“Facing the Fentanyl Crisis: Overdose Challenges and Responses in North Carolina”
Overdose deaths have become a pervasive issue in North Carolina, posing a challenge that residents have grappled with in recent years.
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According to the state health department, the American Indian/Indigenous and Black communities face the highest risks. Between 2019 and 2021, reported overdoses more than doubled within these populations—rising by 117% among Indigenous individuals and 139% among Black individuals. Over the same period, overdoses increased by 53% among white individuals.
Overdose
The problem has been further exacerbated by the proliferation of illegally manufactured fentanyl. In 2021, the state estimated that fentanyl was likely involved in 77% of overdose deaths.
Estimates from the North Carolina Office of the Chief Medical Examiner indicate an average of 11.4 overdose deaths daily in 2023.
In Wake County during 2023:
- Wake County EMS responded to 1,268 suspected overdoses.
- Wake County EMS administered 1,578 doses of Narcan.
- Wake County EMS distributed 132 Narcan overdose reversal kits.
The danger of fentanyl lies not only in its widespread availability throughout the state but also in its potency. According to the U.S. Drug Enforcement Administration, fentanyl is approximately 100 times more potent than morphine.
The speed at which fentanyl can induce an overdose largely depends on the method of ingestion—whether it is inhaled, injected, or absorbed. Synthetic fentanyl is illicitly sold in various forms such as powder, eye drops, nasal spray, pills, or on blotter paper, as reported by the National Institute on Drug Abuse.
Once fentanyl enters the body, it binds to opioid receptors in the brain, which regulate functions like emotions and pain. This binding can depress the central nervous system and respiratory function, as noted by the Centers for Disease Control and Prevention. Insufficient oxygen supply due to respiratory depression can cause rapid loss of consciousness and, if prolonged, can lead to permanent brain damage or death as other organs fail due to lack of oxygenated blood flow.
Naloxone has emerged as a critical antidote for opioid overdoses. Approved under the brand name Narcan, naloxone reverses the effects of opioids by binding to opioid receptors in the brain, allowing the body’s natural response systems to restore normal breathing.
