Exploring the Opioid Epidemic
Buncombe County 2010 - 2019
Opioid Fatalities Over Time
In the mid 1990's the American Pain Society urged the healthcare industry to consider adding "Pain" as the 5th vital sign. In 2001 the Joint Commission followed suit publishing standards for pain management, including prescribing opioids. Since then, opioid addiction has become an epidemic which has affected our entire nation.
By gathering data from death certificates recorded at the Register of Deeds we have been able to use public records to gain a better understanding of opioid deaths over the past ten years in Buncombe County.
After a steady increase, 2017 saw the greatest amount of opioid related fatalities. After the STOP Act was enacted opioid prescriptions were limited and fatalities decreased in 2018. In more recent years, synthetic opioids such as Fentanyl are present in the majority of all opioid overdoses often in combination with other drugs.
This interactive timelapse shows opioid related fatalities in Buncombe County from 2010 - 2019 cumulatively. Deaths which occurred at Mission Hospital were not placed on the map, but were included in demographics. For HIPAA compliance zoom and selection functions are limited.
Scroll down to learn more about those who have died.
Who are they?
The demographics of these people can reveal a lot of information about the opioid epidemic. This timelapse displays the occupation listed on the death certificate for the decedent. The map displays 1 year at a time and shows a wide variety of jobs.
From 2010-2019 each year showed more death certificates from males than females.
The majority of death certificates indicated that the race of the decedent each year was white.
Although there were some changes over time, generally the ages of the decedents were concentrated in the 20's and 30's.
The majority of death certificates listed residences within Buncombe County each year.
Continue scrolling to learn more about Narcan, what has changed over time, and for resources to get help.
Narcan/Naloxone
Another factor to the opioid epidemic is how to respond in emergency situations. Narcan (Naloxone) is an overdose reversal medication which can be administered in an emergency situation that has been utilized by EMS, hospitals, law enforcement, and community members.
EMS Narcan administrations show similar trends as fatalities from year to year. More recently groups such as Steady Collective, WNCAP (Western North Carolina Aids Project), and Buncombe County Health and Human Services show even greater numbers of community administrations. In 2019 there were 886 doses of Narcan administered by community members, this can be crucial in an emergency situation as it can be administered before EMS arrives on scene.
Has anything changed?
Some demographics showed consistent trends over time such as gender and race; but others shifted with the introduction of the STOP Act and other national campaigns and regulations. This legislation was intended to reduce the amount of unused or misused opioids in circulation.
The age of fatalities and narcan administrations through EMS has shifted over time. From 2011-2013 fatalities (orange) were concentrated in those in their 20's and 30's, however narcan administrations (blue) were more spread out.
In 2017 the STOP Act was introduced which helped limit inappropriate prescribing of opioids, subsequently the age of narcan administrations became concentrated in those in their 20's and 30's correlating with deaths.
Polysubstance (using multiple substances) has also become a concern as more than half of all overdoses in 2019 included multiple substances. This increasing trend has resulted in federal funding once focused only on opioids now expanding to include all substances.
Coping With Loss
The National Safety Council adopted the Celebrating Lost Ones map allowing for family and friends to place an image and their story on an interactive map. This project helped raise awareness of the impact of the opioid epidemic and can help families that are coping with the loss of a loved one. This map can not only be used to read other's stories, but allows for families and friends to add to it as well.
As shown by occupation in the demographics this epidemic is affecting our community at all levels. These are our health care workers, our restaurant workers, our construction workers, and so much more. They all had families, neighbors, and coworkers whose lives have been forever altered.
Getting Help
Detox alone only works in 10% of people, but Medicated Assisted Treatment (MAT) works in 50% of people. MAT includes Buprenorphone and Methadone and often many of these people are given Naloxone in case of emergency if they return to use.
Call Appalachian Mountain Community Health Centers at (828) 257-4745 to explore recovery options. AMCHC also treats Hepatitis C.
Call Mountain Area Health Education Center at (828) 257-4730 if you are interested in starting on Buprenorphine. They also have a special program for MAT if you are pregnant or a parenting woman.
Call VAYA Health at 1-800-849-6127 for referrals for outpatient substance use individual or group counseling.
Check out Buncombe County Health and Human Services for more information to see a greater collection of information and resources. "Closer Than You Think" is a countywide plan to raise public awareness, and "Safer" is for harm reduction and Syringe Exchange Programs or SEP's.
What Next?
Understanding where and how opioid addiction has affected our community can help us move forward to make a positive change. With legislative actions such as the "STOP Act", new life saving medications like Naloxone, and local involvement in programs designed for education and assistance it is possible to make a change.
The Buncombe County Detention Facility partnered with the Health Department in March of 2020 to begin providing Naloxone overdose kits to detainees reporting opioid use when they are released from custody. The detention facility is now providing Medicated Assisted Treatment (MAT) and linkage to MAT services for those diagnosed with opioid use disorder. They are one of the few detention facilities in the South to offer a MAT program to detainees.
If you or anyone you know is struggling with opioid addiction please reach out, you are not alone.
