In the midst of a national opioid addiction crisis, doctors in North Carolina are prescribing more and more painkillers. Western North Carolina is no exception, according to reports. But a simple clerical error from one such report has helped motivate one mountain community to better tackle the crisis at home.
Back in January, the North Carolina Department of Health reported that some 257 pills per person were prescribed in Macon County last year—the highest ratio in the state. For a rural county with a population of just over 34,000 residents, that ranking alarmed many in the area to the problem of addiction.
Just ask Stephanie Almeida, a local substance abuse counselor. “I don’t see it fading," she says. "Folks are still needing services. Even folks that are in treatment, receiving services are still at risk. I don’t see it slowing at all.”
But then, in February, it was discovered Macon County’s prescription ranking was based on skewed figures. Basically, one of the county’s doctors added an extra zero or one somewhere in their reporting. The actual figure was closer to 78 painkillers per person, moving Macon County from first in the state, to fiftieth.
Regardless of the ranking that one little clerical error helped motivate the community to tackle its opioid problem.
“Which was a huge clerical error,” that’s Macon County Sheriff Robert Holland. While the initial ranking was unfortunate, and wasn't the only reason locals have fought back against the crisis, Holland says it did help to further highlight an otherwise longstanding issue in the community. “So, all of these things that are popping up that people are doing are not things that were just thought of overnight. It’s been a process, and it's been an ongoing process for quite some time now.”
Holland has served as sheriff since 2002, and is popular throughout the community for his hardline stance against drugs. Just in the last few months, Holland has undertaken several high profile drug busts, targeting those higher up in the local drug trade who were long suspected of dealing. Most of those busts, says Holland, involved some degree of opioid trafficking— like heroin or prescription painkillers—or a combination of opioids and other hard drugs common in the area, like crack or methamphetamine.
“Yes, meth is a problem, and we were dealing with meth primarily. But then, all of a sudden, opiates came into play. And so we started having to deal with not only meth, but the opiates, and that became a significant problem. Because it’s so easy to get. There’s not a household in Macon County, or basically any town, that doesn’t have some kind of narcotics in it.”
But it's not just law enforcement that was taking on the drug problem in Macon. There were enough busts that the county was approved for an unprecedented special three week session of narcotics court, specifically to handle those cases. District Attorney Ashley Welch says this can help rid the community of dealers more efficiently, while handling lower-level offenders separately.
“We started prioritizing who was for trial, and we started looking at who we felt deserved pretty substantial sentences. Because there’s a difference between an addict and a dealer. We realized Macon County juries were ready to deal with our drug problem in Macon County.”
While law enforcement is handling those active in the local drug trade, other groups are making themselves more available to its consumers. In the last year or two, several well-known young people from Macon County overdosed on prescription painkillers, drawing many to hold a special community prayer event each Friday downtown. Franklin resident Anna Juanita is among those who come to pray.
“We used to think heroin was a big city problem, like you hear about in Atlanta or Charlotte. But it's here now, in Franklin. Our little town.”
A few miles down the road, a local ministry is nearly at capacity, acting as a shelter for many of the area’s indigent. Consisting mostly of low income families seeking a new lease on life, more than twenty people are getting ready to eat a spaghetti dinner. Pastor Lowell Montieth says most of the people who come there have struggled with drugs.
“I would say only one or two percent of people who actually come here did not end up homeless because of substance abuse, in some way or fashion.”
Monteith is thankful that the community is pulling together in this fight against drugs, and opioids in particular. He says the raise in awareness is bringing more people to his door.
"When you get to that place in drug addiction, or in alcoholism, or in depression, you don't get yourself out. You need a hand up, you need a handout. You need somebody that's willing to stand with you and stand for you. Not just to get the pat on the back because they did their good deed for that day."
But despite a raised sense of awareness in the community, the county is still seeing an increase in opioid related incidents. Last year Macon County Emergency services administered narcan to 24 different patients upon arrival--narcan being a reversal agent which allows those overdosing the ability to breathe. This year, just since November, the county has administered narcan 20 times. Meanwhile in the North Carolina General Assembly, legislation has been introduced this session which would greatly limit the initial amount of painkillers a doctor can prescribe a patient.