‘It doesn’t happen overnight’: New Hanover County working on more solutions to opioid crisis, Novant seeing success with medication assisted treatment

“This is a significant change in what our options are to treat these patients,” Dr. Brandon Smallwood said.
‘It doesn’t happen overnight’: New Hanover County working on more solutions to opioid crisis, Novant seeing success with medication assisted treatment
Published: Aug. 16, 2023 at 6:16 PM EDT|Updated: Aug. 17, 2023 at 9:34 AM EDT
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NEW HANOVER COUNTY, N.C. (WECT) - The opioid epidemic has impacted communities across the country. Now, millions of dollars in opioid settlement money are being used for possible solutions to the crisis.

“We do know that New Hanover County has sort of had a little higher rate of deaths associated with opioids. And I’ve observed that, you know, working in the ER over the last several years, I think in particular with COVID-19, it just even intensified even more,” Dr. Brandon Smallwood, an emergency room physician at Novant Health New Hanover, said.

Smallwood has had a front row seat to the opioid epidemic for nearly a decade.

“So you’re looking for opportunities about what can we do differently. And in the emergency department, you know, we have a history of when patients came in previously, there was not a whole lot that we could offer other than, you know, connect them to outpatient resources. And, you know, you might give them Narcan and rescue them from the overdose and then they would follow up with someone out in the community, and we would wish them the best,” Smallwood said. “But with some research that’s come through the emergency department concerning medication assisted treatment, which is MAT, we know that we’re at a unique opportunity for a patient who is in crisis, whether it’s an overdose, or they just need help with opioids, maybe they have an abscess in their arm related to IV drug use. That gives us an opportunity now to be their help.”

Without this treatment and extra attention to the patient, only about 20 percent of those patients actually follow through with care. With the new MAT program, they’re seeing about 70 percent of patients follow up and get that continuous treatment.

“So, our program is focused that identifying those patients and offering them medications that have been shown to decrease death from overdose and just decrease death related to opioid use in general,” Smallwood said. “What’s really great about medication assisted treatment in the emergency room is we can intervene, a lot of times at the time in the emergency department, we can assess them, we can evaluate them, if they’re the appropriate patient for our program, we will start them on the medicine in the ER, and we’ll observe them for about an hour. And if they’re doing better, then we can go ahead and write them a prescription for 7-10 days worth whatever we feel is necessary. And then we’re going to connect them as best we can with someone to follow up with. So it’s really at the time of care, which is a really amazing opportunity for us.”

This program, just one of many efforts to help with the opioid crisis in our community.

Jennifer Rigby, Chief Strategy Officer for New Hanover County, says they’re working on more solutions, like expanding the MAT program at the New Hanover County Jail.

“We have funds dedicated to support the building a new treatment facility. If you recall, there was a facility here called The Harbor that closed a number of years ago. And so, there’s an effort to reopen, kind of Harbor 2.0, if you will. We have funds allocated for education and outreach, really to help folks know the warning signs and help folks know when they might want to think about getting help or getting a loved one help,” Rigby said.

Rigby hopes more education will eventually help break down the stigma around substance use disorders.

“I think it’s important to take a step back and look at the root causes of opioid use and substance use disorders. And I think when you do that, you look at mental health. And really, we’re in a mental health crisis and many communities are after COVID, certainly in a mental health crisis. New Hanover County established mental health and substance use disorder fund,” Rigby said. “We’ve looked at it from a very comprehensive perspective, we’ve brought in a lot of stakeholders from across the community, a lot of partners, nonprofit partners, law enforcement partners, health care providers, so that we can really look at creative and innovative ways to address this.”

So far, the county has $50 million in an escrow fund from the hospital sale, $18 million from opioid settlement money, and an additional $18 million dollars through another litigation effort.

“It doesn’t happen overnight. And so, we’ve put together a comprehensive strategy focused, it’s a five-year strategy, and it’s focused on kind of before an individual finds themselves in a crisis, during that crisis, the support that they may need, and then after they’ve come out of the crisis received treatment, the type of support that they need to maintain their overall well-being,” Rigby said.

Both Rigby and Dr. Smallwood say community partners working together are what helps make a difference.

“This is a significant change in what our options are to treat these patients. And when you work in the emergency room, your goal is saving lives,” Smallwood said.