WEST JEFFERSON — As the nation continues to grow more concerned about opioid misuse, representatives gathered to discuss how the national crisis is affecting Ashe County on Thursday, Aug. 29, at Ashe County Public Library.
The panel discussion served as the second installment of the On the Same Page Literary Festival Read, centered on the festival’s featured book, “Dopesick: Dealers, Doctors, and the Drug Company That Addicted America” by Beth Macy.
The panel, moderated by Dakota Todd, project manager of grants at Ashe Memorial Hospital, consisted of six representatives.
Panelists included Chief Deputy Danny Houck of the Ashe County Sheriff’s Office; Laura Lawson, licensed clinical social worker and counselor; Cody Darnell of Ashe Medics; Donna Hill, community health services director at AppHealthCare; John Simmins, recovery peer-support specialist at AppHealthCare; and Ashley Sheets, Department of Social Services children’s protective services supervisor.
According to data from a community health survey collected in 2017, substance misuse is the No. 1 health concern in Ashe County, Todd said.
During the past 10 years, data shows that unintentional poisonings in the county have increased, with 302 reported hospitalizations related to overdoses between 2004 and 2016 and an increase of 100 hospitalizations in the last four years, Todd said.
“That’s actually a lot for our small county,” Todd said.
Currently, the only measure AMH has in place to gauge opioid misuse is a question assessment given to patients, Todd said, noting that patients are not always honest in their responses.
In an effort to combat the risks of opioid misuse in the county, AMH received a $200,000 grant in May aimed at developing a strategic plan with community leaders to prevent and treat opioid addiction.
The Ashe Substance Misuse Coalition, comprising members of Ashe Medics, ACSO, Vaya Health, Ashe County Health Department and Daymark Recovery Services, was formed in May through the AMH grant.
The coalition’s goal is to increase education on substance misuse among community members and health providers within the county. The group is also looking into ways to improve treatment for those struggling with addiction, Todd said.
In Ashe County, the rate of opioid-related deaths is 7 percent higher than the state average, Todd noted. The prescribing rate is 22 percent higher than the state average, Ashe Post & Times previously reported.
Hill, who works with the Health Department in education and prevention efforts regarding opioid misuse, said that developing treatment methods in Ashe County is crucial in lessening the risks posed by addiction. She added that people struggling with addiction face a number of problems along the path to recovery.
“The stigma that is associated with addiction and treatment is a huge barrier,” Hill said. “Our people don’t seek treatment because they’re ashamed of what people are going to think if they’re receiving treatment.”
Hill continued, saying that opioid misuse has to be approached from both ends, being prevention and treatment. In order for those struggling with addiction to take the first step towards recovery, she said the community has to come together to tear down the walls that stigmatize treatment.
“People do recover,” Hill said. “It is possible, but it’s only possible with support from their community.”
In December 2018, AppHealthCare received a $100,000 grant to combat opioid misuse in Ashe, Alleghany and Watauga counties, with funds specifically allocated for the development of a peer-support specialist program in Ashe County.
Peer-support specialists are typically recovering addicts who work with those currently struggling with addiction, or those who are taking steps towards recovery, Hill said.
Simmons, who serves as a peer-support specialist for AppHealthCare, described how he works works closely with incarcerated individuals and those who have been recently released from jail. He provides Narcan delivery training — the opioid antagonist used in treating overdoses — as well as lessons learned from his own experiences with addiction.
As someone who has been in long-term recovery for 36 years, Simmons said the ultimate goal should be keeping people alive.
“People look at recovery in different ways, but the one thing you cannot recover from is being dead,” Simmons said. “I’m all about saving lives — whatever it takes.”
Addiction and the effects of substance abuse have made lasting impacts on Simmons’ life, he said. In 2013, Simmons’ son died from a heroin overdose after being released from jail in Florida while on his way to move in with Simmons in Alleghany County, he said.
Simmons emphasized the need to increase support efforts for those who have recently been released from jail — something he now focuses on as a peer-support specialist.
“The focus needs to be on the addict, not the pill epidemic,” Simmons said.
Simmons, Lawson and Sheets each spoke on the impacts addicts have on their family. Lawson, who provides counseling services for family members of addicts, said substance misuse affects more than just the addict.
“Our community needs help,” Sheets, who works with DSS, said. “We don’t have a lot of treatment options in Ashe County for families.”
Sheets said that DSS deals with entire families in an opioid-related situation. Currently, there are 56 children in Ashe County’s foster care service, and half of those have arrived since January, Sheets said.
“I would say 99 percent of those cases have involved substances of some kind,” Sheets said. “We see firsthand how the opioid crisis affects the families of Ashe County.”
Agreeing with other panelists, Sheets said increasing treatment opportunities for the people of Ashe County should be a priority. She explained that when a child is placed in foster care, their parents tend to lose their medicaid options, which means they lose access to any treatment they may need for addiction.
Sheets added that the county provides assistance for children within the foster care system, but getting parents the treatment they need is the biggest issue the county faces.
From the perspective of law enforcement and first responders, both Houck and Darnell discussed the impacts the opioid crisis has on the individuals responding to overdose calls.
“For law enforcement, it’s been a real strain on us,” Houck said, adding that responding to these calls takes an emotional toll and leaves lasting scars. “In my short amount of time since becoming your chief deputy in December, I have already seen the effects of opioid use in breaking up families.”
Darnell, who has been working as a paramedic for the past four years, agreed with Houck that opioid-related calls leave lasting emotional scars on first responders.
“We see this day-in, day-out,” Darnell said.
The average response time for Ashe Medics is at least 10 minutes, Darnell said. Since opioids suppress the respiratory system, those who overdose typically go into cardiac arrest, resulting in a lack of oxygen flow to the brain, Darnell explained. After six to eight minutes without oxygen, the situation becomes fatal.
Darnell added that these people pass away before Ashe Medics can rescue them because they are unable to arrive on-scene in that six to eight minute window after an overdose leads to cardiac arrest.
In an effort to decrease the number of opioid-related deaths, Ashe Medics carries giveaway Narcan on their trucks to pass out to families after responding to an overdose call.
Darnell said that after resuscitating an overdose victim with Narcan, the patient has the right to refuse treatment and be transported to a medical facility. He explained that an opioid’s halflife — or the length of time that it remains in someone’s system — could last up to 12 hours. The halflife of Narcan is only six hours, meaning a patient has the potential to relapse even after being resuscitated, Darnell explained.
Darnell also agreed with other panelists, saying that Ashe County needs more treatment facilities and opportunities to prevent situations when patients relapse, particularly because many people do not have the health insurance to pay for treatment at a hospital.
“We need to, as a community, come together and talk about these people with the respect they deserve as someone suffering with a disease,” Darnell said. “Ashe is rural — when it affects one, it affects us all.”