Greensboro, N.C. – Governor Pat McCrory joined law enforcement officers, first responders, legislators and health care officials today at the Guilford County Sheriff’s Office to sign legislation making naloxone, a life-saving opioid reversal drug that has already saved 3,300 North Carolinians, more accessible.

The legislation represents an early accomplishment of the Governor’s Task Force on Mental Health and Substance Use, which delivered a report to Governor McCrory in May recommending expanding capacity for opioid treatment services, medications and overdose prevention, such as naloxone.

Beginning at 2 p.m. today, pharmacies in North Carolina will begin making naloxone available without a prescription. North Carolina is the third state in the country to issue a standing prescription order statewide for naloxone.

McCrory signs bill widening access to overdose antidotes
News & Observer 6/20/16

The final trigger for me, to write about what a colossal job NCHRC is doing, how pronounced their accomplishments are, was their Legislative Day at the General Assembly-Law Enforcement and Community Summit on Heroin in North Carolina, May 12th. I saw Police Officer after Police Chief after Sheriff after State Bureau of Investigation Special Agent! (Ret.), get up and talk about their efforts to grow and support naloxone use by the troops as just a beginning gambit in supporting people toward recovery. Ret. Police Chief Jim Johnson, of Huntington, VA, told a compelling tale of his reversal; how he traversed from classically dead set against these ideas (“a staunch opponent of needle exchange”), through horrific addiction (the “communities’ youngest overdose death was 12 years old and oldest was 77”) to complete promotion of these ideas “because they work”. As a guy who’s been on the other side of the law, who’s regularly broken out in the hives most of you call hand-cuffs, this was inspiring. We are now on the same side working together!

Allow me to repeat-I’m not a bleeding heart. The Police aren’t hired to necessarily be Social Workers which is my way of saying they have a job to do. I have nothing against consequences for bad actions, but these are drastic times and they call for different approaches. And-we have proven we cannot incarcerate our way out of addiction.

Allow me to back up a bit.

Early on-starting some twenty years ago- my work was in homeless agencies and they often had a Harm Reduction wing. An agency I worked at for 8 years received the first Open Society Harm Reduction grant issued in the USA. It went out to three cities, as a trial project, to be expanded as they showed success. This put me into a learning curve that was challenging to my innate belief structure. I want to elaborate but first I need to say; though this Open Society approach had some new ideas, harm reduction (HR) is as old as Hippocrates. A Physician of Classical Greece considered the Father of Western Medicine, he preached the Hippocratic Oath, still in favor today. The Oath was a paper written sometime around 400BC (we think) it is summed up as, “First, do no harm”.

To my eyes, harm reduction really hit with the founder of modern nursing, Florence Nightingale. It’s the nurses who bring harm reduction to the people, especially for the indigent. So harm reduction is nothing new. Applied to substance use treatment, it’s true that all manner of treatment programs would not “tolerate” resuming drug use, “relapse” they called it, and ask them to leave. To kick someone out of treatment, for doing what they do, seems foolish now with hindsight, but was the norm back 30 years ago. Also, if someone’s not really in recovery than they didn’t really relapse, so that word is considered passé and no longer useful. Return to use is the phrase now. This illustrates a way harm reduction can and has entered the field, in some cities, but it has grown into much more, starting with needle exchange and moving to naloxone dispensers. This is where my learning curve began and I originally felt internal resistance to HR.


The only thing that matters is: not my internal belief structures but that, like ROSC in general, these directives actually work. Needle exchange does not just reduce HIV transmission-it definitely does that-BUT ALSO significantly reduces accidental needle-sticks for arresting officers. That alone is reason to do it. Plus, if they are signed up in the program then they are engaged. That becomes the portal to services and treatment options for people using drugs. Trained staff can keep their eyes and hearts open for that window of opportunity that means movement toward a fuller recovery. You understand, it takes caring and skillful people to do that work and NCHRC is made up of just such people. That means more people getting into more recovery earlier. Harm Reduction! What a concept.

Now we’ll back up again, because the real picture is Law Enforcement Assisted Diversion Programs (LEAD). LEAD “diverts’ people to a case manager/social worker before they get involved with the criminal justice system. A comprehensive training/program/body of knowledge that starts with the Police and diverts non-violent offenders into treatment and away from jail. Immediately we are saving money because it’s cheaper than lock-up and shows significant success with percentages of people who do not re-offend. Fayetteville Police have a LEAD program going, under the direction of Captain Lars Paul and he reported great successes. Data is coming people! On the coast, New Hanover/Brunswick Counties are looking to add LEAD and out west, under the excellent, willing direction of Waynesville Police Chief Hollingsed, Haywood County is adding LEAD.
Thanks to NCHRC efforts, there are 77 NC police departments dispensing naloxone.

If we see a ROSC as a spectrum of care {disease living on a spectrum too} then NCHRC (and others) are representing the “left” end of the spectrum, under the Prevention label, with; drug overdose prevention & education, HIV/HCV/needle-stick injury prevention and LEAD. If you’re familiar with all this the next logical question/issue is; how do we get more beds to handle the new people???


Beds are over toward the other end of the ROSC spectrum but it is clear to me, I actually see efforts that the NCHRC are making, to advocate for and grow more beds in the state, as they go about their work. Now what they need is support from all of us!
To do some fact-checking I sat down with Tessie Castillo, Advocacy and Communications Coordinator. I’d call her the #2 under Executive Director Robert Childs, but they’re not much concerned with titles or anything else except what’s going to get results today! It was both a revelation and confirmation for me to find out she had previously worked for the American Federation of Labor and Congress of Industrial Organizations (what we know as the AFL-CIO); the revered Worker’s Union of my Detroit youth, a national trade union center and the largest federation of unions in the United States. Clearly she was born with a desire to make a difference and these HR initiatives are bringing measurable differences to the streets. It has been said that working to make a measurable difference is one of the four core actions that bring fulfillment. (The other three being; live a life of passion, create financial independence and eliminate unnecessary struggle)
BTW, NCHRC accomplishes all this with only 6 full-time people, and a few part-time and with (almost) NO tax dollars. They were receiving some tax dollars but that is ending and all other financing comes from various private streams; foundations and such.
HR and LEAD and like initiatives have been working successfully, from Fayetteville to Albany to Santa Fe to Seattle, across the USA, saving money and lives while getting great outcomes, mostly driven by the pain of wide-spread opioid addiction (and the attendant overdose deaths) and is proven beyond any doubt.
I have to add that North Carolina has many prevention warriors working and other harm reduction efforts, including Project Lazarus, led by Fred Brasson and they all deserve our support.