North Carolina’s most serious health and crime problem

Published 5:28 am Thursday, August 31, 2017

The Charlotte Observer

Charlotte doctors tell the Observer editorial board that every week, they see a person die from overdosing on prescription painkillers or heroin.

A Jacksonville, N.C., man told Attorney General Josh Stein that he was in a motorcycle accident and hurt his knee. Within days, he was addicted to his prescriptions and spent the next 12 years addicted and on the streets.

A Statesville urologist told Stein that he discovered patients who would take his paper prescriptions and add painkillers at the bottom by forging his handwriting.

Dr. Don Teater of Waynesville told us that a few years ago while working at a methadone clinic, he admitted five pregnant women on one day who were addicted to opioids. Three had gotten pregnant just so they could get treatment for their dangerous addictions.

Yes, North Carolina, we have a crisis.

“It’s become apparent to me that it’s the most pressing public health and criminal justice issue we have here in North Carolina,” Stein said.

The attorney general was in Charlotte and Statesville for roundtables on the opioid addiction epidemic. Law enforcement officers, health care providers, substance abuse specialists, policymakers and others came together to share what they’re seeing and to learn from each other.

Four of America’s 20 most-addicted cities are in North Carolina, one study found. More than 1,100 people died of opioid-related causes in North Carolina in 2015, a 73 percent jump in 10 years.

There is much to be done, though legislators took an important step this summer. The House and Senate unanimously approved the STOP Act to more tightly regulate the prescription of painkillers. The law limits doctors to prescribing a five-day supply for acute pain and a seven-day supply after surgery. It also requires them to use a statewide database that tracks whether patients have multiple prescriptions from multiple doctors.

But much more needs to be done.

Doctors and dentists need to prescribe narcotic painkillers only when it’s absolutely necessary, as they used to, not as a matter of course as some do now. Even the STOP Act’s limits are too loose in some cases. The Centers for Disease Control recommends a three-day limit. Fewer prescriptions would, in turn, cut down on heroin use, because most heroin users started with prescription drugs.

And if legislators would accept federal expansion of Medicaid, far more addicted people who currently don’t have insurance would be able to afford treatment. Increasing reimbursements would also entice more doctors to provide treatment for addiction.

Finally, North Carolina needs an intense education campaign, especially for young people. One in five 11th graders in the past year have taken prescription drugs that were not prescribed to them, Stein said. Public awareness efforts could reduce opioid abuse, just as they cut drunk driving.

Society is not paying close attention, and so is spending a lot of money on this crisis at hospitals, jails and in other ways. We should pay closer attention, and spend that money in ways that help solve the problem.