►
Description
North Carolina State Attorney General Josh Stein recently sat in on a meeting of Buncombe County’s Safety Net Coalition to talk about opioid awareness.
B
A
This
subject
can
certainly
appreciate
the
opportunity
to
speak
with
the
Attorney,
General
and
honored
that
he
would
come
here
to
Duncan
County
to
hear
our
experiences,
particularly
in
the
opioid
crisis,
I'm
Jim
Holland
and
with
Health
and
Human
Services
and
I,
along
with
dr.
Jennifer,
mullendore
and.
A
Jan
Shepherd
the
health
division
director
for
Health
and
Human
Services,
coordinate
the
safety
net
coalition
meeting,
and
you
see
our
what
we
do.
It's
mainly
made
up
of
medical
providers
in
the
community.
They
serve
the
under
and
uninsured,
and
our
focus
is
how
do
we
make
sure
that
we
meet
the
needs
of
those
Oh
most
times
medically
fragile
population,
particularly
with
the
challenges
that
many
of
them
are
uninsured
and
have
many
needs
other
than
just
their
medical
needs?
A
And
one
of
the
things
that
we've
been
focusing
on
in
the
safety
net
has
been
the
opioid
crisis
and
the
impact
that
that's
had
not
only
on
the
community
as
a
whole.
That
has
safety
net
coalition
members,
the
impact
of
its
head
on
providing
treatment
and
getting
people
access
to
treatment,
as
well
as
the
impact
that
it's
had
on
first
responders
in
our
community.
A
I'd
like
to
take
just
a
minute
before
I
just
go
through
a
couple
of
slides,
just
to
give
sort
of
lay
the
foundation
to
just
recognize
some
folks
that
are
here
today
and
if
I
leave
someone
out.
Please
raise
your
hand
or
please
tell
me
point
that
out
to
me
I'd
like
to
first
listen
as
members
of
Buchan
County
border
commission,
Joe,
Belcher,
Jasmine,
H,
Ferrara
and.
A
A
Well,
thank
you
very
much
for
taking
the
time
so
with
just
sort
of
lay
the
foundation
of
what
we
can
look
at
in
the
safety
net
and
what's
been
happening
in
the
community.
Last
year
at
mission,
there
were
399
babies
born
with
a
positive
toxicology
and
going
to
go
through
withdrawal
and
as
a
result
of
their
their
mother
being
addicted
to
substances
in
Buncombe
County
alone.
Last
year
there
were
17
million
painkillers
prescribed
opioids
prescribed
in
Buncombe
County
Justin
from
community,
based
on
the
data
that
we
have
from
our
vital
records
department.
A
We
had
58
confirmed
drug
related
deaths
in
Buncombe
County
last
year,
there's
still
about
a
hundred
and
three
that
are
still
pending
a
final
toxicology
result
that
we
don't
know
now.
We
do
believe
that
some
of
those
may
even
be
underreported
in
the
58,
and
perhaps
one
of
the
statistics
that
shows
a
continuing
problem
in
the
community.
A
The
first
responders
welcome
County
EMS
responded
to
twelve
hundred
and
seventy
over
those
calls
from
January
1
through
May
this
year
and
continue,
as
you
see,
the
huge
problem
that's
happening
in
our
county
and
in
our
region
and
across
the
state
that
just
as
some
challenges-
and
these
are
things
that
we've
talked
about
within
our
safety
net
coalition,
but
there's
certainly
challenges
that
are
related
to
the
providers
in
the
community
and
how
they
address
the
chronic
need.
That's
both
from
a
physical
standpoint
and
from
a
mental
health
standpoint.
A
The
individuals
just
their
ability
to
seek
services
if
they're
ready
to
engage
in
treatment,
the
impact
that
it
has
on
our
infrastructure,
but
in
our
ports
and
in
our
jails.
The
impact
that
it
has
on
first
responders.
That
is
our
first
responders.
Are
the
oftentimes
the
point
of
contact
and
having
to
go
through
that
process
of
the
tragedy
of
overdoses
and
the
impact
that
that
has
on
them
and
that?
A
Finally,
what
we're
seeing
within
our
school
systems
and
the
impact,
particularly
as
we
address
some
areas
within
school
health,
on
what's
happening
with
their
children
and
by
the
attention
standpoint
and
from
just
a
perspective
what
their
their
medical
needs
as
well,
also
like
to
recognize
Commissioner
out
light
sides
coming
in.
Thank
you
for
being
here
today.
A
Certainly
if
you
want
to
stay
after
1:30,
that's
perfectly
okay,
but
to
be
mindful
of
everyone's
time.
If
you
do
have
comments,
that
would
be
great.
If
you
have
the
opportunity
to
convince
those,
especially
within
the
area
which
you
work
just
as
a
as
a
show
of
hands,
could
you,
if
you're,
if
you
are
a
first
responder,
could
you
raise
your
hand
so
that
we
know
who
you
are,
that
would
be
Asheville
Fire
or
Fire
Department
EMS
law
enforcement?
A
If
you
are
a
medical
provider,
could
you
raise
your
hand
if
you're
from
a
medical
provider
community,
if
you
are
an
educator
or
another
medical
provider
or
in
the
behavioral
health
world?
Could
you
raise
your
hand
from
that,
and
then
we
have
at
least
one
pharmacist
without
chief
pharmacist
here
from
the
country
pharmacist
here:
yeah
well,
Attorney,
General's
Todd!
Thank
you
so
much
for
being
here
and
we
turn
it
over
to
you.
Thank
you.
D
So
much
I
am
so
appreciative
that
you
all
are
taking
your
time
out
to
be
with
me
and
share
the
experiences
that
you
are
having
here
in
Buncombe
County
I,
always
pleasure
to
see
my
good
friends
here.
Don't
think!
Thank
you
very
much
being
here
it
this
problem,
if
intense
here
in
Buncombe
County,
as
you
all
well
know,
but
it
is
all
over
the
state
it's
in
the
mountains,
it's
in
the
Piedmont
and
it's
on
the
coast.
D
There's
one
study
that
identified
four
cities
with
the
greatest
intensity
of
this
problem
in
2016
and
four
of
those
cities
were
in
North.
Carolina
two
were
in
the
East
one,
whether
the
Piedmont
one
was
in
flip
Hill,
so
it
is
everywhere
and
as
I
travel
the
state
talk
about
this
issue
and
meet
people
and
variably.
D
D
His
back
on
the
job
and
gets
prescribed
painkillers
and
gets
hooked
and
loses
a
job
loses.
His
family
loses
control
of
his
life.
Teenage
girl
who
parties
on
the
weekend
gets
into
the
medicine
cabinet
of
her
parents
and
gets
hooked
hooked
on
heroin
stole
from
her
parents
$80,000
and
one
year
to
feed
her
habit.
The
I.
D
Who,
when
he
was
12
his
mother,
had
had
knee
surgery,
got
prescribed
a
ton
of
pills
within
the
medicine
cabinet
and
as
a
teenager,
he
started
messing
around
with
those
pills
and
got
hooked.
Some.
He
was
15.
He
was
on
heroin
by
the
time.
I
was
18.
He
was
homeless,
living
in
a
Walmart
parking
lot,
but
by
the
internal
drive
of
himself
by
the
grace
of
God.
D
E
D
Prescription
pills
to
heroin
and
then
the
heroin
that
they
buy
on
the
street
is
laced
with
fentanyl
because
it's
so
cheap.
It's
a
chemical
analogue
of
heroin
and
insanely
pocus.
The
size
of
a
grain
of
salt
of
fentanyl
is
enough
to
kill
a
person
and
they're
being
mixed
by
garage
chemists,
who
don't
know
what
they're
doing
and
one
dose
won't
have
any
and
then
the
next
dose
will
have
enough
to
kill
somebody
and
that's
why
deaths
are
spiking
and
it's
fighting
on
it.
D
Spiking
all
over
the
country
in
New,
York
Tom,
just
had
a
peak
yesterday
online
that
there
was
a
19%
increase
from
15
to
16
and
opioid
deaths.
It
unprecedented
in
American
history
that
at
such
a
high
baseline
of
50,
some
thousand
people
that
there
was
that
percentage
increase
in
a
single
year,
and
so
we
expect
2017
tragically
to
be
even
deadlier
than
2016,
which
was
clearly
deadlier
than
15.
In
Buncombe
County,
we
saw
the
about
babies.
D
400
babies
born
in
Mission
Hospital
last
year
suffer
drug
withdrawal,
which
means
that
they
don't
sleep
for
two
weeks:
they're
undernourished,
they're,
screaming
high-pitched
wailing
for
days
on
end.
That
was
ten
percent
of
all
births
at
that
hospital.
One
out
of
ten
babies
was
born
suffering
drug
withdrawal.
It
was
a
100
percent
increase
from
2015
200
to
400,
so
we
have
a
crisis
on
our
hand
and
and
what
I'm
convinced
of
is.
We
will
not
turn
this
around
overnight.
It's
taken
us
about
20
years
to
get
to
the
stage
of
crisis.
D
We
know
we're
on
a
terrible
trajectory,
but
we
can
absolutely
turn
the
tide
on
this
crisis
and
we
can
save
lives.
The
important
thing
is
to
do
exactly
what
you
all
are
doing
here
in
Buncombe
County,
which
is
to
get
law
enforcement
at
the
table
with
medical
prescribers
at
the
table,
with
substance
use,
behavioral
health
people
with
survivors
themselves
and
with
your
local
policymakers,
who
can
hear
and
put
into
action.
D
The
ideas
that
y'all
generated
at
the
state
level
do
to
me
that
the
successful
strategy
hinges
on
prevention,
treatment
and
enforcement,
because
you
got
to
try
to
reduce
the
number
of
people
who
get
addicted
in
the
first
place.
You
do
that
through
working
with
prescribers,
so
that
they
change
their
prescribing
practices
and
with
young
people
and
families
to
try
to
address
the
risk
seeking
behavior.
That
leads
to
many
people
to
mess
around
with
the
prescription
pills
last
year
in
North
Cana
that
were
700
mill
million
pills
prescribed
10
million
prescriptions.
D
That's
enough
for
every
person
in
the
state
of
North
Carolina
we've
got
the
prescription
for
opioid
and
Buncombe.
County
have
one
of
the
highest
densities
in
terms
of
pills
per
capita
of
any
County
in
the
states.
So
there's
just
a
ton
of
bills
and
pills
are
dangerous
for
two
reasons:
one
is
it
can
create
addicts
and
people.
I
was
just
reading
a
story
about
a
young
girl
at
the
Black
Mountain
facility.
She
was
a
soccer
player
knee
surgery.
D
Her
doctor
prescribed
her
six
months
worth
of
percocets
ten
years
later,
she's
a
heroin
addict
living
in
public
safety
facility,
so
we're
prescribing
too
much
and
when
even
when
people
aren't
they
don't
use
all
this
pills,
they
put
them
in
the
medicine
cabinet
and
those
pills
just
become
a
magnet
to
people
with
addiction
and
the
young
people
looking
to
make
bad
decisions.
So
we've
got
to
reduce
number
of
pills
treatment.
D
There
are
tens
of
thousands
of
North
Carolinians
living
with
substance,
use
disorders
of
one
form
or
another,
and
opioids
are
becoming
an
increasing
share
of
that
problem,
and
yet
last
year
in
our
state,
one
out
of
ten
people
got
any
type
of
treatment.
Just
let
that
sink
in
only
one
out
of
ten
sick
people
got
any
kind
of
treatment
with.
D
We
accept
the
healthcare
system
in
which
ninety
percent
of
people
with
heart
disease
or
ninety
percent
of
people
with
diabetes,
don't
get
the
health
care
they
need
to
get
healthy,
and
yet
that
is
the
system
we
have
here
in
the
United
States
and
here
in
North,
Carolina
I
just
came
from
pouring
Montford
Hall
right
before
I
got
here.
If.
D
Just
beautiful
remarkable,
an
incredible
facility
that
you're
fortunate
to
have
here
House
was
like
20
teenage
boys
for
upwards
of
a
year
to
give
them
the
intense
wraparound
services
that
they
need
to
get
out.
What
is
the
underlying
trauma?
How
do
you
come
up
with
skills
to
avoid
taking
drugs?
How
do
you
deal
with
whatever
issues
you
have
and
how
do
you
get
educated,
so
you
can
advance
your
your
schooling
and
unfortunately
have
a
positive,
productive
bike,
but
that's
20
slot.
D
H
D
Residents
of
the
United
States
tolerate
that
I
think
that's
something
we
need
to
address
and
then
of
course,
enforcement.
There
are
drug
traffickers
out
there,
making
millions
and
millions
of
dollars
off
of
people's
addiction
off
of
death
and
misery,
and
they
need
to
be
held
severely
accountable
for
the
damage
that
they
reap,
but
there's
a
difference
between
somebody
who's
out
there
pushing
these
drugs
making
a
profit
off
of
these
drugs
and
somebody
who
is
addicted
and
their
crime
is
their
sickness
that
doesn't
tolerate
using
illegal
substances
or
violating
the
law.
D
D
Our
way
out
of
this
crisis
that
we
can't
just
put
people
in
jail
and
expect
them
to
come
out
and
not
go
back
to
the
behavior
order
for
patterns
that
they
rip
because
they
haven't
gotten
the
treatment
and
they
haven't
learned
how
to
live
a
different
life
where
they
can
avoid
those
those
problems.
So
there
are
a
lot
of
innovative
programs
going
on
around
the
state.
Is
what
I'm
discovering
in
terms
of
diverting.
I
D
As
they
engage,
the
criminal
justice
system
diverting
them
to
other
forms
of
relief
treatment
so
that
they
can
get
healthy
and
they
don't
live
off
the
taxpayer
dime
and
in
prison,
which
is
usually
about
four
or
five
times
from
expensive
than
treatment
laws.
So
I
know
that
you
all
are
doing
a
lot
here.
B
D
Group,
the
safety
net
coalition
I
read
about
the
Western
North
Carolina
substance
use
alliance.
I
know
that
the
county
was
debating
community
paramedics.
I
know
they
call
are
working
on
diversion
programs.
You
are
embracing
harm
reduction
strategies,
all
of
which
is
to
the
good,
not
very
much
hope
that
we
can
engage
and
hear
from
you
all
about
the
different
things
that
you're
experimenting.
E
B
D
Was
a
Denzel
Washington
movie
about
a
train
that
was
out
of
control
and
crack
getting
ready
to
crash?
He
has
to
fix
the
train
at
the
same
time,
it's
going
60
miles
an
hour
down
the
track
and
that's
what
we've
got
now.
We
don't
know
what's
going
to
work
so
we're
having
to
fix
things
on
the
fly,
so
we
will
not
address
it
solely
at
the
state
level.
We've
got
important
legislation
that
we're
pushing
there's
the
stop
act
to
deal
with
prescribing
practices.
It
sets
limits
on
the
number
bills
for
acute
pain.
D
It
requires
use
of
the
controlled
substance
reporting
service
database
so
that
there
can't
be
doctor
shopping,
keep
prescribing
to
deal
with
prescription
pad
for
forgeries
and
fraud.
We've
got
a
synthetic
opioid,
Control
Act,
which
will
close
loopholes,
as
relates
some
of
these
fentanyl
drugs,
which
are
killing
people
but
are
not
illegal
in
North
Carolina.
So
we
need
to
close
those
loopholes,
but
we
won't
fix
this
problem
until
we
deal
with
it
at
the
local
level.
So
that's
what
I'm
here
to
learn
from
you
all
today
and
very
much
appreciate
your
taking
the
time.
I
D
This
is
a
an
interesting
issue
because
when
you
just
talk
about
opioid-
and
you
talk
about
this
epidemic,
it
actually
has
been
fairly
non
partisan
and
that's
at
the
state
level
and
the
federal
level
is.
It
is
stop
back.
You
know,
I'm
working
with
Senator
Jim
Davis
from
Western
North,
Carolina,
I'm,
working
with
all
the
representatives
and
senators
are
Republican.
They
feel
this
issue
intensely
and
passionately
and
want
to
address
it.
D
Similarly,
in
Washington,
when
the
last
act
of
last
year
was
the
Cure's
act,
where
they
put
a
million,
but
it
was
three
billion
nationally
for
this
issue,
31
million
of
which
just
got
awarded
in
North
Carolina
to
provide
treatment.
So
that
is
all
to
the
good,
but
then
you
have
what
they
want
to
do
to
Medicaid
and
eliminating
the
Affordable
Care
Act,
which
Affordable
Care
Act,
is
the
single
biggest
program.
D
We
have
dealing
the
substance,
use
disorder,
treatment
in
the
country's
history,
it's
that
insurance
that
is
provided
and
when
you
cut
20
million
people
off
of
health
care,
a
20
million
people
who
no
longer
have
health
insurance
to
pay
for
whatever
services
you
all
provide.
So
it's
this
sort
of
recognition
on
that
specific
issue,
but
then
on
a
macro
level,
they're
taking
two
steps
backwards
and
so
I
think
it's
important
that
we
inform
our
representatives
and
the
people
who
elect
the
representatives
about
the
consequences
of
the
policy
decisions.
They
do.
D
J
Attorney
General,
my
name
is
michael
harney.
I've
been
in
this
town,
since
1992
I
helped
to
coordinate
and
co-found
was
known
as
the
needle
exchange
program
of
Asheville
in
1994
work.
It
was
wonderful
community.
We
ever
exchanged
about
the
legal
Gruyere,
I
thought
you're
doing
this
amazing
work
the
2015
we
went
through
two
hundred
and
thirty
nine
thousand
needles.
In
2016
we
provided
access
to
five
hundred
and
twelve
thousand
meters,
people
who
came
to
Western
North
Carolina,
AIDS
Project.
J
All
of
this
we
were
operating
from
represented
32
different
counties
and
came
from
four
different
states
is.
My
thought
has
always
been
my
wish,
but
of
the
100
counties
you
have
here
in
North,
Carolina
that
all
County
Health
Department's
be
at
least
one
certain
location.
I
know
that
most
County
Health
Department's
off
to
vaccines
and
immunization.
J
Whatever
else
they
do,
I
was
hoping
that
all
County
Health
Department
could
be
worried.
State
I'm,
stigmatizing,
no
discrimination,
locations
for
people
to
access,
clean
needles
and
access
to
you
know
potentially
a
nurse
and
then
to
fully
fund
a
tax
across
the
state.
The
cut
aid
act
is
so
wrong
at
this
time.
As
you
say,
we're
going
down
the
line
with
the
10%
cut,
potentially
in
the
a
black
here
in
Black
Mountain
House,
in
about
a
million
four
hundred
thousand
dollar
loss
at
time
that
we
really
need
more
treatment.
Glad
to
meet.
D
You
and
thank
you
for
being
here
thanks
for
those
comments,
yeah
needle
exchanges
and
rectal
some
funny
needle
exchanges
have
come
a
long
way
in
North
Carolina.
It's
there
now
legal.
When
you
first
were
operating,
you
were
doing
it
because
you
thought
it
was
right,
but
it
wasn't
legal
authority
for
you
to
do
it
and
now
there's
an
entire
statutory
scheme,
and
this
was
a
law
by
the
way
introduced
and
pushed
passed
and
signed
by
Republicans.
D
So
there
has
been
real
change
in
the
way
that
people
are
looking
at
public
health
issues
and
the
growth
of
hepatitis,
C
and
AIDS
obviously,
is
a
great
part
of
this.
But
what
needle
exchanges
have
been
shown
to
do
is
person
who
a
user
who
participates
in
a
needle
exchange
is
five
times
more
likely
to
pursue
treatment
than
somebody
who
isn't
engaged
in
a
needle
exchange
and
so
the
way
that
Neal
extends
work?
Is
it
just
gets
them
in
a
relationship
with
somebody
and
we're
open
to
hearing
from
somebody?
D
A
D
And
there's
actually
legal
immunity
for
people
who
participate
in
illegal,
illegal
needle
exchange
program,
and
there
are
some
law
enforcement
around
the
state
that
just
they
hadn't
shifted
their
mind.
Yet
they
don't
quite
understand
that
the
legal
terrain
has
changed
under
them
and
we've
heard
actually
some
people
for
drug
paraphernalia
when
they
are
legitimate,
registered
user
of
a
needle
exchange
program.
D
G
Services
director
for
Buncombe,
County
and
I've
got
three
concerns,
and
one
of
you
takes
dollars
being
de
perak
mating
we've
been
looking
at
that
hearing
both
of
Patty.
Quite
frankly,
the
problem
is
it's
going
to
cost
$300,000
to
put
it
in
place.
The
state
has
a
grant
program
kind
of
a
pilot
program,
but
I
not
see
that
spread
for
every
county
and
where
I
think
this
can
come
in
handy
here,
for
example,
even
with
drug
problems,
we
can
do
a
lot
of
follow-up.
G
But
when
you're
looking
at
what's
involved
in
this,
the
community
paramedic
problems
and
do
a
lot
of
follow-up
treatment
just
the
same
as
we
lose,
we
refer
to
as
frequent
flyers
or
people
who
use
angle,
which
is
a
loss.
You
know
to
get
some
of
this
logo,
something
else
we're
finding
that
some
of
the
pushers
out
here
also
when
they're
selling
the
drugs
are
giving
them
the
narcan
are
kinds,
a
wonderful
thing.
Until
you
know
you
can
something's
got
to
be
done
about
that
part
of
the
problem.
G
There's
anything
that
can
be
done
on
the
safe
level.
We
would
certainly
certainly
appreciate
it,
and
you
know
these
people,
you
look
at
them
and
you've
got
to
be
out
there
like
law
enforcement
is
and
I
know.
G
Cooper
over
here
takes
it
to
the
city
in
and
the
van
County.
They
deal
with
this
every
day
and
you.
G
D
D
With
forget,
the
name
of
Donald
McDonald's
and
group
Steve
hook
recovering
communities
emoticon
by
the
way
that
Steve
mange,
who
is
my
policy
director
and
the
point
person
in
our
office
for
this
crisis?
So
he's
a
really
great
resource
for
you
all.
If
you
have
follow-up
questions
and
can't
find
me
for
whatever
reason,
but
they
are
partnering
with
this
nonprofit
group,
with
most
of
whom
have
been
through
recovering
themselves,
they
do
and
peer-to-peer
counseling.
D
So
if
they
don't
have
to
hire
as
many
community
paramedics
back
whenever
a
community
paramedic
goes
out,
they
go
out
the
one
or
two
of
these
volunteers.
Now
it
didn't
an
ideal
solution,
but
it
extends
the
reach
and
gets
the
program
up
and
running
New
Hanover,
County
Wilmington.
They
actually
have
in
the
budget.
D
There
are
plenty
of
costs
to
the
county
in
terms
of
EMS
ambulance
services
jail
van
having
to
deal
with
these
folks
and
but
then
the
hospital
has
to
be
or
visits
and
hospitalizations,
much
of
which
may
be
uninsured.
So
to
me,
there's
no
question,
but
it
costs
outweigh
the
benefits
of
reducing
those
costs
outweigh
the
costs
of
the
community
paramedics,
it's
just
those
benefits
or
diffused,
and
it
then
come
out
of
the
same
account.
D
H
D
We're
in
the
process
of
sort
of
aggregating
all
of
these
ideas
and
lessons
we're
going
to
put
together
a
resource
manual
where
we
just
describe
various
initiatives.
The
various
communities
are
dealing
with
and
giving
contact
information
for
that
local
community
so
that
we
sort
of
take
our
work
out
of
it.
So
you
can
just
call
up
the
person
in
Nash
County,
you
add
VMs
and
say
how
is
a
small
for
rural
county
financing
this?
D
How
are
you
doing
that
then
get
some
ideas
and
that
way,
definitely
on
the
law
enforcement
side,
also
in
Nash
County,
the
police
chief
of
Nashville
as
a
program
that
they
called
the
hope
initiative,
which
is
basically
anyone
who
walks
through
the
door.
It
can
turn
in
their
paraphernalia
and
their
drugs
and
there
will
be
no
charges
and
the
police
chief
will
then
take
that
person
to
connect
that
person
with
treatment
sometimes
has
to
connect
them
with
something
Florida
or
in
New
Hampshire.
D
You
can't
always
find
one
within
the
region,
but
basically
the
mission
of
that
Police
Department
is.
If
you
want
to
get
help,
we
will
move
mounts
to
get
you
that
help
and
they
have
had
like
a
hundred
and
thirty
people.
Teeny
little
town
of
Nashville
and
one
year
come
through
the
door.
Fayetteville
has
a
similar,
but
not
exactly
the
same
program.
Called
law
enforcement,
assisted
diversion
lead
where
the
local
law
enforcement
officers
are
empowered
as
they
are
out
the
community.
D
They
know
who
are
regular
users,
they
know
who
cycle
through
the
criminal
justice
system
and
they
have
criteria
whereby
the
person
they
engage
meets
that
criteria.
They
say
look
I
won't
make
an
arrest.
I'll
hold
this
arrest
in
advance,
and
you
do
these
things,
which
it's
a
very
similar
model
to
drug
treatment.
Courts.
I,
don't
know
what
Buncombe
County
status
is
judge,
whether
there's
a
drug
treatment
court.
Here
there
used
to
be
40
or
so
statewide.
D
Now
it's
time
to
28
of
the
states
about
funding
them,
but
it's
the
same
model
and
but
it's
pre-arrest,
whereas
drug
treatment
court
you're
arrested
and
then
the
charges
are
held
in
a
band
here,
the
arrest
is
held
in
the
band,
and
so
it's
it
if
the
different
model.
It
comes
from
Seattle
in
Santa
Fe,
but
Waynesville
's,
get
ready
to
experiment
with
that.
Statesville
is
Gastonia
is
basically
like.
I
said
communities
are
learning
on
the
fly.
I
will
have
a
resource
manual
that
we
can
share.
We
never
trade.
D
They
would
where
you
have
specialized
prosecutors
who
understand
this
issue.
We
have
a
judge
who
understands
this
issue
and
the
prosecutors
of
the
judge
are
constantly
looking
for
ways
to
find
the
appropriate
treatment
for
this
person.
So
they
come
up
with
the
terms
of
it.
Oftentimes
it's
outpatient.
If
you
have
to
go
to
daily
or
weekly
peer
support,
programs
need
to
get
tested
drug
tested
regularly.
D
You
appear
before
the
judge
on
a
monthly
basis,
and
if
you
meet
the
terms
and
at
the
end
of
the
year
the
judge
will
drop
the
charges
so
I
think
that
model
works
very
well.
It's
just
it's
not
widely
implemented
in
North
Carolina,
the
there
are
other
judges
where
that
is
not
formally
a
drug
treatment
port,
but
that's
what
they
do.
Okay,
so
they
end
up
just
doing
it
themselves.
Just
not
the
formalized
structure.
D
I
did
it
a
roundtable
in
Jacksonville
which
is
camp
for
gern,
which
was
one
of
the
four
cities
with
the
greatest
intensity
of
this
problem?
They
don't
have
a
drug
treatment
facility
in
the
entire
county
of
Onslow
County.
It
is
imagine
so
if
you
have
a
sympathetic
prosecutor,
if
you
have
a
synthetic
judge,
you
don't
have
anywhere
to
put
that
person
other
than
the
jail.
So
what
ends
up
happening
is
that
the
jails
become
the
leading
treatment
facility
in
the
state
of
North,
Carolina
and
I'll
be
interested
to
hear
your
experience.
I
C
C
C
Receptive
taking
is
addictive
all
the
way
up
to.
Where
do
I,
how
do
I
get
treatment
with
the
number
up
and
call
for
my
loved
one,
because
we're
doing
it
individually
and
spending
a
lot
of
money
to
try
to
get
a
feel
board
up
in
just
blowing
out
all
the
funds?
And
yet
we
could
do
this
more
centrally.
Other
things
can
be
more
local
and
I
can
probably
need
to
be.
But
that's
what
one
item
that
always
comes
out
I,
don't
know
it's.
The
new
care
is
funding.
Some
of
that
will
be
dedicated
towards
it.
C
D
Is
80%
of
the
cures
grant?
The
3331
million
goes
to
prevention
and
treatment.
I
think
it
will
mainly
be
going
to
treatment,
but
they
will
definitely
have
a
public
education
component.
I
think
that
you
make
a
good
point.
We
deal
with
budget
scarcity
at
the
state
level
too,
and
I
don't
disagree
with
your
point.
It
just
means
that
we
policymaker
Baker's
need
to
be
advocating
for
the
right
type
of
resources.
You
know
part
of
the
stop
back
when
it
was
introduced,
was
twenty
million
dollars
and
treatment
over
two
years
and
it
got
dropped
from
the.
D
He
got
one
in
the
Senate
budget
and
went
in
the
House
budget,
but
then
Greg
Murphy
is
state
representative
from
Greenville
he's
a
doctor
and
a
champion
for
stop
back.
He
got.
10
million
were
added
back
to
the
House
budget
over
two
years,
but
now
that
bills
in
conference
we
have
to
push
Senate,
make
sure
it
funds,
community-based
treatment
and
recovery
services
too.
So
I
don't
disagree
with
you.
It's
just
a
valid
takeaway
for
me.
Have.
C
G
We
do
have
a
little
closure
for
here
at
Salem
code.
We
have
our
Commissioner
here
in
our
sheriff
and
they
run
this
empowerment
yep
and
it
works
well
through
that.
But
we
work
with
surrounding
counties
such
as
Madison,
and
you
can
have
the
most
willing
da
república
new
defense
community,
good
everybody's
on
board.
They
don't
have
the
difficult
for
rural
county
to
have
the
services,
so
one
size
fits
all
approach
is
not
necessarily
work
up.
I
was
interested
to
that
County.
We
have
to
be
creative
out
there.
G
Thank
you
for
help
for
those
counties
that
are
running
successful
programs
to
be
able
to
model
countable.
That
was
what
to
these
other
counties
movement
and
to
actually
advocate
on
behalf
of
rural
multiply,
to
help
them
receive
the
services.
We
have
treatment
providers
here,
top
perfect
we're
less
than
that,
but
it
tell
the
controllers
and
buckles
in
the
lakes
push
for
these
rural
counties
something's,
not
necessarily
in
their
own
I.
Don't
know
what
that
mechanism
would
look
like
with
some
way
we
could
come
together.
I.
G
D
With
you
the
way
I
look
at,
it
is
very
similar
to
the
way
the
state
is
always
fun
to
public
education,
which
is
the
state,
has
been
the
predominant
source
of
public
education
dollars
so
that
every
County
you
know
80
to
90%
of
your
baseline,
is
equal,
and
now
some
school
systems
will
do
their
local
add-on,
just
like
I'm
sure,
Asheville,
City
and
Baulkham
panics
that
schools
do
but
at
least
it
gives
a
getting
gates.
County
a
fighting
shot
like
a
lot
of
northern
states.
D
It's
90
percent
locally
funded,
like
the
state
just
doesn't
put
in
much
money
and
if
you
live
in
a
poor,
County
you're
guaranteed
to
go
to
a
poor,
school
and
I
think
that
treatment
is
a
perfect
example
of
that
and
drug
treatment
courts
or
a
perfect
example
of
that
is
why
the
state
should
bear
a
bigger
load.
In
that
way.
The
successful
urban
city
communities
which
are
chipping
in
a
disproportionate
share
of
revenue
to
the
state,
are
spreading
that
those
resources
to
areas
of
the
state
where
they
can't
generate
it
themselves,
so
I
agree.
K
And
there
are
three
things
that
matter:
that
was
my
everything
of
it.
That
I
just
wanted
to
add
your
response
for
others
the
fun.
What
is
that
was
a
primary
care
group
in
the
future,
but
there
was
only
made
we're
actually
teaching
community
members
like
CPR
how
to
do
in
the
Maitland
phrase
as
a
way
to
help
today
live
another
one
was
that
the
volunteer
group
total
about
a
profit
basically
trying
to
help
place.
K
D
Haven't
been
to
West
Virginia,
but
when
you
look
at
this
crisis
nationally,
West
Virginia
Ohio,
particularly
eastern
Ohio,
New,
Hampshire
and
eastern
Tennessee-
that
that's
the
epicenter
that
that's
where
the
death
rates
are
three
times.
What
we
have
here
in
North
Carolina,
and
what
we
don't
want
to
have
is
one
gun
we're
on
the
trajectory
we're
essentially
eight
years
behind
those
states
and
what
we
don't
want
to
do
is
eight
years
from
now
be
where
those
states
are
and
that's
why
we're
trying
to
get
ahead
of
it.
D
And
when
you
look
at
the
stop
act
and
the
limit
on
the
number
of
pills
that
are
prescribed
and
the
e-prescribing
and
the
mandatory
use
of
this
database.
These
are
ideas
that
we
scoured
the
country
and
found
out
what
are
the
other
states
in
crisis
doing
to
deal
with
it
and
that's
why
we
brought
those
ideas
here:
the
North
Carolina,
so
we,
this
is
a
topic
that
comes
up
and
I
go
to
national
meetings
with
the
Attorney
General.
We
are
exchanging
ideas
but
I'm
not
like
the
idea
of
the
school
plan.
D
D
I,
don't
know
what
the
experience
is
here
sheriff,
but
some
sheriff's
who
told
me
that
75
to
80
percent
of
the
men
and
the
county
jail
are
there
either
because
drugs
or
property
crime
because
of
drugs,
they're
trying
to
feed
their
habit
and
that
upwards?
A
hundred
percent
of
the
women
are
there
because
of
substitutes,
and
so
I
think
that
using
it.
L
Wake
Bagan
with
Megan
and
we
position
I
am
for
the
stop
act
and
trying
to
limit
acute
opioid
prescriptions
in
five
days
or
less
I.
Think
that's
great.
We
have
to
try
to
get
the
number
of
pills
that
are
in
our
community,
but
actually
in
our
medicine
cabinet,
to
be
less
I
like
to
put
a
proposal
out
there
that
at
follow
up
from
surgery
that
you
actually
bring
in
your
unused
opiates.
We.
L
In
right
now,
I
have
a
patient
that
comes
in
and
hands
me
their
bottle
if
I
take
it
I'm,
pretty
sure
on
control
and
I'm
not
allowed
to
do
that.
So
we
need
to
need
to
work
on
that,
because
I
think
we
got
that
out
of
the
community.
You
know
that
you
just
let
me
show
up
at
your
first
post-op
visit.
You
show
up
with
the
mess
that
you
didn't
use.
We
could
really
help
to
reduce
the
amount
and
the
cabinet
I'm.
F
M
M
But
we
we
had
a
lot
of
conversation
about.
How
do
you
increase
the
number
of
legally
supported
Dropbox's
it?
Suffice
it
to
say
we
have
them
but
they're
in
the
walls
of
sheriff's
department,
and
that
is
a
most
friendly
place
for
anything
to
bring
their
medications
to
get
rid
of
them.
They
are
in
some
pharmacies,
but
there
are
handful
in
the
state
of
North
Carolina
and
could
look
across
state
lines
into
other
states.
There
are
more
states
that
have
engaged
pharmacist
and
pharmacies
in
that
work.
M
D
B
D
B
D
And
so
that's
a
drop
in
the
bucket,
but
it's
a
start,
so
we
are
doing
that.
We've
been
working
with
CVS
Walgreens
because
that's
85%,
but
the
community
pharmacists
are
actually
probably
doing
it
at
a
higher
rate.
So
Steve
and
I
will
follow
up
with
one
pharmacy
in
that
regard.
I
think
that
that
solution
that
what
I
hope
over
time
will
become
less
necessary
because
doctors
won't
be
over
prescribing
I
mean
I,
went
in
for
a
minor
procedure,
came
away
with
30
days.
Bill
I
mean
it's
just
I
need
it.
D
B
Sure
we
have
been
doing
the
drop
boxes
in
the
community
type
box
for
a
while.
We've
done
it
three
wired,
the
FC
sponsor
CAD
co-sponsors
substance
for
the
new
coalition,
a
lot
of
it.
The
problem
with
the
DEA
letter
requires
law
enforcement.
Prep,
that's
one
of
the
youngest
parts
that
Steve
was
talking
about
and
or
something
you
know.
B
D
A
lot
of
this
will
require
a
change
in
federal
law
and
governor
Cooper
is
on
the
president's
national
opioid
task
force,
and
so
he
think,
take
we've
been
sharing
ideas
with
him
that
need
to
happen
to
the
federal
level
and
I.
Think
we'll
underscore
this
issue
about
the
regulations,
because
that's
something
hopefully
the
feds
can
take
off
the
straightjacket.
D
It's
holding
folks
back
from
wanting
to
do
good
I
mean
there's
a
reason
why
the
rule
is
there
in
the
first
place
right,
because
it's
very
easy
to
divert
it's
a
he
said/she
said:
oh
I
brought
back
60
of
my
pills
and
then
I
said:
I
got
60
pills.
Let
me
kick
in
20
and
I'll
sell.
40
I
mean
it.
There
are
people.
D
E
Bales
here
among
the
county
commissioners
and
just
comment
regarding
the
West
Virginia,
the
city
that
she's
mentioning
my
hometown,
it's
well
to
West
Virginia,
which
is
where
I
went
to
high
school,
and
so
it
gives
me
a
certain
perspective.
As
a
commissioner
when
we
look
at
okie
over
and
policies,
policymakers
is
state
federal
level,
external
influences
as
affected
poverty
to
incredible
extent,
when
I
go
back
to
where
I'm
from
and
it
I
mean.
If
you've
never
been,
you
should
go,
it
will
enlighten
you
and
open
your
eyes,
but
there's
there's
so
many
people
they
don't.
E
They
don't
have
an
opportunity
to
get
rid
of
the
fields.
So
there's
a
weak
moment.
They
sell
the
fields
and
it
goes
on
all
the
time.
So
crazy
idea
on
drop
boxes,
library,
drop,
lockers
they'll,
be
able
to
drop
box
anywhere
mm-hm
anywhere
to
be
able
to
get
rid
of
the
pills,
because
when
someone
is
driven
to
a
state
of
poverty
and
it's
deep
enough
and
dark
enough,
then
scripture
that
Paul
said
that
for
the
grace
of
God
there
go
I,
you
don't
know
what
you'll
do
when
you
get
to
the
deepest
darkest
moment.
E
When
you
think
you're
trying
to
take
care
of
family,
so
in
Buncombe
County,
one
of
the
things
we
want
to
try
to
avoid
is
to
is
to
to
bring
those
people
out
of
poverty.
I
know
this
extends
beyond
that.
Well,
you've
got
to
watch
that
be
careful
with
that,
and
we've
got
to
remove
that
opportunity
where
they
they
can't
bring
those
bill
size
and
that
moment
takes
when
oh
I
can
sell,
because
I
have
this
moon.
We've
got
to
be
very
careful
with
that
one
step
into
state
federal
level.
E
We
just
need
to
keep
you
need
to
pay
attention
to
the
jobs,
but
each
of
those
opportunities
make
sure
we
open
them
up
and
make
sure
that
as
policymakers,
we
don't
leave
those
people
pretty
easy
for
me
to
move,
but
my
heart's
never
left
there.
So
the
thought
process
goes
back.
The
other
thing
they
did
and
I
don't
not
necessarily
saying
that
we
should
be
this:
they
just
one
of
the
cities
sued
the
farmer
suit
and
they're
just
trying
to
hold
whoever
they
can
accountable
for
the
dark
problem
that
they're
gonna
do.
D
Our
office
is
looking
at
issues
around
liability
and
seeing
whether
there
are
companies
that
engaged
and
deceptive
or
unfair
act
that
helped
to
create
this
crisis.
It's
a
very
complicated
set
of
factors
that
got
us
to
this
point
and
there's
a
lot
of
blame
to
go
around.
The
key
is
we're
in
this
terrible
point
today.
What
can
we
do
to
try
to
turn
it?
Turning
around
right.
N
Here:
I'm
Timmy,
Schick,
special
art
director
for
Beckham,
County,
Health
and
Human,
Services
and
I
just
want
to
bring
light
to
the
smallest
population
of
this
impacts
and
it's
the
children
and
so
in
Peckham
County.
We
have
327
children
in
foster
care
today
and
as
that,
member
ever
had
for
under
the
age
of
5,
and
most
of
his
children
actually
entered
care
between
the
ages
of
newborn
and
to
over.
N
60%
of
this
children
enter
care
specifically
because
of
substance
abuse
issues,
mainly
with
their
mother
and
I,
just
want
to
bring
to
light
that
subpopulation
of
perinatal
substance
use
disorder
and
how
that
impacts,
not
just
that
child,
but
that
mom.
The
lack
of
resources
that
we
have
for
prenatal
and
postpartum
at
folks
who
are
engaged
in
substance,
use,
disorder
and
addiction
and
to
really
talk
about
medication,
assisted
treatment
and
what
that
option
is
and
offers
for
these
moms
to
be
stigmatized.
N
We
are
doing
a
lot
in
this
area
and
I'm
going
to
take
time
to
get
through
that,
but
you
mentioned
the
alliance
I'm
on
a
sub
sub
group
of
the
Alliance,
and
so
we're
working
really
hard
together
to
address
this
and
be
happy
to
share
that
information,
including
a
partnership
with
mission
where
we
have
been
embedded
and
Child
Protective,
Services
social
worker
on
the
mother
baby.
That's
how
many
cases
of
this
that
we
respond
to!
She
is
employed
full
combat
that
is
housed
on
the
mother
baby
unit
mission
to
respond
to
these
cases.
D
Sounds
like
y'all
are
doing
wonderful
thing.
If
you
can
give
your
contact
information
to
speed.
That
would
be
very
helpful
if
foster
cares
is
one
of
many
many
many
hilari
cost
that
society
is
having
to
pay
from
this
crisis
and
foster
care
is
going
up
all
over
the
state,
the
number
of
children-
and
there
are
not
many
more
times
number
of
children
and
there
are
families
prepared
to
take
them
in
terrible
pressure.
O
This
time,
the
problem
with
annual
healthier
and
also
physical,
health
being
invited
I
can
see
a
train
wreck
coming
because
behavioral
health
of
the
physical,
physical,
don't
obey
and
I
think
that
is
going
to
be
a
serious
issues
with
the
MC
others
that
are
not
getting
funded
like
they
could
see
their
services
getting
such
innovation.
So
when
you
try
to
divert
the
behavioral
into
the
physical
you've
got
a
really
problem
and
I
think
it's
going
to
escalate
what
you
kind
of,
reduce
and
funding
is
going
to
be.
The
key
thing.
O
A
We
are
at
time,
if
there's
anyone
that
has
a
question
that
needs
to
be
asked.
I
want
to
make
sure
that
we
have
one
more
time
to
make
sure
we
ask
that
question.
I
also
want
to
take
an
opportunity
to
recognize
a
couple
more
people
that
we're
here
uncle
County,
Commission,
Chair,
brownie
new
minutes
here
and
Asheville
mayor
Esther
manheimer
is
here
and
I
district
attorney.
Todd
Williams
was
here.
He
has
a
baby.
D
A
A
We
would
love
to
be
able
to
stay
engaged
with
you
in
your
office
and
keep
the
dialogue
open,
certainly
from
the
pharmacy
perspective,
and
what
Tammy
was
saying
as
social
work
and
certainly
from
other
providers,
and
we
welcome
that
opportunity
and
thank
you
so
much
for
being
here
today
and
thank
you
all
for
coming
and
just
a
reminder
for
we
will
not
meet
in
case
you're.
Coming
looking
forward
to
the
next
safety
tech
coalition
meeting
not
meet
in
July,
we
will
meet
in
August
and
Lynn.