To stem opioid overdose deaths, NC must embrace these lifesaving medications

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This can reduce overdose deaths

The leading cause of death for people under 50 in the U.S. is not cancer, heart disease, car accidents, or COVID. It’s drug overdose.

Between 2000 and 2020, we lost 28,000 North Carolinians to overdose deaths, and the problem is getting worse. According to a new CDC report, life expectancy in North Carolina is dropping in part due to opioid overdoses.

In my work as a family physician who treats people who use drugs, I see that overdose deaths impact all sectors of society and are not isolated to regular drug users. The synthetic opioid fentanyl, which is 50-100 times more powerful than morphine, now contaminates almost all illicit drugs. It’s found in cocaine, methamphetamines, and counterfeit pills. There have even been reports of it in marijuana products.

The risk of overdose is greater in people who inject drugs, but a high school student taking a pill they bought and they think is the ADHD medication Adderall is also at risk of overdose death.

North Carolina’s Harm Reduction Coalition has done tremendous work in implementing evidence-based strategies, such as distributing Narcan (naloxone) rescue kits to reverse overdose and fentanyl test strips.

But there is a highly effective treatment called medication for opioid use disorder (MOUD), which has been shown to reduce overdose by greater than 60% and maintain people in recovery. Two medications that have shown substantial reductions in deaths are methadone and buprenorphine (known as Suboxone).

Stigma toward people who use drugs and lack of knowledge have impeded MOUD use. A common misconception is that MOUD is substituting one addiction for another. We continue to refer the majority of people with opioid use disorder to abstinence-based programs that maintain small numbers in recovery and have no evidence they reduce overdose deaths.

There is a once in a generation opportunity in our state to increase effective MOUD treatments and reduce overdose deaths. It comes from the $850 million North Carolina is receiving as our share of Opioid Settlement funds. Eighty-five percent of these dollars will go to counties. I urge county commissioners to invest them in effective, evidence-based programs and treatment, and work to increase knowledge while challenging stigma surrounding drug use.

Effective overdose prevention is within our reach. We can’t afford not to act.

Dr. Evan Ashkin, Durham

Teacher shortage will get worse

The writer has taught in N.C. for 15 years.

Instead of doing what’s right by students and working with actual N.C. educators to come up with a workable solution, state leaders are pushing a convoluted teacher pay system that is neither consistent, nor fair.

Administrative evaluations and longevity pay work when teachers are compensated fairly. North Carolina wouldn’t have teacher shortages if the legislature adequately funded education, and if tenured teachers actually received a legitimate pay increase in the last 15 years of their career.

It’s hard to ignore that the North Carolina Pathways to Teaching Professionals plan disincentivizes career teachers in favor of cheaper, inexperienced ones who get so overwhelmed they become a revolving door.

While that saves the state money in the short run, what will it look like in the long run? Who’d go to college to get an education degree knowing they’ll barely make a $50,000 salary after 10 years? When there is no master’s pay for career growth?

This pay model will worsen the teacher shortage and put a choke-hold on career teachers. Instead of demanding some sort of compromise from the legislature to solve this issue, state leaders chose a widely unpopular option that will only make teachers more enraged over the lack of respect we receive.

Since I came here in 2008, corporate tax cuts have won out in the state budget, leaving firefighters, police officers, teachers and state employees to take it on the chin. Carrying that burden on our shoulders and in our wallets to make up for cuts gets old and degrading. I’m all for bringing jobs, but what’s wrong with 1 or 2% corporate tax rate? It would go a long way in funding schools.

Jeff Schweickert, Raleigh