And the need is growing, said Tish Shrader, a registered nurse and clinical supervisor in the Emergency Care Center of Halifax Regional.

Shrader was one of several speakers at an opioid epidemic community forum last week sponsored by the Roanoke Rapids Police Department.

“The need is growing. The dependence is getting worse,” she told the audience at Kirkwood Adams. “Patients are becoming more demanding and aggressive regarding their expectation that we will provide them with, or prescribe them narcotics.”

Because of this Halifax Regional has implemented a chronic pain policy. “We encourage patients to be seen by their primary care providers to manage chronic pain or to be referred to a pain clinic.”

The providers have access to the North Carolina Controlled Substance Database to see whether patients have been prescribed narcotics recently, including the type and quantity of the medication. “This has helped drive down prescriptions and, in turn, reduces the saturation of narcotics in the community,” she said.

But there are repercussions. “There are many people out there with legitimate health problems who need narcotics to manage their pain. Prescription drug abusers have made it harder for the ones who truly need the medications to get what they need.”

Shrader said in 2015 Halifax Regional saw 238 patient visits coded as illicit substance abuse and use for cocaine, heroin and other opioids. Fifteen of those visits were related to heroin.

Last year, Halifax Regional saw 353 visits with 24 related to heroin. “That’s a 67 percent increase in overall visits and a 62.5 percent increase in visits related to heroin.”

This year, Halifax Regional has seen 222 visits — 14 directly related to heroin. “That averages out to be approximately 30 patient visits per month and puts us on target to see about the same amount of visits as we did last year.”

Shrader commended law enforcement for its efforts for sponsoring drug drop-off days to get prescription medication out of homes.

“We see all sides of the issue in the emergency room,” she said. “We treat the patients affected by opioid use and abuse, whether it is intentional or otherwise.”

While Halifax Regional doesn’t currently have inpatient detox, it refers patients to nearby centers such as Coastal Plain in Rocky Mount, RINC in Henderson and others in Ahoskie and Greenville. “Halifax Regional does offer support and resources for substance abusers, as well as their family members. And family members of drug abusers are often forgotten collateral damage. They need support resources as much as the drug abuser.”

Deborah Marshall, an ER colleague with Shrader, is also part of the Celebrate Recovery jail ministry at the Halifax County Detention Center.

She sees addiction from inside the emergency room and inside the jail.

“I have been called out of the ER to a vehicle with someone not breathing on many occasions,” she said. “Their aces gray with no visible signs of life … You wheel them in, start an IV, give them Narcan and pray that it will work and that this will be the time they learn from their mistakes and will decide to change.”

They wake up confused and fighting, Marshall said.

While relieved the person has come around and given a second chance, “ … Then immediately they want to leave and you give them all the reasons they should stay and get help and they just want to walk right out the door to chase their next high.”

Marshall uses these opportunities to talk about Celebrate Recovery, AA and NA. “ … Unfortunately they have to want to change and there lies the problem. You can have all the resources in the world, but if they don’t want it, they will return to the same lifestyle.”

The jail ministry gives her another opportunity to reach out. “ … Most of them are not going to walk into a church service because of the fear of judgment and shame they have built up. So I go and meet where they are.”

On the law enforcement side, seizures of heroin have increased, Chief Chuck Hasty said.

In 2013 82 dosage units were seized. The following year 127 dosage units and 17.8 grams of heroin was seized.

With the advent of the City County Drug Task Force, the police department and task force seized 417 dosage units and 86.1 grams of heroin in 2015.

Last year 2,485 dosage units and 71.1 grams of heroin was seized. As of July 31, 34,851 dosage units and 6 grams of heroin have been seized.

The police department has administered Narcan more than 40 times since first carrying it in 2015 and on July 25 the police department field-tested seized drugs and it tested positive for heroin and Fentanyl.

District 6 Chief District Court Judge Brenda Branch said during a question and answer period, the problem is not just one of the streets and broken homes. “It’s also someone sitting in your home reading. Not all drug addicts are coming from the streets. They’re coming from everybody’s home. I see different types coming into my courts.”