He met with reporters this morning before giving the commencement address at Halifax Community College.
“More people die in North Carolina every day from drug overdose. Drug overdose is now the number one cause of accidental death in North Carolina, more than car crashes,” he said in response to questions on the matter posed by rrspin. “It’s the first time in decades that anything other than car crashes is the number one cause of accidental death.”
Stein said the problem is evolving. “It primarily starts with prescription opioids, Oxycontin, Oxycodone and others. People get addicted either because they get it prescribed to them or they may be a young person who goes into their parents medicine cabinet and takes them as extra pills and then they get addicted that way. Eighty percent of people on heroin start out with a prescription drug addiction.”
What’s happening now in the state, Stein said, “Is we’re seeing a bit of a transition from prescription pills to heroin and a chemical analog called Fentanyl and those are highly deadly. The number of deaths that result from overdose of pills has been fairly constant for the last five to eight years, about 500 people a year. But if you look at the number who are dying from Fentanyl and heroin overdoses it’s like a spike. Last year was the first year that more people died from heroin and Fentanyl than died from prescription pills.”
What that has created, he said, is “a real crisis on our hands and it’s going to require a multifaceted long-term approach and a long-term commitment to address it.”
He said said he believes the comprehensive solution hinges on prevention, treatment and enforcement.
“On the prevention side, we have to do a better job of educating young people about the risk. Survey data shows most young people think that a prescription drug isn’t as dangerous because it’s from a doctor. One out of every five eleventh graders last year reported taking prescription drugs of which they were not prescribed which is highly risky.”
Stein said the state has to do a better job having doctors and dentists prescribe more smartly. “There’s just too many pills out there. There were 10 million scripts written last year, 700 million pills, the majority of those pills are just sitting in medicine cabinets and that’s where they can get diverted by young people.”
The number of people getting addicted, he said, can be reduced by doctors and dentists prescribing smarter.
“We have to invest more resources as a county, as a state, as a city in drug treatment.
When I talk to law enforcement agencies what I hear over and over again is that we will not arrest our way out of this problem. This is a demand problem as much as or more than it is a supply problem.
“We have to help people stop being addicted because there are hundreds of thousands of North Carolinians with an addiction, not all heroin or opioid addiction. But only one out of 10 people who had a substance use disorder last year got any kind of treatment. We would not accept it if 90 percent of people with heart disease or diabetes did not get medical care but we do somehow for substance abuse disorder.”
Stein said substance abuse disorder is an illness, “a chronic illness, it changes your brain chemistry so we have to do more in treatment.”
Legislation called the Stop Act is proposed to address smarter prescribing and it appropriates more money for treatment.
The third element, enforcement, he said, “Means making sure we give local law enforcement the tools that they need to effectively fight this crime because there are drug trafficking organizations that are making millions of dollars on the death and misery that they create in our state and they need to be punished.”
The proposed Synthetic Opioid Control Act is designed to close loopholes in the state’s controlled substances laws to deal with the development of Fentanyl. “It was a particular analog of Fentanyl which was responsible for 77 deaths we know of in North Carolina last year.”
The particular analog, he said, is not illegal under state law. “We need to make sure that we update our laws to deal with all these new variations. It used to be that opium and heroin came from the plant, the opium poppy. Now it comes from a chemistry lab and we’ve got to make sure the laws reflect that because it’s exceptionally dangerous.”
Fentanyl, he said, is deadly. “Fentanyl the size of a grain of salt can kill you. It’s that potent. It’s 50 to 100 times more potent than heroin.”
On the enforcement side, he said, “One thing I do is I can approve wiretap applications and wiretaps when there’s probable cause are very effective tools at going into the heart of these trafficking organizations. Once you get into their electronic networks you just see how the web goes out there.”
Stein said he is currently meeting with law enforcement to determine their needs. “I look forward to hearing from local law enforcement about what they need from the state and I will go fight for them to make sure they have the tools that they need.”