Guilford partnership works to stem rise in opioid deaths

Guilford County is experiencing an increase in opioid overdose deaths and emergency department visits, according to county and state data. Guilford County Solution to the Opioid Problem, or GCSTOP, is a partnership between Guilford County Emergency Services and the University of North Carolina at Greensboro that provides education and outreach about the opioid epidemic. Wake Forest University student Jeff Kirkpatrick spoke with program director Michael Thull about the initiative for WFDD.

Interview highlights

Thull begins with a discussion about the origins of GCSTOP:

"The program started in 2018 with our Post-Overdose Response Team (POST) ... That branch of what we do is when EMS and Guilford County responds to the scene of an overdose, the paramedics on scene offer folks who have survived overdose the opportunity to have someone from our team, someone with lived experience, to follow up with them to offer counseling, support, we provide the medication Narcan, which reverses an overdose, for them to have on hand. Today we operate one of two syringe service programs in Guilford County. We have a hepatitis C bridge counselor. And then lastly, and of our fourth arm, our justice-involved program. In North Carolina, folks are 40 times more likely to suffer a fatal overdose in the two weeks following release from prison or an abstinence-based treatment program. So getting to folks while they're incarcerated and trying to connect them with resources has been really important."

On why opioid and other drug-related deaths have been rising in Guilford County:

"We tend to see a lot of clusters near these transportation zones, essentially, so many people travel through and to Guilford County. The other thing that we see a lot, just kind of anecdotally in terms of the services that we're providing, is even though GCSTOP provides services only in Guilford County, a lot of the folks that we're interacting with we find our traveling to us from surrounding counties. For instance, there are five counties that adjoin Guilford. Of those five, Forsyth County is the only county that operates a syringe service program similar to ours, Twin City Harm Reduction. So we see a lot of folks from Rockingham, Alamance, Randolph County, Davidson County, folks who are traveling to Guilford County, the closest urban center for medical care or resources. That also tends to be inflating those numbers. The other thing that we're seeing really has, I think, a lot to do with the drug supply itself. We see these trends nationally and in North Carolina as well. The drug supply is contaminated with fentanyl. In a lot of cases, it's only fentanyl that people are able to obtain. And we're seeing an influx of the veterinary drug Xylazine in our drug supply, and Xylazine is a drug that does not respond well to Narcan. So we're seeing a nationwide increase in serious overdoses."

On reaching out to young people:

"One of the things that we're seeing — which has been encouraging and heartbreaking simultaneously — is that a lot of educational institutions are reaching out, wanting to engage in conversations, particularly about fentanyl and how it's showing up, not just in drugs that people inject like heroin, but showing up in the form of pills and things that young adults and teenagers, in particular, may not see the danger in them. This you know looks like Xanax, but in actuality, it's pressed fentanyl. And really encouraging folks — parents, in particular, community organizations — to have very frank conversations about substance use. I see the community starting to coalesce in that way of saying yes, this is really an issue. And it's going to mean equipping people with the knowledge of the dangers that are there and the tools to make sure that those dangers are not fatal."