Drug overdose ER visits in NC increased 22%

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While the state and the nation have been overwhelmed by the COVID-19 pandemic, the opioid epidemic has marched along its shadow.

Preliminary data from the NC Department of Health and Human Services says that hospital emergency room visits for drug overdoses in 2020 increased 22% over the previous year.

According to DHHS, heroin overdoses were the top reason people were treated in hospital ERs for drug overdoses. “Commonly prescribed opioids” were the third-most common reason for overdoses that led to trips to the hospital.

Ben Powell of SouthLight Healthcare, a substance abuse and mental health treatment non-profit in Wake County, said he considers the COVID-19 pandemic the overarching reason for the increase, and the anxiety and social isolation that have resulted as secondary factors.

Powell is a physician assistant who runs the SouthLight opiate treatment program under the guidance of the medical director.

Another factor is the rising prevalence of fentanyl, a strong synthetic opioid, being mixed with other drugs, Powell said.

There’s increasing concern “about the mix of drugs that are being placed into illicit substances that people are buying now,” he said. Many times, people don’t know that they’re using fentanyl, he said.

Powell referenced a 2017 paper out of the National Bureau of Economic Research that said that for every 1% increase in unemployment, the opioid death rate per 100,000 increases 3.6% and the rate of opioid overdose ER visits per 100,000 increases 7%.

Information on drug overdose deaths in 2020 was not available, but the CDC said in a December press release that the COVID-19 pandemic appeared to be leading to increased deaths.

More than 81,000 people in the country died of a drug overdose in the 12 months that ended in May 2020 the CDC said, more deaths than in any 12-month period in recorded history.  The data suggested that overdose deaths were increasing with the pandemic, the CDC said.

Complete data on overdose deaths over those 12 months in North Carolina was not available.

Before COVID-19 killed more than 2 million people worldwide and devastated economies, opioid addiction was the most prominent public health challenge that focused the attention of the state and the nation.

The week’s top stories on Policy Watch

1. Experts warn of pandemic-relatedeviction tsunami

Another round of stimulus payments or more creative solutions are essential to thwart a social crisis

With the first shipments of a second COVID-19 vaccine arriving as early as next week, many North Carolinians are feeling a new kind of hope as the pandemic stretches into 2021. But without swift government action at the state and federal levels, the new year could usher in an “eviction tsunami” and economic devastation, according to experts who gathered to discuss the problem Tuesday.

The virtual discussion, sponsored by the Duke Law Global Financial Markets Center and the North Carolina Leadership Forum, brought together subject matter experts from across the ideological spectrum to discuss the crisis of rent moratoriums and aid programs expiring in the new year.[Read more…]

2. DEQ’s Michael Regan is Biden’s nominee for EPA administrator

NC Department of Environmental Quality Secretary Michael Regan is the President-elect Joe Biden’s nominee for EPA administrator, according to multiple news sources.

Policy Watch reported yesterday that Regan was the leading contender for the job. A Goldsboro native, Regan has been DEQ secretary since 2017; he was appointed by Gov. Roy Cooper.

A DEQ spokesperson could not be reached for comment.

Regan worked at the EPA for nine years in the late ’90s and mid-’00s before joining the Environmental Defense Fund.

EDF issued this statement from Hawley Truax, Southeast Regional Director of Environmental Defense Fund (EDF). Regan previous served as EDF’s Southeast regional director. [Read more…]

Bonus read: Supporters, detractors grade Regan’s performance as NC DEQ secretary

3. Treasurer’s office, state auditor eyeing 100-plus cities, counties, utilities on “Distressed Unit” list

In a budget crisis, these entities can lose control of their finances to the state 

Janet Gerald, mayor pro tem of Kingstown, knew high sewer costs were a financial strain for the town when she was took office three years ago. Still, the realization that the town needed to relinquish control of its spending hit her hard.

“I was a little disappointed,” she said. “I was sad. I was heartbroken. I was embarrassed. I was crushed.”

Like dozens of towns and a couple of counties in North Carolina, Kingstown landed in financial trouble over problems paying for sewer services. The town, whose 680 residents live in a two-square-mile rectangle in Cleveland County, owes the city of Shelby upward of $200,000 for sewer services, Gerald said.[Read more…]

4. Black Americans are reluctant to take a COVID-19 vaccine. Efforts to build trust are underway.

A history of unethical medical experimentation on Black people has raised vaccine concerns among communities of color.

Coronavirus vaccines were a topic of the day for volunteers at Global Scholars Academy in Durham last Saturday. The church across the street, Union Baptist just north of downtown, was hosting a coronavirus testing site on one side of the school, and volunteers were distributing meals and Christmas gifts on the other side.

The FDA had authorized the Pfizer vaccine for emergency use the night before. Public officials and some residents have turned their hopes to science to help lift the country out of the deadly and economically devastating COVID-19 pandemic.[Read more…]

5. COVID-19 vaccine could be less effective in people with high PFAS levels in blood

The COVID-19 vaccine could be less effective in people with high levels of perfluorinated compounds — PFAS — in their blood, several scientists announced today.

High levels of PFAS exposure is known to be linked to a “plethora of adverse health effects,” including immune system disorders, said Linda Birnbaum, a toxicologist and former director of the National Institute for Environmental Health Science.

That means people with high levels of PFAS in their blood could have a weaker response to the COVID-19 vaccine, and build up fewer antibodies to the vaccine.

“It’s not that you won’t get any response, but that it could be decreased,” Birnbaum said.[Read more…]

6. Vaccine miracle offers model for tackling another giant crisis (commentary)

There are a lot of important lessons that Americans should glean from the mostly awful year that will soon and mercifully come to an end – some of them quite sobering.

We must recognize, for instance, that we still have many miles to travel in conquering the nation’s original sin of racism and that the ground on which our democracy rests is not as rock-solid as we long assumed.

And then there’s the painful reminder that mass willful self-deception — in which millions of humans are driven by fear and mistaken perceptions of self-interest to believe and repeat demonstrable lies —  must still be combated at every turn.

Happily, however, we’ve also received some more hopeful lessons, most notably about the power of truth and love and coming together as a community. [Read more…]

7. Education Secretary Betsy DeVos heads for the exits, leaving a legacy of turmoil

WASHINGTON— During her four years in office, U.S. Education Secretary Betsy DeVos failed to broaden her appeal beyond the moment she won a wild Senate confirmation fight by the closest of margins. She didn’t even try.

Instead, the billionaire Michigan native and Republican megadonor championed private and charter schools, often trying to funnel federal funding toward them. Her full-throated support outraged Democrats in Congress, riled the nation’s powerful teachers unions and never registered as a major priority for the Trump administration.

In higher education, she resuscitated for-profit colleges and wrote sweeping regulations on campus sexual assault to give more weight to the accused, generating an onslaught of criticism.[Read more…]

8. Mark Johnson’s rocky tenure comes to a close in familiar fashion

State Superintendent Mark Johnson will end his tenure this month the same way he started it four years ago – at odds with the State Board of Education.

The state board’s decision to require high school students and some middle school students to take End-of-Course exams in person during the pandemic is the most recent point of contention between the controversial superintendent and the board.

Johnson believes the tests should be waived, along with the rule that makes the exams 20% of a student’s grade.

“[SBE] Chairman Eric Davis and the next State Superintendent, Catherine Truitt, disagree with my position and have declared that the State Board’s EOC rule is in effect regardless,” Johnson wrote in an email he shared this week. “This has put your local superintendents, school boards, and principals in difficult situations without consistent guidance on how to proceed.” [Read more…]

9. Gov. Cooper’s pardons correct wrongful convictions of five innocent men

Gov. Roy Cooper issued pardons of innocence to five men, Ronnie Long, Teddy Isbell Sr., Kenneth Kagonyera, Damian Mills and Larry Williams Jr., according to a release from his office yesterday. It marks the first time he has used his constitutional power to pardon during his governorship.

Long, whose case has received the most public attention, spent the longest time — 44 years — incarcerated among the five clemency recipients. He was originally convicted of rape and burglary by Cabarrus County Superior Court in 1976 has already been released from custody but expected the pardon of innocence. The pardon clears his name and makes him eligible to seek compensation under state law. [Read more…]

10. Contamination prompts Colonial Pipeline to buy three homes near Huntersville gasoline spill

11. Weekly radio interviews and commentaries:

Click here for the latest newsmaker podcasts and commentaries from Rob Schofield

12. Weekly Editorial Cartoon:

Task force recommends new environmental justice positions at four key state agencies

The task force was named after celebrated North Carolina civil rights activist Andrea Harris, who died in May at age 72. (Photo: task force report)

One of the most striking disconnects between state agencies occurred last year when the Department of Commerce announced at a legislative committee that it supported the Atlantic Coast Pipeline.

Meanwhile, the NC Department of Environmental Quality, although it ultimately approved the permits, was concerned about potential damage to the environment and the communities that lay in in the pipeline’s path.

Duke Energy and Dominion eventually killed the project; DEQ has since rejected permit applications for an unrelated Mountain Valley Pipeline Southgate proposal. But there has been a consistent lack of continuity among agencies in considering environmental and social justice implications of their projects.

In a report issued this week, a task force told the governor that permanent environmental justice and inclusion positions should be created at the departments of Commerce, Transportation, Natural and Cultural Resources, and the Office of Emergency Management.

The Department of Environmental Quality already has such a position.

If the four agencies create new positions, that would require funding, likely through the legislative budget process. Or an existing position could be converted or expanded to address environmental issues.

The group, officially named the Andrea Harris Social, Economic, Environmental and Health Equity Task Force, was created earlier this year by Gov. Roy Cooper to study how the COVID-19 pandemic is disproportionately harming communities of color. The task force spent the fall pinpointing how the state needed to advocate for and assist these North Carolinians. Among them were expanding rural broadband, job creation, health care and environmental justice.

Polluting industries commonly locate in low-income neighborhoods and communities of color. And this pollution, particularly in the air, can cause or worsen respiratory illnesses. A Harvard study showed that exposure to fine particulate matter known as PM 2.5 increases the severity of COVID-19 symptoms and risk of death from the disease.

At dozens of public meetings about various environmental projects, community members have clamored for clean jobs rather than those created by polluting industries. The task force posed a similar question: Could we improve the economic development and health outcomes of a Tier 1 county without causing additional environmental burdens?

The four agencies that would create an EJ position routinely make decisions that can further burden these communities with pollution — or in some cases alleviate it.

For example, the Department of Transportation’s new toll road extension, I-540, routes through a low-income mobile home park.
Active Energy, a wood pellet plant in Robeson County, received a $500,000 building reuse grant from the Department of Commerce.

The Office of Emergency Management is key to helping these communities after a hurricane or flood; many of these neighborhoods are located in areas vulnerable to the effects of climate change. The Department of Natural and Cultural Resources is consulted when major projects route through Native American land; that agency is also over state parks and the Division of Land and Water Stewardship.

A second recommendation is for state officials to conduct an inventory of aging buildings — schools, senior centers and hospitals — that have radon, asbestos, mildew and mold contamination. Cleanup of those buildings could create jobs, the task force wrote.

Schools in Robeson and Edgecombe counties have been selected to test the proposal.

The “sick building” problem caused by legacy pollutants is due to delayed maintenance. “Nowhere is this problem more apparently than in NC’s public schools, especially those in hyper-segregated, concentrated poverty communities,” the presort reads. “Due to aging and poorly functioning HVAC systems, young people attending these schools are exposed to a host of chemical and biological contaminants that adversely affect their health and overall well-bing and their ability to learn.

“Reopening these schools amid the pandemic is likely to exacerbate the problem,” the report continues, “as buildings with poor ventilation, already a crucible for building-related diseases, can potentially become hotbeds for the spread of the coronavirus.”

The task force also recommended what is bound to be a heavy lift: that the legislature change statutes and rules to incorporate environmental justice into regulations. Since conservatives gained control of the General Assembly in 2011, environmental justice has been eroded, not strengthen, particularly in the annual Farm Acts.

“Legislation will be paramount to ensure our environmental justice ideals come to fruition,” the report reads.

The legislature convenes Jan. 13.

Congressman, State Senator talk “dire” state of COVID response, looming Supreme Court fight in town hall

“The situation is dire,” Rep. David Price (D – N.C.) told a virtual town hall Wednesday night. “I’m not going to sugar coat it in any way.”

The event, held by progressive group ActionNC, brought together Price, State Sen. Natalie Murdock (D-Durham) and progressive advocates to talk with North Carolinians about COVID-19, the future of the Supreme Court and what it means for health care and the Affordable Care Act.

Rep. David Price

“I can’t possibly overstate the magnitude of this loss,” Price said of the recent death of Supreme Court Justice Ruth Bader Ginsburg, calling her “a giant” who left a lasting impact on the law, women’s rights and voting rights.

The push by President Donald Trump and Senate Republicans to replace Ginsburg less than two months before the November election is a hypocritical “power grab” that threatens the legitimacy of the court, Price said.

It also imperils the Affordable Care Act, which Republicans hope to overturn through legal challenges.

“This November the Supreme Court will hear a case that could determine the future of the Affordable Care Act,” Price said. The outcome of that case could mean a return to patients being denied coverage because of pre-existing conditions, life-time caps on coverage and the loss of coverage for millions who have come to rely on it.

The rush to replace Ginsburg and constant assaults on the ACA are indicative of “the Republican Senate becoming a graveyard for so much that the country needs,” Price said.

Price and Murdock both said lawmakers — in Washington and in Raleigh — should instead be concentrating on helping Americans during an ongoing pandemic that has already claimed 200,000 lives and devastated the economy.

“North Carolina is facing billions of dollars in revenue shortfalls over the next few years,” Murdock said. “If Congress doesn’t pass a bill with significant aid soon it will force more devastating cuts to food assistance, unemployment benefits, health coverage and other support for struggling families, just when they need help the most.”

State Sen. Natalie Murdock

Price agreed, saying what’s been proposed by Republicans in Congress simply won’t get the job done.

“If they stopped to take one look around, they’d see Americans are clearing food bank shelves, facing threats of eviction and receiving unemployment benefits that don’t come close to paying the bills,” Price said. “They would see small businesses forced to close their doors as demand isn’t keeping pace. Americans can’t afford to wait or suffer any longer. They need a comprehensive relief bill, similar to the Heroes Act. And they need it now.”

Alexandra Sirota, director of the North Carolina Budget and Tax Center, said direct federal aid to people, state and local government is urgently needed.

“”Bolstering state and local infrastructure with federal funds can ensure that every community has what is needed to support families and sustain a response to COVID-19 and the economic downturn until recovery is secure,” Siota said. “North Carolina can’t afford to meet needs alone. The state has already allocated all of the previously provided federal dollars and still there are too many unmet needs, like rental and food assistance. Inaction by the Senate and White House will only extend the harm for people and prolong the downturn.”

The North Carolina Budget and Tax Center is a project of the non-profit North Carolina Justice Center, of which Policy Watch is also a part.

Black and Latinx people are most impacted by the pandemic and its economic fallout, said Mary Williams-Stover, executive director of NC Council for Women & Youth Involvement.

“The COVID pandemic is impacting everyone, but it’s not impacting us all equally,” Williams-Stover said. “All the data shows women are struggling with the aftermath of the pandemic more than men and Black women, who already faced the greatest employment and health care barriers even before COVID due to pre-existing health disparities, are significantly impacted by the pandemic.”

An April report by the Budget and Tax Center found Black people are about 22 percent of the state’s population but make up 38 percent of cases and 37 percent of COVID-infection related deaths. More than 13 percent of Black women in North Carolina are uninsured, ActionNC pointed out, making them particularly vulnerable.

The numbers for Latinx people were even more grim. They make up about 10 percent of the state’s population but 46 percent of COVID cases.

Both Price and Murdock emphasized the need for the North Carolina General Assembly to expand Medicaid in the state. Their refusal to do so has prevented North Carolinians from accessing care that would otherwise be available to them even as other Republican-led states have opted for expansion, they said.

That’s particularly dangerous during a pandemic that imperils both peoples’ health and their economic stability, Price said.

“I’ve always said – and economists of all stripes will back me up on this – the danger is never doing too much,” Price said. “The danger is doing too little.”

New poll: Closing the coverage gap is wildly popular in North Carolina

In case you missed it, 75% of North Carolinians support closing the coverage gap, according to results from a poll commissioned by Care4Carolina — a coalition working to improve health care and expand access in North Carolina. The survey of 612 registered voters, conducted by Harper Polling and The Stewart Group from August 26-27, found that a solid majority want to ensure that more have access to health care, while only 16% oppose. This support is not limited to singular political ideologies as 64% of self-identified Republicans, 76% of unaffiliated voters and 83% of Democrats favor closing the coverage gap in the state.

Amid a global pandemic that has claimed the lives of nearly 200,000 Americans and has infected almost 180,000 North Carolinians, voters in the state continue to recognize the importance of health care access. Most voters see dealing with COVID-19 as the most critical election issue of the 2020 cycle with 61% believing that closing the coverage gap is of significant importance.

Since 2010, the General Assembly has refused to adopt Medicaid expansion, intentionally leaving at least 600,000 of our neighbors without access to quality health care. Even in the midst of a pandemic that has robbed 1.1 million North Carolinians of their jobs, a further 367,000 losing their employer-sponsored health insurance, which pushed 178,000 more into the coverage gap, leaders in the General Assembly have refused to allow legislation to move forward to address this crisis. In fact, during the recent floor debate around HB 1105, Representative Donnie Lambeth, the primary conservative sponsor for closing the coverage gap, proclaimed that the state could not expand Medicaid because the program itself was going through transformation and was broken. This thinking does not seem to square with the rest of North Carolina, let alone his home county. Voters in Senate District 31 (Forsyth and Davie) approve closing the coverage gap 69 % to 26%.

Why do legislators continue to deny expanding Medicaid when voters continue to support it? This past short session addressing state needs around the pandemic was an incredible opportunity to expand Medicaid. Too many North Carolinians are wondering what they would do if they get sick and need access to health care. A $335 check is not going to provide the working mother of one, earning minimum wage, the health care she needs. It is our sincere hope that during an economic downturn caused by a global pandemic that our state leaders would come back to session and do what is right by their constituents. They need to expand Medicaid.

You can find the full poll results here.

William Munn is a policy analyst in the the North Carolina Justice Center’s Health Advocacy Project.