By Rose Hoban
In August 2013, Tanya Smith got the phone call no parent ever wants to receive: Her 20-year-old daughter, Taylor, was dead of a drug overdose.
What was worse, Taylor’s body had been dumped on the side of the road. The people she was taking drugs with were afraid that if they were caught they would be arrested. So, instead of calling for help as Taylor lay dying, they waited until she died, then dumped her body and ran off.
As Smith told her story Thursday at a Heroin Summit at the General Assembly building in Raleigh, the legislative auditorium fell absolutely silent.
Smith is a law enforcement officer at Kennesaw State University in Georgia and she was in North Carolina to support legislative efforts here to change the legal paradigm around how law enforcement responds to calls in which drugs are involved.
In the past two years, the North Carolina General Assembly has passed two laws intended to reduce the harm that comes from the use of opiate drugs ranging from prescription pain medications to heroin. House Bill 850, passed in 2013, allows people possessing needles to tell a law enforcement officer they have the paraphernalia without fear of arrest. Senate Bill 20, passed the same year, allows people to call 911 in case of an overdose without fearing arrest. The Good Samaritan Law, as it’s known, also allows for wider distribution of naloxone, a drug that can reverse an overdose in less than a minute.
But members of the North Carolina Harm Reduction Coalition, which sponsored the summit, would like to see those laws tweaked. NCHRC director Robert Childs said he would also like to expand the number of laws that allow for people overdosing on opiates to live long enough to have a second chance. And Childs’ group has the support of some prominent Republican lawmakers.
“We’d like to expand HB 850 to include residue,” said Childs, referring to the heroin residue that can linger in syringes and other paraphernalia. “Those are the ones that tend to be more likely to have HIV and viral hepatitis, and the current legislation on those syringes isn’t clear.”
“We definitely need clarifications on that so that people feel they can declare them to officers,” he said.
Heroin overdoses climb
As states such as North Carolina and Georgia have cracked down on so-called pill mills – doctors’ offices where it’s easy to get a prescription for pain medications – the price of opioid drugs has risen sharply. That’s driven people who are addicted to opiates to look for cheaper alternatives, the most popular of which is heroin.
“Heroin was available; it became increasingly more available,” said Tad Clodfelter, a substance abuse treatment provider from SouthLight Healthcare, located in the Triangle. “[Heroin] was a much cheaper option, about five times less expensive. So the availability and the increase in pain pill addiction was a big factor in the resurgence of heroin use.”
In the early 2000s, deaths from heroin in North Carolina were about 40 to 50 per year. In 2011, the number rose to 77 deaths; then in 2012, it rose to 150, even as the overall number of overdose deaths has started to decrease.
According to Clodfelter, Durham police seized five times more heroin last year than in prior years and the Raleigh Police Department seized 24 times more heroin in 2012 than it did in 2010.
Rep. John Faircloth (R-High Point), who spent almost 20 years in law enforcement, helped to push through the needle decriminalization law and said he’s behind new legislation to make it better.
“I had officers … who were sticking their hands in folks’ pockets when they were searching them and coming out with a needle stuck in their finger,” Faircloth told the gathering. “We did the needlestick bill, and I think the officers are glad we did.”
As the law stands, if someone hands over a needle to a police officer they won’t be prosecuted for the needle.
“The law doesn’t reach any further right now,” Faircloth said. “We do have a problem with syringes and used syringes. People don’t want to have them on their body if they get stopped, so they get rid of them or they hide them.”
Faircloth’s bill would expand the exemption from prosecution to syringes that have residue in them.
There’s also a move to create needle drop-off boxes at police stations and sheriffs’ offices. Those would go alongside drop boxes for opioid pills that are now found in most law enforcement offices.
Childs reported that his organization has passed out more than 7,000 free naloxone kits, which include a vial of naloxone, a syringe and needle and instructions on how to administer the drug in case of overdose. The NCHRC has also recorded at least 300 “saves” as a result of naloxone distribution. But his not-for-profit doesn’t have a large budget for buying the drug, which is becoming more expensive as more states pass laws expanding its use.
NCHRC’s position is that too many people using heroin and opiates in North Carolina still don’t know about, or don’t trust, the harm reduction laws. So they don’t call 911 when an overdose happens.
In Georgia, lawmakers decriminalized the possession of up to four grams of heroin if police arrive as a result of a 911 call for an overdose.
“The mentality for me is we’ve got to have a shift that we’re not having an arrest, we’re reacting to save somebody’s life and get them into a rehab program, give them a second chance,” said Chief Ken Ball of the Holly Springs, Ga., police department. “We’re trained from the day we sit down in the chair at the academy to kick ass, take names, put them all in jail. But there has to be a shift.”
Also in short supply are substance abuse treatment beds and protocols to use the best, evidence-based treatments, Clodfelter said.
“With heroin dependence, we know what works,” he said. “And in the vast, vast majority of cases, we don’t use it.”
Clodfelter talked about how the drugs suboxone and methadone to supplement behavioral treatment for addiction are still not used enough, even though the literature shows that treatment approach works better than “just saying no.”
“Greater than 90 percent of opioid addicts who use abstinence-based treatment relapsed to opiate dependence in the first year,” he said. “Conversely, patients receiving medication-assisted therapy, along with counseling and behavioral strategies, have, in the first year, a greater than 50 percent chance of remaining opiate free.”