BRUNSWICK COUNTY — As North Carolina continues to fight an opioid epidemic, Brunswick County residents, who have high rates of opioid prescriptions, will soon have access to another line of care with one of Trillium Health Resources’ six new mobile care units.
According to N.C. Department of Health and Human Services data, more than 28,000 North Carolinians lost their lives to drug overdose between 2000 and 2020.
Beginning in January, Trillium will partner with Wilmington-based nonprofit Coastal Horizons, an addiction treatment center, to operate two mobile health clinics in coastal N.C. counties for patients with Medicaid or who are uninsured.
With a population of just over 136,000, 13.5% of the Brunswick County residents under the age of 65 did not have health insurance as of 2020, according to the U.S. Census Bureau. That’s higher than the state average of 10.2%.
“The goal of the mobile clinics is to decrease barriers related to accessing care for the underserved and rural communities in order to promote health equity for all,” Trillium vice president of innovative development and member solutions Christie Edwards said.
Coastal Horizons reported treating 1,706 active patients for mental health or substance abuse disorder in Brunswick County in 2020.
The mobile care unit will visit Brunswick County once a week with locations, times and dates to be determined based on needs within the community. Trillium and Coastal Horizons will partner with county stakeholders and community members to determine the best route and schedule for people to access these services.
Brunswick, along with the other counties, was selected based on its “high percentage of historically marginalized populations who have a need for increased access to care,” Edwards explained.
According to a news release, the pandemic offered Trillium a reminder of “health care disparities experienced by people of color, rural residents and Medicaid-insured individuals across the 27 counties [Trillium serves].”
Brunswick County is considered to be at high risk for deaths associated with opioid use disorder, according to N.C. Department of Health and Human Services. As it is one of the top 10 North Carolina counties with the most individuals prescribed opioids; 18.4% of Brunswick County residents receive pills, compared to 13.7% statewide.
In 2019, a Brunswick County community health opinion survey identified drug misuse as the greatest health concern and area needing the most improvement.
As mental health and substance use disorder issues continue to rise, particularly amongst historically marginalized demographics, emergency rooms are being flooded with patients. According to the Journal of American Medical Association, emergency department visits for mental health conditions, suicide attempts, drug and opioid overdoses, domestic violence, and child abuse and neglect were up in mid-March through October 2020, during the Covid-19 pandemic, compared to the same period in 2019.
The goal of the mobile unit is to offset the need for patients to use emergency rooms for access to healthcare. In 2020, Brunswick County’s rate of overdose emergency room visits was 79.8 per 100,000 residents in 2020, which is lower than the state average of 142.5 per 100,000 residents.
Trillium and Coastal Horizons have partnered in the past, most recently opening a new Opioid Treatment Program in Shallotte this past August. The medication-assisted treatment program serves Brunswick County residents suffering from opioid addiction.
According to the Trillium press release, the mobile clinics could also offer medication-assisted treatment for individuals experiencing opioid addiction in the future.
Trillium launched its first mobile care unit earlier this year, partnering with PORT Health to serve Chowan, Perquimans and Pasquotank counties. With roughly $1.4 million from the federal Substance Abuse Treatment Block Grant, distributed by NCDHHS, Trillium can now serve 16 counties in total with its new mobile health clinics.
“The initial mobile clinic has been very successful so when additional funds became available, Trillium was happy to be able to expand this model to additional communities,” Edwards said.
Specific services may be tailored for each of the mobile units but should include mental health screenings, general health checkups, vaccinations, substance use disorder treatment, traditional therapy, assertive outreach, medication management via telemedicine, care management and peer support.
According to Edwards, the primary services delivered through the current mobile unit are outpatient therapy and medication management.
“If provider locations are not accessible or available, people often miss basic treatments or procedures for preventable conditions,” Trillium executive vice president Cindy Ehlers said in the release.
Additional partnerships and coverage of the six new mobile care units include:
- Monarch serving Halifax, Gates, Northampton and Nash counties;
- PORT serving Dare and Carteret with one unit; and a second unit will provide disaster relief to work with shelter response efforts after hurricanes;
- Coastal Horizons will also have a unit to serve Bladen County;
- RHA will serve Beaufort, Hyde, Tyrrell and Washington counties (including Ocracoke Island).
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