PENDER COUNTY — Pender County officials discussed the allocation of national opioid settlement funds at the county commissioners meeting Monday, reviewing both achievements and struggles in the county’s ongoing fight to address the opioid epidemic.
READ MORE: Tri-county anticipating an additional $30M in opioid funds
The National Opioid Settlement is the outcome of nationwide litigation against manufacturer Johnson and Johnson, as well as three of the country’s largest pharmaceutical distributors — Amerisource Bergen, Cardinal Health, and McKesson. Of the $26 billion agreed upon in the July 2021 payout, North Carolina will receive $750 million over an 18-year period. The North Carolina Association of County Commissioners signed a memorandum of agreement with all 100 North Carolina counties and 47 of its municipalities to govern the distribution of the funds. Disbursement began in the second quarter of 2022.
According to Pender County Health and Human Services Director Carolyn Moser, Pender has so far received $489,000 of the $6,816,000 designated to the county over the next 18 years. According to Moser, none of the county’s money has been used to date and officials still have to decide the breakdown of funding.
However, a Pender County Substance Abuse Prevention Team has provided recommendations to the commissioners. The team includes members from county’s health department staff, EMS, sheriff’s office, Pender Memorial Hospital, Pender County Schools, and addiction treatment center Coastal Horizons. They recommended funding be used in three areas:
- Early intervention — including substance abuse training of adolescents and parents
- Recovery support services for individuals in recovery, treatment, or remission
- Evidence-based addiction treatment, focused on medication-assisted treatment
“Our substance use prevention team worked hard to gather information to make informed, responsible decisions on recommended strategies,” Moser told Port City Daily.
Moser recommended the funds go to agencies beyond the health department that provide the three strategic recommendations of services; however, she wasn’t specific on which. The health department, she explained, offers support in the guided areas of strategic planning and explained the prevention team has been “pulling money from other health department accounts to cover” time.
Pender County Chari Jackie Newton specifically asked which agencies would benefit and where the intervention programs would be managed and administered.
“Who is responsible, where does the buck stop?” she asked
“That’s what the RFAs would tell us, we aren’t the authority,” Moser answered. “We would like to hear their proposals and see how they suggest dealing with early intervention.”
Newton cut her off to ask: “They who?”
“I do not know who would apply for the funding,” Moser said. “It would be solely for Pender residents.”
The next step is for a request for application (RFA) for agencies to be considered for grant funds. The county commissioners would be required to approve the RFAs in three-year terms. The prevention team would provide ongoing monitoring to assess the quality of grantees’ services.
According to Moser, there is not yet a projected date for the initiation of the RFA approval process.
However, she advocated a conservative approach to distributing settlement money, arguing the county should refrain from spending the entirety of the funds.
“Our intent is not to spend all of the money, our intent is always to leave funds in that settlement fund in case something were to come up that would seem like a really good benefit to everyone,” Moser said.
Moser presented to commissioners Monday the county’s team outreach so far and gave background information on overdoses in the county. According to the North Carolina Department of Health and Human Services, 32 Pender County patients suffered an EMS suspected opioid overdose from July 2022 to June 2023, an increase from 17 suspected overdoses the previous year. Moser said males between the ages of 25 and 54 represented the largest risk group for opioid overdose; the 65-and-older demographic still represents around 15% of overdoses.
Thirty of the 32 suspected opioid overdose encounters received Naloxone — also known as Narcan — of which 29 (97%) had an improved response. Moser described the county’s use of Naloxone, an opioid antagonist medication designed to rapidly reverse overdoses, as a major success of prevention. But while a growing number of professionals, such as Pender County school nurses, have been taught how to administer the medication, limited availability of the drug presents an ongoing problem.
“One of our concerns has been about the availability of Naloxone in the community,” Moser said in the meeting. “It is available at pharmacies, but you have to pay for it, and it’s between $30 and $40. So that’s a deterrent right there and adds another access issue for us.”
The health and human services director said it generally takes more than one dose, sometimes up to three or four, to rouse an overdosing patient. This presents a significant cumulative expense.
Moser identified other issues in Pender County’s overall approach to addressing opioid abuse, including statistical delays, inadequate transportation for residents, and the absence of a post-overdose response team. This group responds to individuals between 24 and 48 hours after EMS is called to assist in an overdose and work with a patient on receiving treatment.
For example, last year the City of Wilmington gave $750,000 to expand Coastal Horizons’ Cape Fear Opioid Overdose Quick Response Team. It helps connect people who have overdosed with treatment options within 72 hours of the incident.
ALSO: $750K to expand city’s opioid response team, help reduce repeat overdoses
Another problem Moser presented was the absence of substance-use education and intervention for individuals in jails, as well as a shortage of “case navigators,” social workers who help former inmates connect to substance abuse prevention programs, which may include housing, food, and job training assistance.
“What you see is, once individuals are in the jail and no longer using any kind of substance, and then they leave the jail, they just assume they can go back to the same dose of opioid or any other kind of substance that they were on when they entered the jail — which is why several of these individuals will overdose and die once they are out of jail,” Moser explained.
She argued case navigators help prevent substance abuse relapse among former inmates.
Moser described the lack of affordable housing, “especially in terms of affordable rental housing,” as a root cause contributing to opioid abuse.
Newton responded to Moser’s presentation by urging more immediate, concrete action.
“One of the guiding principles that I believe ought to be our mainstay is spending this money to save lives,” the chair said at the meeting. “It is not a slush fund, it is not a rainy day fund, it is not a reimbursement fund, it is a fund to save the lives of people who live in Pender County. We need to spend the money. I’m not a fan nor a proponent of waiting to see and group-thinking this thing to death.”
Tips or comments? Email journalist Peter Castagno at peter@localdailymedia.com.
Want to read more from PCD? Subscribe now and then sign up for our morning newsletter, Wilmington Wire, and get the headlines delivered to your inbox every morning.
