GREENSBORO — In the midst of the opioid epidemic, Guilford County saw a decrease in the number of deaths last year caused by the narcotics.
In 2018, 912 opioid calls that Guilford County paramedics responded to ended in 79 deaths, according to Emergency Services Director Jim Albright. That’s 35 fewer than the previous year, though the number of overdoses increased by 217 calls.
The opioid epidemic has been a concern in Guilford County since 2014.
The National Institute on Drug Abuse reported that year that 245 million opioid prescriptions were filled, making it the most frequently prescribed medication in the U.S.
Opioids include not only illegal drugs like heroin and illicit fentanyl, but also prescription pain medications like oxycodone, hydrocodone and methadone, according to the U.S. Centers for Disease Control and Prevention.
After 2014, the number of overdose deaths in Guilford County kept increasing: 47 in 2015, 73 in 2016 and 104 in 2017.
“As the death toll continued to climb, it became apparent to us that we had to have a paradigm shift in the way we were treating folks,” Albright said. “Simply responding to the call and reversing the overdose and then trying to provide some street-side counseling just simply was not enough.”
Former state Sen. Trudy Wade helped Albright get funding from the General Assembly to start Guilford County Solution to the Opioid Problem, or GCSTOP, and in March 2018, the program got underway with the help of such partners as UNC-Greensboro.
Albright hired Chase Holleman to lead the program as the rapid-response navigator.
“GCSTOP is designed to prevent repeat overdoses, to counsel persistent users to enter treatment or adopt evidence-based harm-reduction practices,” Albright said. “The organization provides syringe exchange, harm-reduction training and community overdose-response education.”
Within one to three days of an overdose, a team of people made up of police officers, social workers and peers provides information and counseling regarding treatment options and dependency, and also connects the person with services and case management, Albright said.
“Now we treat it as a chronic brain condition — a chronic health condition — and not the thought of a moral failing,” Albright said. “We’re actively working to reduce the stigma of drug use as we change the verbiage from ‘addict’ to ‘a person suffering from substance-abuse disorder.’ ”
He said he realized that approaching people moments after their drug overdose had been reversed wasn’t the right time. Instead, according to Holleman, paramedics ask patients if they’re willing to have someone reach out to them within 72 hours of an overdose. If they sign a release, Holleman and his team are there.
Holleman said he knows firsthand what the patient is going through.
Holleman was 18 when doctors prescribed opioids after he was assaulted. He said addiction set in, and heroin was cheaper and more accessible.
Holleman overdosed three times by age 20 before he underwent treatment. He said has not used drugs or alcohol since May 2013.
“The drug feels euphoric,” Holleman said. “Like a warm blanket you’ve never felt before. It’s incredibly powerful and makes you not feel anything.
“I think that’s the draw for a lot of people — to escape painful feelings.”
Holleman said he remembers waking up from an overdose once feeling as if he had the worst case of the flu in his life.
His body was in full withdrawal after doctors administered naloxone to reverse the effects of the narcotic.
“It’s awful,” he said. “The only thing you remember is waking up in an extreme amount of pain.”
The pain made him agitated, disoriented and incredibly sick.
At the time, naloxone, sold under brand names like Narcan, wasn’t available to the general public.
Holleman said he knew the risk he was taking, but the addiction was stronger, and the withdrawal and cravings made him feel as if he would die.
And that understanding, Holleman said, helps him relate to the people he is helping.
As the rapid-response director of GCSTOP, Holleman counsels overdose patients, finds them help getting treatment, gives out clean needles and offers naloxone to drug users.
Since March 2018, Holleman has had 600 individuals referred to GCSTOP and made contact with 419 people.
“We assure them of their safety and build rapport with them,” Holleman said.
From there, his team continues following up, whether that’s phone calls, texts or in-person visits.
Since March, the team followed up 1,556 times — 885 of those in person.
It also has helped get 100 people into treatment.
And though all paramedics, police, sheriff’s deputies and firefighters carry naloxone now, GCSTOP has given out 1,000 naloxone kits to people in the community, credited for saving 201 lives in 2018.
In addition, GCSTOP officials offer clean injection supplies —150,000 since March — which helps decrease the number of people exposed to hepatitis C and HIV in the county. That simple action also helps build a relationship and trust with opioid users, Holleman said.
It has also led some users to reach out and ask Holleman for help.
“We are really happy when someone wants to make a lifestyle change and to be there and witness that with them,” he said. “It feels incredible.”