Lack of treatment more of a problem than sentencing options in NC opioid epidemic

Treatment options for North Carolinians with addiction are woefully inadequate.

That was the conclusion Tuesday at a task force meeting on sentencing reforms for opioid convictions. The meeting began with a presentation from Duren Banks, of RTI International, who was tasked with examining policy changes in North Carolina to help curb the heroin epidemic.

According to her research, there has been a 31 percent increase year-over-year in emergency room visits due to opioid use and North Carolina is leading the southeastern states in the increase. About three North Carolinians die from an overdose each day.

In terms of policy change considerations to lesson the impact, Banks wrote that discrimination of opioids is important — 10 ounces of fentanyl is much different than 10 ounces of heroin.

She also wrote about the importance of treatment and diversion to treatment instead of punishment, encouraging medically-assisted treatment prior to release from jail and linking offenders to treatments (and continuing medically-assisted treatment) post jail.

“Addiction is a disease,” her report states. “Punishment for a disease does not work, and might do more harm than good.”

There didn’t appear to be a lot of disagreement from stakeholders at Tuesday’s meeting, but there was a lot of practical concern about the lack of treatment options in the state.

Judge W. Todd Pomeroy, a superior court judge for the 27th judicial district (Cleveland and Lincoln counties), said it’s typically 90 to 120 days for treatment availability and the re-offense rate for someone in the throes of addiction is every few days.

He said it’s nice to talk about sentencing legislation, but if addiction is not addressed at the front end, it’s not going make a difference.

“I had someone last week – the next available bed [for treatment] is all the way at the end of June, so what do I do with that young lady until the end of June?,” he asked. “Am I punitive and leave her in jail for 110 days after she’s already been in there for 90 days and her maximum sentence is five to 15 months? Do I let her out and put her on electronic monitoring? I know where she is but I don’t know what she’s doing. Do I have her drug-screened twice a week by probation? She’s going to test positive. So then what do I do with her?”

Pomeroy said he frequently uses the Black Mountain Substance Abuse Treatment Center for Women and praised the dedicated people there, but said there are only about 60 beds and 15 staff members.

“How many women in this state do you think have an addiction to opioids?” he asked. “More than 60. That’s where the issue is. That’s where the rubber meets the road. I can have all the discretion in the world, but when I don’t have discretion to put someone somewhere immediately, it’s meaningless.”

Julie Honeycutt, director of Hope RX in Henderson County, said she lost her 20-year-old daughter to an opioid overdose and agreed that sentencing means nothing without treatment. She recalled choosing to leave her daughter in jail once for 18 days pending treatment availability.

“[People with addiction are] not able to walk out the door and seek the treatment they need; they’re not able to go out and do what they need,” she said. “They need navigation, they need case management — I know that’s a big drag on our resources, but we need more of that hand-holding to go on to help these people get to the services they need.”

She also said she’d like to see more resources offered to people in the jails because she believes that’s where there can be a big change. She and judges at the meeting also acknowledged that jail is where a lot of individuals with addiction go because there is no other place for them.

“I’d rather them sit there and go from A to B, because you let the walk out the door, they’re going to fall right back in to the gully,” Honeycutt said. “We need to make sure we stop that and we spread that net and stop that from happening.”

Insurance can also be a major barrier for those seeking treatment.

Christen Linke Young, Deputy Secretary for Policy and Operations at the Department of Health and Human Services, said that 90 percent of people entering incarceration are uninsured. Greater access in North Carolina to insurance could go a long way in battling the epidemic, she added.

Banks also pointed out that New Jersey passed legislation last year that mandates insurers cover 180 days of treatment without pre-authorization, which can add to the waiting period.

Mike Cannon, of Wilson, warned the task force that if they don’t do something soon, the epidemic would get worse. He lost his son to a heroin overdose in 2015 and has since spent time talking at schools and churches.

He said most of the kids (junior high and high school aged) he talks to report either using or knowing someone who uses alcohol and marijuana on a regular basis; about 60 to 65 percent report the same about pills and about 25 percent report the same for heroin use.

“Our kids are in trouble — we’re losing kids every day,” Cannon said. “We’re seeing this epidemic explode.”

Nothing was decided at the meeting and lawmakers said they planned to reconvene after the short session, which begins May 16. They plan to address the drug trafficking — the appropriate definition and sentencing guidelines — at the next meeting.

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