WNC agencies offer new approaches to battle opioid addiction

By Brooke Randle 
[email protected] 
While the opioid epidemic continues to rage across the nation, government agencies and advocacy groups in Western North Carolina seek alternatives to curb overdoses and reduce soaring incarceration rates.
Bill Hollingsed, 19-year veteran Chief of Police of the Waynesville Police Department, said he has seen the growth of the epidemic first hand. According to Hollingsed, opioid-related overdoses account for a quarter of Haywood County’s deaths.
“One out of every four people in my community, our community here, died of an opioid overdose,” Hollingsed said. “That’s car crashes, that’s heart attacks, that’s fires. The whole scheme of things. One out of every four people in our community died of an opioid overdose.”
Saving lives
The Centers for Disease Control and Prevention estimates more than 91 individuals nationwide die each day of opioid overdoses, making saving lives among the biggest priorities for communities.
Harm Reductionist Hillary Brown of The Steady Collective, an Asheville-based organization which aims to provide support to drug users, said distributing naloxone, a drug known to reverse overdoses, remains essential to reducing accidental deaths.
“It’s saving people’s lives and drug users need to have it because drug users are the real first responders to these overdoses. It’s not EMS and it’s not the cops,” Brown said.
According to Brown, The Steady Collective compiles data volunteered from drug users who have used naloxone to perform an overdose reversal. From January to September, nearly 200 reversals were reported. Since then, Brown said the number of reversals has continued to rise rapidly.
“We’ve now about bypassed that by a lot in just the last couple weeks,” Brown said.
Brown said many overdoses can be attributed to heroin being replaced with fentanyl, a powerful and often deadly narcotic.
“We’re at a particular fix, if you will, in Asheville where there’s so much fentanyl that it’s not like people are just using a bunch of drugs and overdosing. They think they’re using heroin and what they’re using is fentanyl,” Brown said. “We’re seeing folks who are long-term heroin users, they’ve never overdosed in a dozen years that they’ve used and all of a sudden, they’re getting all of this fentanyl-tainted heroin and the dose they’ve used before is not a safe dose anymore.”
A rise in addiction, a rise in crime
As addiction rates climb, so does crime and incarceration. In 2004, The Bureau of Justice Statistics reported 17 percent of state prisoners and 18 percent of federal inmates said they committed their current offense to obtain money to purchase drugs.
“Pills are expensive on the street. Heroin is cheaper than pills but it’s still an expensive habit. So they’re gonna have to do something to help supply that habit and that may be through theft,” Hollingsed said.
Bob Kandra, Adjunct Instructor  of Criminal Justice at Mars Hill University, said the rates of incarceration and subsequent felony records for drug crimes have resulted mostly from antiquated laws and attitudes from the War on Drugs era.
“The impact of the prosecution of the drug laws the way they currently are have absolutely devastated communities and have devastated just the structural nature of a lot of American families, especially for persons of color and areas of the country that are economically depressed,” Kandra said. “Until we change the way we’re gonna deal with those offenders or deal with those crimes, I don’t think that we’re going to meet with as much success as we want.”   
Kandra, who spent most of his career working for both the Federal Bureau of Investigation and the Central Intelligence Agency, said the current criminal justice system contributes to skyrocketing numbers of incarcerated individuals without aiding the issue of addiction itself.
“Once we put someone in a penal institution, despite efforts to provide either counseling, drug abuse counseling or even educational possibilities, in most cases the services aren’t sufficient to go ahead and lift them to where they can re-enter society,” Kandra said.
Root of the problem
The Waynesville Police Department seeks to change that.
According to Hollingsed, Waynesville will join 12 other cities across the country in implementing Law Enforcement Assisted Diversion, a program which offers alternatives to arrest for addiction related crimes. Individuals accused of prostitution, theft and other low-level crimes related to drug addiction may qualify for the opportunity to enter treatment programs instead of facing immediate arrest and jail time.
“It’s a pre-arrest program. We want to stop the addiction, to stop the habit, to stop the theft,” Hollingsed said. “Where we make the distinction in our policy is if you’re out here selling drugs, if you’re victimizing the community, you’re not eligible. Prison’s the place for you.”
Hollingsed said he hopes treating addiction will, in turn, reduce crime. A 2015 study by the University of Washington which evaluates the LEAD program and recidivism reported participants in the program were 60 percent less likely to be arrested within the first 6 months of the evaluation than people in the control group.
“We’ve seen it work in other places. If we can stop the cause of committing a crime, then we think it will stop that crime, which will in turn bring down that recidivism. That’s what we hope will happen here,” Hollingsed said.
A May press release from the North Carolina Department of Health and Human Services reports the state of North Carolina received a $31 million grant to fight the opioid crisis through the 21st Century Cures Act, a law enacted in late 2016. A portion of that grant now funds the LEAD program for Haywood County.
Hollingsed, who has worked as an officer for more than three decades, said while some of the measures may appear counter-intuitive to the ideology of law enforcement, attitudes about addiction need to change in order to find solutions that work.
“I’ve been a cop for 33 years and it’s hard for me to say arresting somebody and putting them in jail is not going to solve the problem, but it’s not,” Hollingsed said. “We are not solving the problem. We are not stopping the cycle of addiction.”
Reducing harm
As more opiate users turn to heroin, healthcare and advocacy groups raise concerns over the safety of intravenous drug use. The National Institute on Drug Abuse reported in 2010 injection drug users account for more than half of all new cases of HIV nationwide.
According to the North Carolina Harm Reduction Coalition, needle exchanges, which aim to provide clean needles and injection supplies to drug users for little or no cost, have only recently gained legal status in North Carolina since summer of 2016.
Michael Harney, Prevention Educator and Street Outreach Worker at the WNC AIDS Project and coordinator of the Needle Exchange  of Asheville,said providing clean needles and supplies to users remains vital in reducing diseases like HIV and Hepatitis C. Harney said the demand for clean needles has risen dramatically in the last few years.
“In the last several years, probably the last 5 or 6 years, it has really increased to more than something we did on the side. A major part of our daily work is keeping up with the demand,” Harney said. “From the minute we open the doors until we close them, people are coming and going all day long.”
Needle exchanges remain controversial. Opponents often cite enabling drug use as a concern. As a result, few exchanges operate in North Carolina and the surrounding areas. Harney said while the Needle Exchange of Asheville serves an 18 county region, reports from within the organization show drug users from as many as 32 counties across five states seek resources from the exchange. The demand has left Asheville Needle Exchange scrambling to find funding to cover the extra costs.
“This has become more than just a public health state of emergency, but an economic emergency, a social emergency, kind of a humanitarian emergency, just in this region. I bet if we expanded, we could serve 50 states,” Harney said.
Changing attitudes
For Hollingsed, WNC faces specific challenges in the fight against addiction. The sudden availability of powerful narcotics have left smaller communities, like Waynesville, desperate for alternatives.
“We have all the things that bigger cities have in rural communities. Sometimes when you look at the maps, as far as the overdose rates, it’s the smaller communities that are hit the hardest,” Hollingsed said.
Hollingsed said attitudes from law enforcement surrounding the nature of addiction must change in order to begin to see progress.
“It is a paradigm shift for law enforcement to be involved in this. If you look around this office, you know I was a SWAT guy. I did SWAT for 15 years, that is my background. So it takes a lot for law enforcement to kind of have a new outlook on what is going to help the situation,” Hollingsed said. “And that’s what we’re trying to do here. Give it a shot and see if it works. Because arresting the person, it’s a revolving door. We’ve got to stop the addiction before we can stop the crime.”