioid overdoses in the past 17 years. Additionally, according to a report by The New York Times, in 2016, the number of opioid-related deaths outnumbered deaths caused by car crashes, gun violence, and HIV in their own individual peak years.
In response to the new research and statistics, Smarjesse has advocated for student resource officers (SROs) at Roberson to carry Narcan, a nasal spray administered to someone who has overdosed on opioids. She, along with Deputy Corey Ray, are among those on campus now armed with the overdose-reversal method.
To prevent such overdoses in the first place, Buncombe County Schools have promoted drives to dispose of unused or old prescription medications throughout the year, including one on Oct. 28.
“It (the drop off) was really successful. And it’s the best way to do it. They have those drives about two or three times a year, but you can always drop them off at the sheriff’s office or the court house downtown,” Smarjesse said.
On Nov. 9, Buncombe County Commissioners Ellen Frost and Mike Fryar held a town hall to discuss the opioid epidemic within Buncombe County. A participant shared her story of addiction and recovery, while trauma surgeon and palliative care doctor Red Hoffman gave a presentation and answered the audience’s questions.
“We are both here because this is the prevailing challenge of our community. We have read the numbers; the statistics are staggering. In Buncombe County, you are now more likely to die from an overdose than you are to be hit by a car. It’s absolutely staggering,” Frost said.
Vaya Health, a local public managed care organization, established the WNC Substance Use Alliance in January 2016 to combat the epidemic within the counties of Western North Carolina. Rachel Leonard-Spencer, the Marketing and Communications Director at Vaya Health, said that the alliance was established so that various individuals and organizations could convene and share their ideas and expertise on specific issues relating to the epidemic.
“This (the epidemic) wasn’t something we were just reading about in the news that happened somewhere else. It’s happening right here in Western North Carolina communities. There are a lot of great organizations that have a piece of this puzzle and are doing a lot of good work. But we saw a need to bring everyone to the table in response to the rates of overdoses from opioid drugs and the rates of addiction,” Leonard-Spencer said.
On Oct. 26, President Trump declared the opioid epidemic a national public health emergency. Several days later, the President’s Commission on Combating Drug Addiction and the Opioid Crisis recommended the establishment of nationwide drug courts. These courts, the commission’s report explained, would be aimed at placing substance abusers into treatment rather than sending them into the prison system.
North Carolina Gov. Roy Cooper is one of the six members on the President’s commission. Gov. Cooper hopes to reduce the oversupply of prescription opioids within North Carolina by signing the Strengthen Opioid Misuse Prevention, or STOP Act, into state law on June 29. In the case of acute pain, the law, which goes into effect Jan. 1, 2018, limits physicians’ prescriptions of opiates to a dosage lasting for no more than five days. As for surgeries, dosage is expanded to last no more than seven days.
Throughout the year, Vaya Health will coordinate with Gov. Cooper via the North Carolina Department of Health and Human Services (DHHS).
“We are extremely close to DHHS. In fact, we report directly to DHHS as part of our contract as a government agency, and we work with them on issues like this. That’s the biggest way we partner with the Governor’s office,” Leonard-Spencer said. “This has been a very robust partnership with the state, and we are all working toward the same goal.”
With over 17 million painkillers prescribed in Buncombe County alone in 2016, Smarjesse worries about the effect of the epidemic in the future, especially because of its prevalence within the world of pop culture.
“It’s glorified, and it’s made to sound like a really great thing,” she said. “It decreases everyone’s sensitivity as to how serious this is.”
Opioids are chemicals which are composed of heroin, synthetic drugs such as fentanyl, and prescription pain relievers.
Because they produce euphoria in addition to pain relief, opioids often lead to dependence and overdose by users. People are typically drawn to opioids because of their pleasant effects, including an increase in motivation and confidence. After the initial dosage, however, the user is typically left unsatisfied, which increases their desire for more drugs to the point of overdose.
To increase awareness of the risk of opioid addiction among young athletes, Smarjesse spoke to Roberson athletes and parents at a required winter sports meeting on Nov. 9.
“Athletes are more at danger because they get hurt, and then they get surgery, and then they get all of this oxycodone. And after three days, the chances of being hooked a year later go up tremendously. For people on them longer than five days, a year later, 33 percent will still be hooked on them,” Smarjesse said.
America has dealt with opioid use since the 1800s, but because of philosophy surrounding pain tolerance and recent actions taken by those in the medical and insurance community, the epidemic has worsened in the last decade.
“In 1996, pain became the fifth vital sign. Doctors began to be taught that our job was to get our patients’ pain as close to zero as possible. And all the rest of us were taught through the media that our pain should be at zero,” Hoffman said. “In 2008, I was still being taught that if I prescribed opioids to a patient, they would not get addicted.”
In the Civil War, morphine was used as a pain reliever for wounded soldiers. Then, in the early 1900s, for those who could not afford morphine or similar drugs, heroin became a cheaper substitute. Although more painkillers, such as OxyContin, have been developed since, trends show that people tend to turn towards heroin because of its accessibility and cheaper price.
“As doctors are pulling back and not prescribing as many opioids, now we’re seeing in the last two years that a lot more people are turning to heroin,” Hoffman said.
While she says the statistics are alarming, Hoffman wants to remind people that addiction should not be something to be ashamed of and those affected by the epidemic should not be hesitant to reach out for help.
“Addiction doesn’t care who you are. It does not discriminate. Addiction truly is a disease,” Hoffman said.