The opioid crisis continues to gain momentum in NC. Unintentional opioid poisonings took the lives of 2225 North Carolinians in 2017, a 29% increase over the previous year and overdose deaths increased over 800% between 1999 and 2017. In NC, there are now approximately 6 unintentional medication or drug overdose deaths per day, the vast majority of which are opioid related.
Opioid prescribing metrics have in fact improved in NC in the last few years and deaths due to prescription opioids are leveling out. Unfortunately, deaths due to illicit opioids particularly heroin, fentanyl, and fentanyl analogues have increased dramatically during this time and are now involved in 80% of opioid overdose deaths. These illicit formulations are both more potent and more unpredictable. The toxicity is further amplified by other drugs such as benzodiazepines and stimulants as well as alcohol which are involved in an increasing proportion of OD deaths.
The infectious disease implications of intravenous drug use are staggering. Hepatitis C rates in NC increased 360% over the last 10 years and heart valve infections have increased 985% over the same period. New cases of infection with HIV, syphilis, chlamydia, and gonorrhea are also on the rise, with very dramatic racial and ethnic disparities, particularly in African Americans relative to whites.
Prescribers continue to play an important role in prevention by following prescribing recommendations for both acute and chronic pain conditions whenever possible, counseling patients about safe storage and disposal, and co-prescribing naloxone to at-risk patients. Likewise, physicians play an important role in treatment by identifying opioid use disorder (OUD), offering office-based medication assisted treatment (buprenorphine and naltrexone), and connecting patients with specialized SUD treatment. Providers also play an important role in sustaining recovery.
OPDAAC’s goals are simple: reduce overdose deaths and reduce ED visits.