“One of the things we’ve done is start to control prescriptions of opioids, but we have to look at alternatives to pain management,” said North Carolina Gov. Roy Cooper, D-Rocky Mount, during a community roundtable held April 23 at the Haywood Regional Medical Center in Clyde. “There are other ways to attack pain other than simply prescription of opioids.”

Cooper was referring to the STOP Act, passed in North Carolina in 2017 and intended to foster better prescribing practices among physicians by limiting the amount of opioids that can be given on a patient’s initial visit. 

“There is research going on, on drugs that are non-opioid that can make sure they attack pain, and we’ve got other drugs people can use other than opioids and various other alternatives to pain that doctors really need to look at and look at as a first entry with patients rather than just simply prescribing opioids,” Copper said. “We know that when people are prescribed opioids that their risk of becoming addicted increases.”

Cooper and other community leaders were told by Dr. Don Teater that even a one-day opioid prescription leads to a 6 percent chance that patient will still be on opioids a year later, and with an estimated 30 percent of Americans attempting to manage chronic pain, swarms of new prescription opioid addicts are created each day. 

Prescription opioids are exactly what got Haywood County Resident David Dick in trouble in the first place, about 40 years ago.

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“My left leg was nearly torn off. I was nearly killed,” Dick said of a workplace accident. “I spent three years in surgeries, tibial rods — it gets to be rather involved. It’s just the constant prescribing of opioids left me nothing else on my mind.”

Dick struggled with addiction for “probably 35 years” and has been clean for three, he told the group, but it hasn’t been easy. 

“I know how tough it is out there. I know that once you get on opioids — I spent years wanting off of them,” he said. “The need for the drug gets ingrained so deeply in you that you just don’t think of anything else when you have an opiate in your system.”

That all-consuming desire has led to a strain on law enforcement resources, especially in small counties like those in North Carolina west of Asheville. 

“The opioid crisis has created an issue with in law enforcement as far as we’re always in a position of having to work drug-related crimes,” said Waynesville Police Chief Bill Hollingsed. “The opioid crisis has expanded that investigation into a whole new arena where a lot of individuals in the past that have not been affiliated with the drug trade enough found themselves as part of an addiction involving opioids.”

Hollingsed said that as a matter of economics, the opioid crisis is rapidly becoming a heroin and fentanyl crisis. 

“We never had a heroin issue in this community until about two-and-a-half years ago,” he said. “It’s cheaper for an individual to acquire heroin than it is pills.”

Invariably, Haywood County Sheriff Greg Christopher also comes into contact with many who’ve run afoul of the law due to opioids. 

“Our detention center averages about 107 people per day at this time, $73 a day for our taxpayers for each individual that spends the night there,” he said. “That’s about $3.3 million per year. About 85 percent of people that come into our facility openly admit to being an addict of some kind, and 30 percent openly admit that they have a severe opioid problem.”

Christopher said that it’s expensive to handle those kinds of problems within a county jail setting, but for addicts in recovery like Dick, it’s also expensive to handle them out on the streets. 

“I pay for mine,” Dick said. “I don’t have any insurance. I literally work and half my income goes to Suboxone, but there’s a lot of people out there that probably don’t have the income that I have that they can just take that money needed for medication to get off the drugs.”

The lack of healthcare coverage was a pervasive topic throughout the roundtable; Cooper has been a strong proponent of the expansion of Medicare in North Carolina, which so far has gone nowhere.

Cooper is just one of three governors and one of six overall who sit on President Donald Trump’s Commission on Combating Drug Addiction and the Opioid Crisis.

Last fall the group issued a report with a slew of recommendations, from enforcing the Mental Health Parity and Addiction Equity Act of 2008, which prohibits health plans from limiting benefits for people with mental health or substance abuse disorders, to greater data sharing amongst state-based prescription monitoring programs. 

The report also calls “a positive step” recent research conducted in conjunction with the National Institutes of Health into non-addictive painkillers.

“I feel that it’s progress,” Dick said. “I hear a lot of people wanting to do things. I’m just hoping that this can get done on the federal level, if the money’s there.”