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Three deaths a day: NC grapples with opioid crisis

November 14th, 2017

— On average, three people a day die from opioid overdoses in North Carolina, and that’s just the tip of the iceberg, state officials working on policies and programs to reverse this trend told legislators Tuesday.

For every death, there are three hospitalizations, they said. There are four emergency room visits on top of that, according to a presentation from the state’s Department of Health and Human Services.

And, although this is a statewide issue, the worst problems are often clustered in rural areas – the very areas with few long-term treatment options for addicts.

Since roughly half of the people who turn up in emergency rooms with an opioid problem don’t have insurance, there’s little incentive for the private sector to place treatment programs where they’re needed most, Dr. Susan Kansagra told a legislative oversight committee.

“It’s a little bit of chicken or the egg,” said Kansagra, DHHS’ point-person on the state’s opioid crisis.

Searching for a Fix
Searching for a Fix

Kansagra and her colleagues never said the words “Medicaid expansion” in presenting Tuesday to legislators, many of whom represent the Republican majority in Raleigh that has declined for several years a vast extension of the federally subsidized health insurance program in North Carolinas. But she and DHHS Secretary Dr. Mandy Cohen repeatedly told General Assembly members looking for answers in the opioid crisis that access to insurance is crucial.

They didn’t say “Obamacare,” either, despite specifically urging people to sign up for federally subsidized insurance through the program’s online health insurance exchange. Open enrollment on is underway now, and Kansagra said many people can get plans for less than $75 a month.

GOP legislators have resisted expansion at least in partly over cost concerns. House Appropriations Chairman Nelson Dollar who was in Tuesday’s oversight committee meeting, said there’s too much uncertainty surrounding federal health care policy, and the future of expansion funding, to expand the program in North Carolina and potentially put the state budget on the hook for hundreds of millions in new funding.

Dollar, R-Wake, also said he’d like to hear in a future meeting from the local organizations that the state funds to deal with mental health and addiction issues. He described Tuesday’s presentation as a 40,000-foot view.

“I think you need to hear maybe a little fuller picture about where we are in terms of treatment on the ground, where those folks are seeing the gaps, where we’re having successes, what’s working, what’s not working,” Dollar said. “I think that would actually give you a little bit better picture of what’s going on at the grassroots level.”

The upshot of Tuesday’s report was that North Carolina is making some progress stemming the tide of opioid overdoses but has much more work to be done. So much so that DHHS officials believe they’ll soon be reporting an average of four overdose deaths a day, instead of three, Cohen said.

That’s largely due to a massive spike in overdoses from heroin and synthetic narcotics, as opposed to opioids prescribed by doctors for pain. Overdoses from prescribed pills have actually decreased slightly in recent years. Dollar said that points to some success for laws the General Assembly has changed in recent years.

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