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Opioids in the Mountains Part 2: The Dope Game

Mark Wilson, Associated Press
The Drug Enforcement Administration during a multistate crackdown on prescription drug abuse with raids at pain clinics, pharmacies and other locations in the South

Opioid abuse is on the rise throughout the nation, and North Carolina is no exception. But with its rise in use among addicts, it’s also put a greater burden on law enforcement—at both the local and federal levels.

“It seems to be that there’s a lot of availability of it, and I think a lot of people were at some point doing prescription painkillers they end up not being able to get those and they use heroin which is also an opiate to deal with their addiction issues.”

That’s Asheville Police Chief Tammy Hooper speaking with WCQS back in February about the rising problem of heroin in her city.

“But yeah, we do have some heroin issues going on in the city and in our county… We’re not immune to that here, based on what’s going on nationally.”

Just like in Asheville, opioids of every stripe have become a problem throughout the region. Macon County Sheriff Robert Holland echoed Hooper, as well as other local law enforcement agencies, and confirms a marked rise in opioid-related incidents in his jurisdiction. In a written statement, Holland said “we have a substantial number of people misusing prescription opiates and some have evolved into using heroin.”

And while law enforcement continues to deal with opioid-related crimes at the local level, authorities at the federal level are continuing to do the same, and both are reluctant to call them an epidemic, per se, as the drug methamphetamine still remains the most destructive drug in the region by comparison.

According to Special Agent Michael Althoff, of the Drug Enforcement Administration, opioids are not only a close second to meth, but both are largely the products of Mexican drug cartels operating in the Southeastern United States.

“The majority of our time is taken up by methamphetamine cases," says Althoff. "That still seems to be the prevalent issue… And ironically, the Mexican drug cartels are behind the methamphetamine distribution, as well as the most recent heroin epidemic that we’re facing here as well.”

Althoff, whose work with the DEA in North Carolina dates back nearly twenty years, estimates that opioid-related crimes make up roughly twenty five percent of his current caseload. But today’s opioid problems are different from those of the past, he explains­. With the advent of prescription painkillers proving for many people to be a gateway for heroin use, the forms in which people take opioids are not only more varied, but their ability to push the limits of the drug have increased, with the advent of overdose reversal drugs like naloxone.

“Many are purposefully overdosing themselves, because it’s a greater high, in the anticipation that someone will revive them. It’s a greater game of Russian roulette,” says Althoff.

But the problem goes beyond the black market. Beneficiaries of what’s often call “the dope game”, are no longer just Mexican drug cartels, or street-level drug dealers, but are now in many cases medical professionals, some of whom are involved in more unsavory business practices.

In fact, there’s an entire DEA division devoted to keeping this s’ector of the medical industry running cleanly. Special Agent Chris Fletcher heads up North Carolina’s Tactical Diversion Squad, and says that many pain management practices which prescribe patients synthetic opioids for the purposes of rehabilitation—such as methadone and suboxone clinics—are in it for the profit motive.

“There are people out there that definitely need those treatments, whether it be mental health, traditional therapy, or medications, but then you’ve got other people that are looking at it just for pure profit, and they’re doing it illegally.”

Before beginning his work with the DEA thirteen years ago, Fletcher worked in mental health, and says that once an addict has supported their addiction long enough, they will do anything to maintain it.

“They’ll do whatever they can to get the money,” Fletcher continues. “Whereas [with] meth, they’re physically getting high, with opiates they physically get sick. They can’t function, so their desire, their motivation to go get it is just to be well—not just to get high. They’ll do whatever they can, and yeah, I’ve heard of people from family members, prostitution—the typical things that you hear a drug addict that’s severely addicted to stuff might do.”

And it’s this affect that opioids have on their addicts which has compelled many in the medical and pharmaceutical industries to capitalize on. Fletcher calls it the “addiction model”, and says that every aspect of the industry can be culpable—from patients selling their prescriptions, to clinical workers scheming with them, to pharmacies unethically filling prescriptions for the sake of making a sale. The bottom line, Fletcher says, is that today’s opioid epidemic presents society with complex problems, and requires complex solutions.

Credit NC Department of Public Safety
Pill drop operations like these are held all across the state by local and federal law enforcement agencies throughout the year

“There’s way more involved than just the traditional ‘oh, okay, it’s a meth deal where one person sells meth to another, and it’s totally illegal.’ It’s kind of cliché to say, but you can’t arrest your way out of the problem. This is an issue where, yeah, we can go arrest all the people that are dealing opiates, or we can arrest these doctors that are illegally distributing these medications, but, at some point, you got to help the people that are having to deal with it.”

But in the end, one thing everyone WCQS spoke with—from opioid addicts, to police—one thing everyone seems to agree on is that education and resources are key to fighting this epidemic. 

Full Interview with Special Agent Michael Althoff, of the Asheville Field Office's Drug Enforcement Administration, which presides over the sixteen westernmost counties of North Carolina.

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