213 Narcan doses: Craven County among the highest in NC for opioid deaths

Sep. 9—Cancer and heart disease remain the leading cause of death in Craven County, with opioid overdoses and COVID-19 making a significant impact over the last several years.

The Community Health Assessment (CHA), which covers the years 2018-2020, shows that various forms of cancer led to 260 deaths in Craven County in 2019, while heart disease accounted for 230 deaths.

Other leading causes of death included cerebrovascular diseases, unintentional injuries (including overdose), and lower respiratory diseases.

When the 2018 CHA was released the top five leading causes of death were cancer,t heart disease, chronic lower respiratory disease, intentional Injuries, and cerebrovascular disease.

The North Carolina Division of Public Health requires local health departments to conduct a comprehensive CHA every three to four years. The purpose of a CHA is to examine the health issues and status of communities within the county and to identify health priorities. The report provides a review of the health of the community, tracks progress in addressing priority health issues, and identifies new initiatives and emerging issues that affect the health status of county residents.

After a slight downward slope in 2018, opioid-related overdose deaths among Craven County residents have been on the rise. Craven County is currently ranked as one of the highest counties for overdose deaths in North Carolina.

The overdose death rate in 2019 for Craven County was 35.2 per 100,000 residents, which was double the state's rate of 17.2 per 100,000 that year.

According to the NC Department of Health and Human Services Opioid Dashboard, 2020 opioid death data has been delayed due to COVID-19, but 2020 emergency department data suggests overdoses may have increased during COVID-19.

In 2019, the rate of opioid overdose emergency department visits among residents of Craven County was 114.5 per 100,000 compared to the state rate of 50.6 per 100,000. In 2020 the rate of opioid overdose emergency department visits for Craven County increased to 145.9 per 100,000 while the state rate slightly increased to 61.9.

On March 14, 2020, the first confirmed case of COVID-19 was reported in Craven County. As of Sept. 2, 2021, the county had reported a total of 11,414 COVID-19 cases, resulting in 136 deaths.

The CHA found that the largest age group of individuals with confirmed cases are 25-49 years of age (37%); followed by individuals 50-64 years of age (20%), and then individuals 18-24 years of age (14%). Most deaths have been in individuals that are white, over 65 years of age.

Gender death trends have been consistent throughout the pandemic and currently stand at 47% female deaths and 53% male deaths, the study found.

"We have struggled to maintain programs that address population health and foster a culture of self-efficacy," the CHA report states. "Many things had to change due to COVID-19 such as pausing face to face meetings with staff and community partners, reducing appointment slots for patients, increased wait time for diagnostic services for patients, unemployment, virtual learning for students, pausing group classes, lack of community services, and removing staff from regular job duties to work COVID-19 case investigation, contact tracing, community testing and then vaccine clinics."

Prior to the COVID-19 pandemic, the county health department collaborated with community organizations to hold suicide prevention and mental health awareness training.

QPR (Question, Persuade, Refer) is a training that teaches residents to identify warning signs of suicide and how to get help for someone in crisis. Mental Health First Aid is a public education program that helps participants identify, understand, and respond to signs of mental illnesses and substance use disorders.

In 2019, eleven training sessions were held in Craven County. Due to COVID-19, these training were put on pause in 2020. The Craven County Health Department plans to resume these trainings by the fall of 2021.

The CHA report points to progress that was made in the following access to care areas:

— Craven Area Rural Transit System (CARTS) had a total of 6,056 usage stops on the Yellow loop and 5,962 usage stops on the Red loop for FY 2019-20. These loops have stops for health services that include hospital, primary care, dental, and pharmacy services. CARTS has also played a key role in bringing elderly and underserved individuals to their COVID-19 vaccination appointments. CARTS was awarded a grant at the end of 2020 that allowed them to provide free services to individuals from January 1 through June 30, 2021.

— From March 8, 2020 through December 31, 2020 over 56,000 COVID-19 tests were administered in Craven County. This was accomplished through partnerships with community medical providers, CarolinaEast Health System, Craven County Health Department, City of New Bern and Greene County Health Care, Inc. The health department held community testing events twice a week from April of 2020 through February 2021.

— During 2020, a total of 155 nasal naloxone kits, which are used to treat someone who has overdosed on opioids, were distributed to local law enforcement agencies. The receiving agencies were the Craven County Sheriff's Office, Riverbend Police Department, and Bridgeton Police Department. The Craven County Health Department provided a total of 22 naloxone kits to parents at no charge.

— From January 1, 2020 to December 31, 2020, a total of 213 naloxone administrations were logged by Craven County agencies that use the OD Map system. That number marked a 64% increase from 2019, when a total of 130 naloxone administrations were logged.

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