Commissioners Hear Latest On Drug Abuse In Transylvania – Transylvania County, NC
Last updated 3/23/2021 at 8:54am
“Eye opening” was the reaction by some Transylvania County commissioners recently to statistics about local substance abuse and its impacts.
In 2018, a Community Health Assessment reported 42 percent of Transylvania County residents said their life had been negatively impacted by their own or someone else’s substance abuse, and 22 percent of residents said they drank to excess, among the highest numbers in the region.
According to the preliminary findings in a Western Carolina University study entitled “Behavioral Health Among Adults in the Transylvania County Detention Center,” 72 percent of inmates surveyed had a drug addiction, which is also called a substance use disorder (SUD), a medical condition and a mental health disorder.
During the 2018-2019 fiscal year, according to the county’s Department of Social Services, about 70 percent of local children came into DSS custody as the result of parental substance use.
Earlier this month, members of the local C.A.R.E. Coalition highlighted these and other statistics during a presentation to the Board of Commissioners and explained their approach to tackling SUDs. In 2010, a grassroots community group of health care professionals dedicated to reducing substance abuse in the county, particularly among the youth, formed the C.A.R.E. (Community Awareness Recovery Effort) Coalition.
C.A.R.E. Director Kristen Gentry described the coalition as driven by local community members who tackle substance abuse through a collaborative and multi-faceted approach, from prevention through treatment and recovery. C.A.R.E has three staff members, 50 active coalition members and 20 community partners, in-cluding support from Transylvania Public Health, and relies on state and federal funding.
The coalition’s approach is “evidence-based,” she said. It’s been “proven” that most substance abuse begins in childhood and adolescence. Prevention work, therefore, focuses especially on youth, particularly on stopping access to alcohol, tobacco and other drugs; changing community norms; and making young people “more resilient” to using substances.
Other initiatives include the 2018 formation of the Transylvania Opioid Response Team, with support from the UNC School of Government, which works on treatment and recovery for opioids and methamphetamine; and the re-equipping of local EMS emergency vehicles with Narcan, which reverses life-threatening opioid overdoses. In 2020, it was used 14 times.
Gentry went on to highlight through statistics the human and financial costs of SUDs.
According to the Centers for Disease Control, tobacco annually claims about 480,000 deaths; alcohol, more than 95,000; and other drugs, 70,000.
The yearly financial cost, according to the National Institute on Drug Abuse, is $740 billion, including $300 billion from tobacco; $249 billion from alcohol; and $271 billion from illegal and prescription drugs.
Jim Hardy, a retired teacher who serves on the coalition’s executive board, told commissioners the “costs of substance abuse are staggering.”
In a letter from the coalition and the Opioid Response Team to commissioners, Hardy described his own early addiction to tobacco: “I know addiction firsthand. I began the path to addiction at 13. Like many teenagers, I was encouraged by friends and lured by the thrill of experimenting with a forbidden substance. By age 15, I was hooked, and at 25 was smoking almost two packs of cigarettes a day. I was waking up every morning with chest pain, and the birth of our first child was close. I had tried several times, unsuccessfully, to quit. At 7:30 p.m. on July 17, 1968, I vowed never to take another puff on anything made of tobacco. That was 52 years ago, and I have kept that vow. It was one of the hardest things I have ever done. Nicotine is said to be more addictive than heroin and harder to quit. It was 18 months before I went an entire day without thinking of having a cigarette. I dreamed about smoking more than 10 years later. I was lucky. I am still healthy, although it is possible I may still contract some smoking related illness. There was no stigma to my addiction. In fact, smoking was encouraged, advertised everywhere and even promoted by some doctors. Two thirds of adults smoked, and movie stars glamorized it.”
Hardy told commissioners that when thinking about substance abuse the most “obvious” reactions are the financial costs involving health care and incarceration.
“What is often overlooked are the costs to families and the larger community,” he said. “Those costs include, but go way beyond dollars and cents. Each person in jail or prison leaves behind family members. Spouses are left to cope without a breadwinner and children, greatly increasing the demands on mental health and social services to provide support. The costs of dealing with troubled children burden our schools. Perhaps more disturbing is 50 percent of children with a parent who has been incarcerated will become incarcerated themselves.”
There is also a public safety cost. Maintaining a drug habit is “expensive,” Hardy said. It leads to property crimes to support it, increasing law enforcement and court costs, making the overall community “less safe,” he said.
Other impacts include delayed social and emotional development, exposure to physical and psychological harm, financial distress and violence. Often, Hardy said, “children grow up scarred, turning to substance abuse and going to jail and prison.”
Another added burden is placed on schools, which have to deal with troubled students.
There is “hope, however,” Hardy said. Every $1 spent on treatment and recovery saves $4 in health care and $7 in criminal justice costs, while every $1 spent on prevention services saves up to $10 in long-term costs, he said.
Anna Windham, a C.A.R.E. Coalition co-ordinator, went over the prevention “strategies” they use, in particular for local youth: promoting the safe storage and disposal of prescription drugs; reducing the stigma of SUD and raising awareness; reducing youth access to alcohol and drugs, including evidence-based education at the local high schools; and supporting behavioral health efforts.
These strategies, she said, have seen a decline in the fatal overdose rate and overdose-related EMS calls; less medication being prescribed, and more people are safely storing or disposing of medication.
Teresa Radford was also hired to coordinate the $200,000 the Opioid Response Team received in federal funding for 18 months to conduct an extensive needs assessment and strategic plan focused on local harm reduction, treatment and recovery efforts for opioids and methamphetamine use.
This will involve input from local law enforcement and others in criminal justice, local agencies, and those who have a SUD or lived with someone with a SUD.
Next steps for the coalition include finishing the strategic plan and preparing to implement it, with the goal of receiving more funding to help with its implementation; and cultivating the local “political will” to play its part in reducing substance abuse.
Commissioner Larry Chapman asked what kind of “advocacy” is occurring at the state and national levels.
“You are getting states all over legalizing marijuana, which is directly against what you are trying to do here,” he said. “The southern border is now open, and I think what that will do is just drive down the cost of drugs, with more availability.”
Gentry said all of the coalition’s funding is federal and officials are “limited” as far as advocacy, noting the “fine line between advocacy versus lobbying.” The coalition, because of its funding, can’t take positions on specific bills or proposed laws, she said.
Instead, the coalition focuses on local policies or state laws that it can “educate” elected officials about on SUD-related issues.
Chapman asked if this is “a winnable battle.”
He said the country has been “fighting” poverty and other things for decades but doesn’t seem to “be making much progress.”
“I think it is a slow, but winnable, battle,” Gentry replied.
With prevention, “the fruits of your labor” may be a decade away, she said.
Chapman asked if the pandemic had an impact.
Hardy said, “absolutely,” noting the news reports of significant increases in alcohol sales.
The $200,000 federal grant, he said, is directed specifically toward opioids and methamphetamines, which are “basically the drugs that are ‘popular’ right now in people’s attention.”
He said alcohol kills twice as many people as opioids do, and cigarettes and tobacco kill five times that many.
Chapman asked whether D.A.R.E. (Drug Abuse Resistance Education) is still functioning.
D.A.R.E., which was founded in 1983, has changed, Hardy said. Studies have shown that D.A.R.E. “was not an effective program and there were some negatives to it,” he said.
The program, today, Hardy said, is more about “talking about it… rather than just saying, no.”
Commissioner David Guice said the coalition had presented “eye opening” information. Guice was formerly the state’s commissioner of Adult Correction and Juvenile Justice.
“The staggering fact is that the ‘War on Drugs,’ as we have all known it for years, has been a complete failure,” he said. “We thought we could address them by locking people away, but that doesn’t work. We all know that now, and we’ve got to address things differently.”
In the letter to commissioners, the coalition addressed the “War on Drugs”: “Drug use and addiction have been characterized as a moral failing, making the person who uses drugs out to be of poor character and therefore deserving of contempt and banishment from normal society. For the last 49 years, the ‘War on Drugs’ has reinforced the image of the ‘drunk in the gutter’ and the ‘junkie in the alley.’ Thus, people experiencing alcohol and other drug problems go to prison, not treatment. As a result, citizens and their families impacted by SUD have felt isolated and alone because of the stigma – the guilt and shame associated with drug use. That wall of silence compounds the pain and stands in the way of treatment and help. In fact, much of the damage associated with drug use is the result of the way we treat people who use drugs and not the drug itself. ‘The War on Drugs’ has really been a war on people. Since it began in 1971, almost $2 trillion has been spent fighting it. These are the direct costs. The related costs are estimated at seven to 10 times that amount. The design of this war is the equivalent of throwing gasoline on a fire to put it out. Instead of reducing the spread of drugs and addiction, it has done just the opposite, making drugs easily available everywhere, sowing violence across the nation and around the world, and destroying millions of lives in the process.”
Guice said for the C.A.R.E. Coalition’s “good work to continue and to see an impact on young people” the county is going to have to invest in the effort.
Commissioner Jake Dalton said he grew up in a home that suffered from the impact of SUDs and the subject “hits” him “hard.”
Fortunately, he said, he and his brothers didn’t “follow that path.”
He said it all comes to down to someone making a “personal choice…and their lives will be a whole lot better.”
After the meeting, Gentry was contacted for her response to Chapman’s comments about drug legalization and its negative impact on C.A.R.E.’s mission.
“From a prevention standpoint, legalization of any drug, including marijuana, would increase availability and access for youth,” Gentry said. “The science is clear and robust in showing that any substance use is harmful to young people’s developing brains and increases their risk for substance use disorder as adults. This holds true across drug categories. For example, using marijuana or alcohol or nicotine as a teen increases risk for an addiction to a different substance as an adult.
“The coalition is composed of many community stakeholders with diverse perspectives and interests. However, one shared goal among our coalition members is to limit access and availability of all drugs and alcohol for youth. If N.C. were to change its laws around marijuana, the C.A.R.E. Coalition would continue work here in Transylvania County to develop local solutions to issues that arise from that legislation.
“Because of its work on tobacco and alcohol policy, the coalition is poised to advocate for targeted policy that impede youth’s ability to obtain cannabis, reduce their exposure to normalized use, and limit aggressive or widespread commercial advertising.
“Examples of these policies could include: zoning for cannabis dispensaries or grow operations to be over a mile from a school zone, limiting advertising, advocating for cannabis and tobacco free zones or events, placing limits on the amount of THC present in retail products, and limiting outlet density, so availability of cannabis products does not adversely impact marginalized communities. Other community coalitions in states that have legalized marijuana have seen significant reduction in youth use through these local efforts. Their successes bear fruit as these teens reach adulthood and are not dependent on a substance, but can live happy, healthy and productive lives free of addiction.”