Needle exchange legalization
A used syringe slides into a bio-hazard receptacle as part of a needle exchange program. (NC Harm Reduction Coalition)

ASHEVILLE — Buncombe County Commissioners have decided for now to not fund a $100,000 media campaign aimed at educating the public about opioid abuse.

“We’ve got to stop and think because it’s important that we get the biggest bang for our buck,” Commissioner Al Whitesides said, though he recognized the opioid problem is “completely out of hand.”

At Tuesday’s meeting, the commissioners decided to spend more time researching best practices and see what’s already being done to address the opioid epidemic.

Drug poisoning causes more deaths annually in North Carolina than either traffic accidents, or firearms, according to the Centers for Disease Control and Prevention annual report last issued in 2014. Local statistics have followed the national trend. Since 1999, there have been more than 165,000 deaths from overdoses related to prescription opioids.

At a commissioners meeting last month, Jim Holland, of Buncombe County Health and Human Services, asked for nearly $1 million to help curb the accelerating opioid epidemic.

Holland recommended the county create three new positions for community paramedics, to fund a media campaign aimed at educating the public on opioid addiction, to support a 14-bed treatment facility for mothers recovering from drug addiction that’s currently under construction, and fund a peer-support network.

This week, commissioners discussing the idea expressed concerns about the proper approach.

“This board is committed to saving lives in Buncombe County and reducing this epidemic of opioids,” Commissioner Joe Belcher said. “There’s so many partners we’ll have to call on, it’s going to be bigger than an advertising program.”

He said he doesn’t really know how it’s going to look yet.

Holland’s suggestion to hire three community paramedics to Buncombe County EMS would cost $95,000 per position. They would provide follow-up after an overdose episode and provide support for creating a long-term treatment plan, similar to what happens now in domestic violence cases when someone who is abused can be followed up with a few days after to talk about a plan for getting out of the abusive situation.

Commissioner Jasmine Beach-Ferrara has been the most vocal about supporting the community paramedics to help address the issue because she said research has shown that’s effective. But when the commissioners learned the EMS will not be ready to hire for those positions until the next fiscal year, she said it made sense to wait until the budget talks in June to decide to allocate funding for the positions.

A collaborative effort to address the opioid epidemic locally remains underway. Physicians and local government officials met Tuesday afternoon to discuss strategies in a meeting that will take place regularly called “Safety Net.”

Last year, doctors prescribed more than 16 million pain pills in Buncombe County, up from 12 million in 2011.

Despite the increase in prescriptions, Buncombe has still remained behind most other counties in North Carolina in numbers of pain pills prescribed, ranking it 39 on a scale of 1 to 100, with 100 being the county with the most pills prescribed per resident.

Counties bordering Buncombe, including McDowell and Rutherford, are some of the most prescribed counties in the state. That could mean that some problems with addiction from those counties are spilling over into Buncombe.

Peggy Weil, from The Steady Collective, spoke to commissioners Tuesday about the effectiveness of the syringe exchange program. The Steady Collective is a peer-to-peer, harm-reduction based support group that welcomes current and former drug users, she said. She also expressed concern about the wisdom of investing resources in a media campaign.

“I’m concerned a $100,000 public commercial campaign doesn’t have proven benefits that [the] money could have if it were earmarked for a syringe-exchange program,” she said.

The collective works out of the Haywood Street Church one day a week and Firestorm Books and Café one day a week. According to its website, the collective offers free naloxone, a medication that can reduce the effects of drug overdose, and free overdose-prevention trainings. They also offer free syringes and biohazard containers for needle disposal.

A bill currently proposed in the legislature would allow local and county funds to support syringe exchange programs. Currently, public funding can be used for overdose kits, outreach workers, education materials and sharps containers to dispose of syringes safely. Those are the efforts the group hopes the county commissioners allocate funds toward.

“That’s how we’ve kept syringes out of our parks and streams,” Weil said.

Next, as the commissioners come up with budget plans this summer for 2018 fiscal year, they will review what to include to address the accelerating opioid issue in the county. Some of the issues discussed already could be on the table, but so could additional ideas resulting from research or community proposals.

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Amanda James is a contributing government reporter for Carolina Public Press.

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