Catch ‘em young

Robbinsville – Every major effort for change has to begin somewhere.

The Graham County Board of Commissioners have gauged public input, consulted medical experts and even considered the effects of what they have witnessed concerning the opioid crisis locally to develop the Graham County Opioid Settlement Strategic Plan.

Nothing if not brutally honest, the 13-page document was unveiled during a special-called workshop June 14. Over 18 years, Graham County will receive $1.18 million of the $750 million paid out in the National Opioid settlement last year. McKesson, Cardinal Health, AmerisourceBergen, and Johnson & Johnson-owned Janseen Pharmaceuticals will be responsible for paying out the funds, which is hailed as the second-largest, attorney-general settlement in North Carolina history.

Attorney General Josh Stein and the N.C. Association of County Commissioners agreed to a split between counties/municipalities (85 percent) and allocated funding by the N.C. General Assembly (15 percent).

Then-Graham County Finance Officer Becky Garland told The Graham Star after the settlement that the funding must be used for evidence-based strategies to help address the epidemic. Facilitated by Human-Centered Strategy, LLC.’s Heather Gates, a 15-member panel attended one or more sessions to develop the local plan.

In short, the strategy can be summed up in one sentence: catch ‘em young.

Shared vision

It is no secret that Graham County struggles with a local opioid crisis – and for that matter, other drugs as well.

Before the plan is mapped out, the document focuses on what is helping and hurting the greater good. The list of pros is much shorter than cons, but spotlights resources already available in the county; those who are willing to help anyone battling addiction; and the work underway to educate students.

Then, there are the cons. Without listing each in the plan (anyone who wants a copy of the document can request it through the local health department), the assessment of local factors playing against winning the war includes the lack of discussion about Hepatitis C/infectious diseases (from needle use); embarrassment/fear about calling 911, or even asking for help; lack of funding; the fact that “death by distribution” has only been charged twice in Graham County since Gov. Roy Cooper signed it into law in 2019; confidentiality issues; a purported bias from physicians; risk of losing jobs/lingering stigma if related to someone who does, due to drug use; a lack of affordable housing; and poverty/unemployment.

The strategic plan hopes to curb the issues altogether by both offering more resources and heavily emphasize the dangers of opioid addiction to a younger generation.

It is a sad reality that adolescents who are years away from selecting a college are first going to have to choose against a toxic chemical that can destroy their future altogether.

Data from the N.C. Department of Health and Human Services paints a truly heartbreaking spotlight on the crisis: 4,041 North Carolinians died from an overdose in 2021 – 77 percent of the deaths were linked to fentanyl, either on its own or mixed with other substances.

Funding recommendations across Graham County are outlined in the document as follows:

* Prevention. The leading agency for this is Graham County Schools, with HIGHTS (Helping Inspire Gifts of Hope, Trust & Service, a Western North Carolina-based organization), the Graham County Health Department and Western Carolina University all collaborating for the cause. There is a $45,000 allotment for fiscal year 2023-24; then $10,000 each cycle from 2024-27. Strategies include hiring a youth support counselor; using Western Carolina students who are pursuing social work as a career to work with Graham County Schools on mental health and substance-use issues; and implement more programs like “Summer Knights,” a Tuesday gathering outside the high school for students to socialize throughout the summer.

* Connect to Care. This step is broken into two parts. Part 2A (“Community Linkage to Care and Post Overdose Response Team”) is spearheaded by the county health department, in collaboration with local EMS and law-enforcement officials, as well as WNCAP (Western North Carolina AIDS Project, based in Asheville). Community Linkage to Care is already in existence at the health department (located at 191 P & J Road), and helps provide support for those struggling with addiction, treatment and recovery; certified peer-support specialists are expected to be hired to help keep funding from expiring, but $120,000 for 2023-24 will aid the cause tremendously.

The breakdown for funding thereafter from the settlement is $48,000 (2024-25); $49,000 (2025-26); and $15,000 (2026-27) – with the final three years contingent on matching/leveraging funds to help increase grant-writing success and braid funding. Part 2B is strictly under the health department’s umbrella: contract a clinical counselor to assist those using – or who have used – opioids, by means of the 12-step Prime for Life curriculum.

The funding bumps up $2,000 per year after a $10,000 investment in 2023.

* Reduce Harm. The Western North Carolina AIDS Project takes the lead here, with Grace Place, A Community Table/Five Points Center and the health department assisting. There is a $20,000 allotment for each year between 2023-26; the AIDS project will explore potential expansion of harm-reduction services and supplies available to county residents.

This is where the controversial “Narcan” comes into play. Narcan is the commonly-used term for Naloxone, an opioid antagonist that is administered to try and reverse an opioid-related overdose before proving fatal. The division about Narcan exists due to its ability to be obtained at a low cost, while other medicines like insulin (used to treat diabetes) can boast a 4-figure price tag.

* Cross-Cutting Impact Across All Approaches. The health department and Substance Use Coalition form a tandem here, with $29,000 coming this year; $5,000 in both 2024 and 2025; and the amount for 2026 still to be determined. The goal with this step is to decrease the negative stigma surrounding those addicted to opioids, by launching a community-wide educational campaign. The entities hope to utilize local pastors and those who are clean from drug use to share their stories in hopes of binding all the aforementioned efforts together and halt use before more lives are lost.

Additionally, expanded services for members of the Eastern Band of Cherokee Indians will also be made available under the plan, through both the Cherokee Indian Housing Authority and Tsalagi Public Health; and Grace Place/Five Points Center will be exploring options for locations to help individuals recover from use and get the support needed to leave addiction in the rearview mirror.

For details, call (828) 479-7900.