Opioid Crisis in the High Country

North Carolina has been hit hard by the opioid crisis, and the High Country has not been spared from the deadly toll being exacted across the state.

According to Governor Roy Cooper’s office, between 2005 and 2015 North Carolina has seen opiate related deaths increase from 642 to 1,110, or a 73 percent increase, and Watauga County has seen that number increase from three to seven, or a 133 percent increase, during the same time period.

“I’ve watched it spiraling out of control since I started working with substance use and I don’t even know that we have hit a tipping point to go the other direction yet,” Jesse Smathers, specialty populations clinical director at Vaya Health, said.

Smathers said Vaya has been flooding the state with Narcan, a drug used to treat people who are overdosing, to help prevent any further loss of life.

Vaya Health is what’s called a managed care organization, which means that it administers Medicaid and other state or federal sources of funding to local clinics. Vaya operates across 23 counties in Western North Carolina and is headquartered in Asheville.

Smathers said Vaya will negotiate the purchase of large amounts of Narcan. Their biggest partner for disseminating it is the North Carolina Harm Reduction Coalition, which has locations set up where people at risk can pick it up cost free.

Beginning May 1 of this year Smathers said Vaya received funding through the 21st Century Cures Act to the tune of about $8 million to help combat the opioid epidemic, through which they have been able to provide free treatment to over 500 new patients.

To qualify for treatment one must have no insurance, been without medication assisted treatment for 30 days and be at or below 300 percent of the poverty line.

In Watauga the McLeod Addictive Disease Center administers treatment to those fighting opioid addiction.

Kelli Haas, program director at McLeod, said they provide methadone, suboxone and buprenorphine supplemented with group therapy to help people get past their addiction.

She said during the first 30 days of treatment clients are required to attend weekly counseling sessions, but as they progress in their treatment the meetings become less frequent.

The amount of time clients stay for treatment can vary wildly, Haas said, with some staying for a month or less and others using their services for years.

She said that people from all walks of life seek treatment at McLeod’s, and that they even have a few Appalachian students who come to them for help with addiction.

Ben Asma, assistant director and substance abuse counselor at ASU, said while Appalachian has not been hit as hard as surrounding areas, they are doubling down on efforts to educate students and prevent addiction.

Haas said even though methadone treatment is effective there is still stigma around it, with some believing it’s just replacing one drug with another.

Smathers said he prefers to think of treatment for addiction like diabetes, where there is a behavioral element, but many need some kind of medication to stabilize themselves.

He said that sobriety focused programs like twelve-step can be helpful, but also have a tendency to stigmatize those who need medication like methadone to manage their addiction.

He said more clinics are being built in the area but that some counties still will not approve one, which he believes has a lot to do with the stigma surrounding them.

Haas said she really enjoys being able to see how people overcome their difficulty with addiction and go on to live successful lives.

“The majority of our folks, if they wouldn’t be here they would die,” Haas said. “So that’s the rewarding part of this job is getting to see people progress and also just knowing that this is saving their lives.”