Law enforcement, lawmakers open several fronts in opioid battle
By Tyler Stocks
The Daily Reflector
Sunday, May 19, 2019
Editor’s note: This the last story in a three-part series on the impact of addiction, treatment and efforts to combat a public health crisis.
GREENVILLE — As Paula Dance campaigned for Pitt County sheriff in 2018, she routinely identified the opioid epidemic as the most pressing challenge facing law enforcement. Among her mantras was: “You can’t arrest your way out of the crisis.”
Arresting users for drug-related offenses such as possession and theft to support their habits is all too common, Dance said. But unless the offender’s addiction is addressed, he or she will simply repeat their crimes once they are released, she said.
To try and prevent that from happening, the sheriff’s office has started the Sheriff’s Heroin Addiction Recovery Program, or SHARP. The bootcamp-style intervention will soon be up and running at Pitt County Detention Center.
SHARP will offer a structured environment similar to that of a military school while also offering detention center prisoners counseling, spiritual support, life skills, educational and vocational opportunities they will need for a straight, sober life after they leave jail.
To isolate them from distractions, the prisoners who participate will get their own cell block. Staff will direct them through a strict regimen of classes and activities. In addition, volunteers from the community, including mental health professionals, pastors, employers and educators, will also visit the jail to work with prisoners.
“When they come into the intake process upon being arrested, generally they are at their lowest point,” Capt. Chad Singleton, an administrator at the detention center, said of addicts processed in Greenville. “And we believe that is the time to capture the person who wants to make a change. When they hit rock bottom, oftentimes, that’s when they turn for spiritual support or some other type of support so we want to capture it.”
The growing number of addicts incarcerated at local jails is one of the symptoms of the growing opioid epidemic in eastern North Carolina. As prescription medications like Oxycontin proliferated in the 2000s, more people got hooked and turned to harder, cheaper opioids like heroin and fentanyl. That left local authorities dealing with an increasing number of drug overdoses and rising crime. To combat the problem, law enforcement and state policymakers have developed an overlapping approach of strict regulation, enforcement and rehabilitation.
State Rep. Greg Murphy, R-Pitt, and a Greenville physician, has introduced multiple pieces of legislation to help stem the flow of prescription medication into the wrong hands. The Strengthen Opioid Misuse Prevention Act in 2017 was the first to establish strict controls on prescriptions in North Carolina.
“The opioid epidemic in the United States really started in the ‘90s, and a lot of the problems we had encountered were the over-prescribing of opioids by providers,” Murphy said. “So, what we did with the STOP Act is try to influence and restrict the flow of over-prescribing by providers. And it took a lot of hard work and working with different constituencies and stakeholders.”
The act set a new standard for providers to follow before prescribing meds, he said.
“What we did is set a bar for acute pain, not dealing with chronic pain,” he said. “That’s been the hallmark of the STOP Act.”
Other components to the STOP Act include:
■ Limits on the number of opioids that may be lawfully prescribed upon a patient’s initial consultation for acute injuries
■ A requirement that prescribers use the N.C. Controlled Substances Reporting System, a database that records all controlled substance prescriptions dispensed in outpatient pharmacies across the state.
■ A requirement that physician assistants and nurse practitioners at pain clinics consult with supervising physicians prior to prescribing opioids.
“You now have to go in and query a controlled substance reporting system to ... make sure a patient isn’t getting medicines from other doctors, that they’re not getting too much,” Murphy said. “It was just a robust legislative effort to stop the overflow and over prescribing by providers. It’s really worked. We’ve actually cut down the number of opioid prescriptions in the state ... by about 40 percent.”
State Rep. Lisa Barnes, R-Nash, said more legislative efforts are in the pipeline.
“A fellow freshman legislator who is a former sheriff has the ‘death by distribution’ bill,” Barnes said. “If someone sells opioids to a buyer who dies, the seller can be charged in that person’s death. It’s not meant for a friend who gives to a friend but drug dealers will be charged.”
Nash County Sheriff Keith Stone agrees more efforts need to be made.
“We’ve had more than 50 overdose deaths in Nash County since the beginning of the year,” Stone said. “Our task force is working full time. The public needs to know opioids are highly addictive and very deadly drugs. Please ensure your families don’t even try it.”
Stone said he would like to see stiffer punishment for dealers and faster court case resolution.
“It’s killing people,” Stone said.
Lawmakers passed a followup to the STOP Act, the Heroin and Opioid Prevention and Enforcement Act, in 2018. It addresses the complexities of how law enforcement respond to opioid abuse and overdoses. The law:
■ Strengthens consequences for health care workers who steal, dilute or substitute a patient’s drugs.
■ Gives trained investigators appropriate access to prescription data and records to improve investigations.
■ Funds an additional SBI special agent to coordinate with local drug investigators.
■ Expands and strengthens the Controlled Substances Reporting System by adding data on veterinary drugs, National Provider Identifier information, and the name and ID of a person receiving schedule II or III drugs.
■ Clarifies that fentanyl trafficking is covered by state drug trafficking statutes.
■ Invests $10 million a year in community-based drug treatment and recovery services.
■ Invests $160,000 in Operation Medicine Drop to safely destroy unneeded prescription drugs.
■ Invests $1 million a year in naloxone to protect law enforcement officers and the citizens they serve.
Naloxone is a nasal spray used to reverse most overdoses caused by certain opioids. Law enforcement and emergency medical services in the state began equipping responders with a brand of the spray, Narcan, over the last several years. Officials said It has saved hundreds of lives statewide.
Eddie Buffaloe, chief of the Elizabeth City Police Department, said his officers carry at least one to two doses of Narcan with them in their patrol cars. They undergo annual training with emergency medical officials on how to administer the opiate-blocker to someone who has overdosed.
While police most certainly want to help people who have overdosed, the use of Narcan doesn’t solve the widespread opioid epidemic, he said.
“We’ve got to get them to treatment,” Buffaloe said. He called the lack of treatment facilities the “missing link” to finding ways to properly address the crisis.
“Law enforcement is not a treatment facility,” Buffaloe said.
Buffaloe said when possible police try to divert low-level drug offenders to alternative sources that keep them out of the court system and out of jail.
The state’s Law Enforcement Assisted Diversion program allows police to direct low-level drug offenders to substance abuse treatment and other assistance to avoid criminal prosecution, said Donnie Varnell, an investigator with the Dare County Sheriff’s Office and retired special agent with the State Bureau of Investigation.
Varnell said Dare County also has benefited from a needle exchange program which lowers HIV and hepatitis infection rates. It costs between $400,000 to $1 million a year to treat a patient with either virus; whereas, a new syringe costs about 7 cents, he said.
Buffaloe understands the challenges communities face in dealing with the crisis and knows much more work is needed.
“I would say from a law enforcement perspective I don’t think it’s getting better at this point,” he said.
Greenville police Chief Mark Holtzman agrees that law enforcement’s approach to combating opioid addictions has been changing in recent years.
“The presence of needles or the drugs themselves is secondary to us,” he said. “We just want to make sure people stay alive and give them a chance to get back on the right path of treatment and recover from their addiction.”
Law enforcement agencies will still go after suppliers, he said.
“If someone does die from an overdose — and we investigate several of those each year — we look for cases that we can take to the district attorney and actually charge the person who supplied the drug,” Holtzman said. “Here we’re going after the supplier who put the drugs in the hands of somebody that later died.”
Combating the epidemic is personal for Holtzman.
“In my last department, I had two police officers that worked for me who had lost their kids to heroin overdoses in the same year,” he said. “Both of those officers had worked in a narcotic unit at one point in their careers. It can impact anybody. None of us are immune.”
Sheriff Dance said opioid calls remain a constant for her department. Deputies respond to about eight overdoses a month and average 13 arrests a month. The office made 160 opioid-related arrests in the last year.
“We have a narcotics unit that finds information, works cases, conducts drug buys until they get enough to go out and make arrests,” Dance said. “I know maybe a month or so ago, they did a really big bust with black tar heroin. And that heroin usually comes out of Afghanistan. That was a really, really good bust. We got a lot off the street that was intended to be here.”
The office also has an investigator dedicated to handling prescription-drug fraud who has a relationship with all the pharmacists in the area.
While detectives and street deputies deal with the supply side of the equation, the sheriff hopes a program like SHARP, which is funded in the department’s existing budget, will deal the demand side.
According to Singleton, prisoners will rise at 5 a.m., make their beds, eat, shower and be ready for school at 8 a.m. From there, they’ll spend the day in classes, studying, writing, taking online courses and participating in counseling, therapy and peer discussion.
The detention center plans to train volunteers and work with partner agencies, including East Carolina University and Pitt Community College.
“Oftentimes the individuals we deal with haven’t been afforded the privileges to know how to write a resume, or they might be a high school dropout or something,” Singleton said. “We want to connect them to the resources to get a GED, to learn how to write a resume, to build life skills, to treat maybe a traumatic stress they went through as a young child that led to addiction.”
Maj. Jeff Phillips, who is in charge of the detention center, said he and his staff always look for ways to help inmates.
“People from all walks of life come through this facility. And if we can help someone walk out of this facility better than they walked in, of course I’m all for it,” he said. “We want to build them back up and make them good productive citizens within our county and within our state.”
Lindell Kay and Chris Day contributed to this report.