Fayetteville, North Carolina, is a city in the eastern United States with a distinctly patriotic flair, as it is home to the massive US Army instillation of Fort Bragg. The community of military veterans, low-income residents, and a high number of residents working in farming or manufacturing may contribute to higher than average levels of pain and therefore elevated painkiller use and potential misuse. The Fayetteville Observer reports that Fayetteville ranked 15th in the United States for prescription opioid abuse and 18th highest for opioid abuse, including heroin, overall.
Individuals suffering from post-traumatic stress disorder (PTSD), those with low income levels, those living in the rural South, individuals ages 50 and older, and people with a behavioral health issue are more likely to abuse opioids than others, the published study found. In North Carolina, WRAL publishes that three residents die from an opioid overdose every day, another three are hospitalized, and another four seek emergency department (ED) care for issues related to opioid drugs. The North Carolina Department of Health and Human Services (NC DHHS) reports that nearly 2,000 North Carolinians lost their lives to a drug overdose in 2016, many of which involved an opioid drug. In fact, heroin and synthetic opioids like fentanyl contributed to around 60 percent of unintentional opioid deaths that year. In Cumberland County, which includes the city of Fayetteville, the North Carolina Office of the Governor reports that in 2015, there were 41 opioid overdose deaths, up from only 14 in 2005.
A larger percentage of residents in Cumberland County live in poverty than in the rest of North Carolina. The Cumberland County Community Health Assessment 2016 publishes that between 2011 and 2015, approximately 18.8 percent of Cumberland County residents lived in poverty compared to a state rate of 16.4 percent. Cumberland County residents also had lower median household incomes than statewide averages and a higher unemployment rate. Crime, including property crime and violent crime, rates were higher than peer counties and state averages for Cumberland County, and over one-quarter of all survey respondents reported violent crime as a major contributor impacting quality of life. For the state, the Behavioral Health Barometer: North Carolina 2015 indicates that rates of alcohol dependence and abuse are slightly lower than national averages (6.1 percent of North Carolina residents versus a 6.5 percent national average) and slightly higher for illicit drug abuse and dependence (2.8 percent for North Carolina residents as opposed to a 2.6 percent national average).
Drug and alcohol abuse, addiction, and mental health concerns are often intertwined. Integrated behavioral health programs can be great resources for recovery. There are many different options for services and care within Fayetteville and North Carolina.
Fayetteville’s Opioid Public Health Issue
The North Carolina Injury and Violence Prevention Branch reports that in 2015 the majority of overdose deaths in the state involved a prescription opioid drug, at 738 fatalities. Heroin abuse and overdose deaths are rising, however, and in 2015, there were 364 heroin overdose deaths. Cocaine was involved in 293 overdose fatalities in 2015 in North Carolina as well.
A particularly alarming trend is the rise in synthetic opioid abuse, as fentanyl and fentanyl analogues are increasingly popping up as an emerging dangerous trend. These drugs are 50 to 100 times more potent than the already deadly heroin, and they are often substituted or added to heroin without a person even knowing it. This can lead to a possibly life-threatening overdose. Fentanyl is also dangerous to first responders as it can be absorbed through the skin. The North Carolina DHHS publishes that heroin, fentanyl, and fentanyl analogue overdose death rates are rising; emergency department visits related to heroin and synthetic opioids are increasing; and there are an elevated number of incidents involving synthetic and illicitly manufactured opioids.
Cumberland County ranks second in North Carolina for number of times naloxone (the opioid antagonist and overdose reversal drug) has been administered by law enforcement; the Fayetteville Police Department administered naloxone 132 times between May 2015 and December 2017, the Fayetteville Observer reports. The Opioid Action Plan introduced in June 2017 by North Carolina Governor Roy Cooper seeks to increase access to the potentially lifesaving drug naloxone as well as heighten community awareness regarding the scope of the issue, expand treatment resources and recovery services, minimize diversion of pharmaceuticals and flow of illicit drugs in the region, and lower the oversupply of prescription opioids.
The North Carolina Good Samaritan/Naloxone Access Law helps to reduce and reverse dangerous opioid overdoses by protecting individuals who call 911 to try and save a life and also those who administer the potentially lifesaving drug. Individuals will not be prosecuted for drug-related charges if they are seeking or asking for help for an overdose. North Carolina has a Standing Order for Naloxone that allows individuals in need to obtain the drug without a prescription. An interactive map indicates local NC pharmacies that offer naloxone under the Standing Order. The Cumberland County Health Department also offers naloxone to residents as needed. The Carolinas Poison Center can provide information and resources on unintentional poisoning and overdose, as can naloxonesaves.org.
Addiction and Mental Health Treatment Options in Fayetteville
Anyone in Fayetteville who is struggling with mental health, drug or alcohol abuse, and/or addiction issues and in crisis can get help through the NC DHHS Crisis Services, which provides information on crisis services by county. In Cumberland County, there are three main options (for immediate help and emergency services, call 911) a resident can call. They can contact the Alliance Behavioral Healthcare Access Center, which is open 24 hours a day, seven days a week; they can have a mobile crisis team visit; or residents can go in to the crisis center, which for Fayetteville residents is provided by the Community Mental Health Center at Cape Fear Valley. More resources and information can be found through Crisis Solutions North Carolina.
Within the state of North Carolina, there are 14 healthcare facilities operated by the state, offering public mental health and substance abuse treatment services through the NC DHHS. The Division of Mental Health, Developmental Disabilities and Substance Abuse Services uses the Recovery-Oriented Systems of Care (ROSC) to promote long-term support for lifetime recovery. Services are provided through a Local Managing Entity (LME), which for Cumberland County residents is Alliance Behavioral Healthcare, the regional LME-Managed Care Organization (MCO). The LME-MCO then partners with private providers to offer local services, a directory of which can be found here.
Substance abuse and mental health treatment services include:
- Case management
- Detox services
- Outpatient services
- Residential programs
- Psychiatric care
- Medical management
- Integrated treatment for co-occurring disorders
- Group, family, and individual therapy
- Transitional services
- Recovery support services
Inpatient mental health services for adults and outpatient services for children and adults in Fayetteville are provided by Cape Fear Valley Behavioral Healthcare, and the Cumberland County Department of Health lists contact and location information. The Cumberland County Department of Social Services (CCDSS) also provides treatment resources for residents.
The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Behavioral Health Treatment Services Locator is a resource for finding local treatment options that are licensed and certified. A coordinated system of care for US military veterans is offered through NC Serves Central Carolina, hosting information on public, private, and veteran-friendly service providers.
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Further Resources and Treatment Modalities
In the state of North Carolina, if a family member, loved one, or other individual believes that a person is in danger of self-harm or a danger to others, they may have them involuntarily committed. This form of treatment is often court-ordered, or mandated, in the form of assisted outpatient treatment (AOT), which may be managed by a community-based local provider.
Individuals who are arrested and put in jail due to a problem associated with mental illness may be eligible for the Jail Diversion Program, which can provide them with necessary support and treatment services as opposed to incarceration. In the same vein, individuals struggling with drug and/or alcohol problems and addiction who are arrested for nonviolent and drug-related crimes may be eligible to enter into the North Carolina Drug Treatment Courts (DTC) system. Individuals will undergo court-mandated treatment for drug and alcohol-related issues, and upon completion of the program, they may have their sentence reduced or charges dropped.
There are many resources for families and individuals in the Fayetteville, North Carolina, community to find treatment, services, information, and behavioral healthcare. Private, public, and community-based providers all offer local services.
Many nonprofit and community organizations host prevention, education, treatment, referral, and recovery support services as well. For example, the North Carolina Harm Reduction Coalition (NCHRC) advocates for policy development, education, and improvement of issues impacting public health, such as drug abuse and addiction. A nonprofit organization seeking to bridge the treatment gap for Cumberland County residents, Better Health of Cumberland County provides services for low-income and underserved populations. The CARE (Compassion, Assistance, Referral, and Education) Clinic also offer free healthcare to eligible residents in Cumberland County.
The nonprofit Partnership for Children of Cumberland County also hosts an Alcohol/Drug Council of North Carolina. A faith-based social services organization, Operation Blessing offers support, resources, and services for Fayetteville and local residents.
There are many resources available for behavioral healthcare prevention, treatment, and recovery support within the Fayetteville area of North Carolina.
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