First responders and local agencies reflect on increased overdoses

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Editor’s note: This is the first part of a two-part series examining drug overdoses in Chatham County.

Local law enforcement and first responders have been working to address one of the largest health crises in Chatham County’s — and the nation’s — history: substance use disorder and overdose deaths.

The Centers for Disease Control and Prevention have characterized substance use disorder — commonly known as addiction — as an epidemic in the United States. In the last year, the CDC has reported more than 100,000 deaths across the U.S. due to suspected overdoses, which is an increase of over 28% since 2020.

Chatham County has exceeded the increased percentage at the national level in overdose cases, with the number of people who overdosed or died due to one in Chatham County in 2021 doubling since 2020.

The Chatham County Sheriff’s Department reported 11 overdoses in 2019 and 21 in 2020 — a number which increased to over 58 overdose calls in 2021 — a 176% increase.

Lt. Sara Pack with the Sheriff’s office said not all overdose calls result in death. Rather, an overdose usually refers to a medical event as a result of substance use.

“This categorization helps first responders prioritize and better prepare for each call,” she said. “When someone reports an adverse reaction of unknown origin to 911 — whether it’s a minor response like dizziness or nausea or something more serious — that call is typically labeled as an overdose within the emergency system.”

Lt. Andrew Freeman, who works within the patrolling sector of the Siler City Police Department, says he and his fellow officers have been responding to more and more overdose calls — including a surprising number of repeat cases.

“I know of one girl we’ve brought back at least five times,” Freeman said. “In the last three years, I would say cases have drastically picked up.”

At a November meeting of Siler City’s board of commissioners, Police Chief Mike Wagner told commissioners that in 2020 his officers responded to 14 drug overdose calls — one of which resulted in death. That number climbed to 25 calls in 2021, four of which resulted in death.

“One is one too many, but four?” Wagner said. “It gets our attention.”

What’s the cause?

Chatham County Sheriff Mike Roberson believes the drastic uptick in overdose calls correlates with the pandemic and quarantines. The isolation associated with COVID-19, he says, has led to more people becoming susceptible to overdosing on various substances.

“The lockdowns and isolation we experienced during the early stages of the pandemic had unfortunate consequences on many within our community,” Roberson said. “The separation and loss of physical touch, the sudden change in routines, financial strains and fear of illness ... It was a lot to handle, and some folks are still dealing with the fallout.”

The drug responsible for most of the overdoses and death, according to Lt. Jason Boyd of the Siler City PD, is fentanyl — a powerful opioid that has also been responsible for the significant increase in drug overdoses nationally. The national overdose death rate increased by 256% between 2000 and 2019, according to the National Center for Drug Abuse Statistics, and then another 30% from 2019 to 2020, according to the Centers for Disease Control and Prevention. Opioid-related deaths jumped 38% between 2019 and 2020.

Fentanyl, Boyd says, works differently than other drugs. For starters, it’s 80 to 100 times stronger than morphine, according to the U.S. Drug Enforcement Administration. Typically, users mix fentanyl with other “street drugs,” such as heroin or cocaine. Because of its high potency, it’s more likely to kill first-time users because it suppresses all of the body’s systems, including the respiratory system.

“We had a death earlier in 2021 that was actually from cocaine mixed with fentanyl, but they thought they were using cocaine only,” Boyd said. “We do have overdoses that are heroin or cocaine only, but most of the time I would say always, it’s fentanyl.”

Some who overdose on fentanyl don’t know they’re taking the drug, according to the Sheriff’s Office’s Pack. Many overdose victims don’t know the cocaine, heroin or other opioids they’re taking have been mixed with the deadly substance.

“An individual may purchase what they believe is a dose of a familiar substance, one they’ve used before — only to realize something is off once it’s already in their system,” Pack said. “In many cases, individuals are chasing a high as a form of escapism, hoping to take a break from their problems. They don’t want to become addicted, and they don’t want to die, but both can happen.”

The toll of overdoses

Siler City’s department has faced diminishing resources over the last two years, including staffing shortages. Because of this, every call takes more officers and other assets away from the department

“Not every overdose results in a fatality, but you still have the same amount of people responding,” Wagner said. “It’s a two-officer response. It’s not a five-minute call; we spend the amount of time needed to make sure the situation is resolved.”

Once local officers respond to the overdose call, they transport some victims to Chatham Hospital. Keith Stinson, Chatham Hospital’s emergency department nursing director, said the combination of an increase in COVID-19 patients over the last year and an uptick in drug overdoses have lstrained the hospital’s resources.

“Ultimately, there’s a strain on emergency departments as is with the influx of COVID patients,” he said. “When you compound that with a critical patient that comes in as an overdose that needs immediate attention, it does make things more challenging with availability and resource allocation.”

Because of the overall increase in patients, Stinson said the hospital has experienced prolonged waiting times for emergency room patients, as well as extended wait times for those waiting to be admitted into a hospital room.

“Patients who are waiting for an inpatient bed remain in the emergency department in a patient care room, which decreases our ability to then move ER patients through,” he said.

Not only do overdose cases in the hospital take a physical toll on the emergency room staff, but it’s also emotionally draining for nurses treating overdose victims.

“There’s an emotional element that happens with the department as well as the physical piece that there’s another added element that needs to be addressed immediately,” Stinson said. “Ultimately, it’s frustrating to see an individual who may have made a decision that negatively impacts themselves and they wrap others around them in by either intentionally or unintentionally being an overdose patient.”

Mental health in substance use disorder

The Diagnostic and Statistical Manual of Mental Disorders, or DSM, classifies Substance use disorder as a medical condition since the manual’s inception.

But in 1980, third edition of the DSM classified substance use disorders as having a mental health component. According to the DSM-V, the most recent iteration of the DSM, two differing disorders relate to drug addiction: substance use disorder and substance-induced disorder.

Substance use disorder is associated with the symptoms associated with routinely taking certain drugs or alcohol, while substance-induced disorders are the symptoms displayed with what the drugs can cause, such as intoxication and withdrawal symptoms once the substance leaves one’s system.

Pack said she believes people stigmatize both mental health and addiction. Because of this, she said the community needs to be willing to help and support addicts — not judge them.

“Addiction is an illness, and individuals with substance abuse disorders may already struggle with shame or self-loathing,” she said. “We want to help replace those feelings with love, proper resources and healthy reinforcement.”

Wagner said he believes mental health plays a huge role in drug abuse and addiction. If there were no stigma around drug addiction, he said, maybe those who suffer from substance abuse would be more willing to seek treatment.

“I think there are several underlying factors that are a part of this increase, but I think that mental health is definitely a major consideration at least in our cases, and I am sure countywide,” Wagner said. “As a community, I think there are programs in place to help, but it is not enough because we have to change the mindset around addiction.”

In part two, we’ll look at how local organizations fight to combat overdoses and overdose deaths.

Reporter Taylor Heeden can be reached at theeden@chathamnr.com.

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