There is a killer in the Twin Counties claiming the lives of dozens of residents each year and threatening the lives of dozens of others each month.

This killer is not human and does not discriminate on the basis of age, race or economic standing. Statistically, its victims are more likely to be white or American Indian males between the ages of 25-54, but it strikes newborns as well as the elderly and affects people of all genders, races, creeds and backgrounds.

This killer is found in many medicine cabinets throughout the Twin Counties, for it can be a friend when properly controlled. This killer is opioid drugs known by such names as oxycodone (such as OxyContin®),  hydrocodone (such as Vicodin®), methadone and several others. It also includes heroin, which has regained its status as as drug of choice for many.

Two weeks ago, the Nash County Sheriff’s Office reported that four opioid overdoses had occurred in Nash County in a 36-hour period and one of those had resulted in a death.

Sadly, such occurrences are all too common. Nationally, the U.S. Centers for Disease Control reported that opioids killed roughly 33,000 people in 2015, more than any year on record. Approximately 15,000 of those deaths — roughly half of all opioid-related deaths — involved a prescription opioid.

Gov. Roy Cooper has recently drawn attention to the impact of opioid misuse in North Carolina.

“Opioid addiction is devastating families across the nation,” Cooper said in a press release. “This is a uniquely challenging crisis for our communities and will require a new level of collaboration between law enforcement, treatment-providers and those in recovery.”

Data released through Cooper’s office in May indicates the impact of the opioid crisis on North Carolina. In 2015, there were more than 1,100 opioid-related deaths in the state, a 73 percent increase from 2005.

The Twin Counties has seen a greater percentage increase in opioid-related deaths during that same time period. In 2005, Edgecombe County reported three deaths compared with six deaths in 2015, a 100 percent increase. Nash County deaths have jumped 450 percent in the same period — from two reported deaths in 2005 to 11 in 2015.

“The problem is very much reflected in Nash County as it is the state and in the nation,” said William Hill, Nash County human services director.

Overdoses from opioids now occur so routinely that most first responders carry naloxone, a drug that can immediately reverse an opioid overdose that is sold under the brand name Narcan, at all times. So far this year, more than 113 emergency calls in Nash County have been coded as overdoses. However, some patients seek help without calling for aid. In 2015, 632 patients were admitted to Nash UNC Health Care emergency department with opioid or heroin overdoses.

Many health care workers are reluctant to discuss the issue for fear of being blamed for the crisis. No doctors in this area would respond to requests for an interview. One local pharmacy was willing to discuss treatments for heroin overdose, but demanded that Telegram staff members leave the building when the discussion of prescription opioids came up.

To be clear, prescription opioids are legal. They are valuable and even necessary for some patients undergoing cancer treatments or end-of-life care. They are a blessing to patients recovering from short-term pain caused by surgeries, accidents or other painful processes. Doctors primarily prescribe opioids because they care for their patients and do not want to see them suffer. They can be a valuable tool in the arsenal of modern medicine, and most patients taking them as advised for a short time under a doctor’s clear instructions have nothing to fear.

However, the CDC says that changing health care policies at the turn of the millennium had a tremendous affect on the development of the opioid health crisis, which has now reached epidemic proportions.

According to the CDC: “Prescription opioid-related overdose deaths and admissions for treatment of opioid use disorder have increased in parallel with increases in opioids prescribed in the United States, which quadrupled from 1999 to 2010  This increase was primarily because of an increase in the use of opioids to treat chronic noncancer pain.”

Experts say much of the reason for the increase is that the Veterans Health Administration lauched an initiative in 1999 known as the “Pain as the Fifth Vital Sign” initiative. This new approach called for health care providers to routinely ask patients about pain levels and made pain management a measure of physician success.

The results of this initiative and the subsequent pressure it placed on health care professionals is that opioid prescriptions have increased from from 116 million in 1999 to 207 million in 2013. In North Carolina in 2016, more than 82 precriptions for opioids were written for every 100 persons in the state. In Edgecombe County, that rate was 78.2, up dramatically from 54.7 the year before. In Nash County, the 2016 rate was well above the state average at 92.3 However, this was down from 2015 when 107.8 prescriptions were written for every 100 people.

Erin Hipp, 32, is now a resident of the The Lighthouse Home, Inc, where she is living as she strives to recover from her substance use disorder and some associated mental health issues. Hipp said she tried marijuana when she was young but developed the disorder after she was prescribed opioids.

“I had a bad back and the doctor prescribed me morphine,” Hipp said. “And I got addicted to it and ended up having to buy pills off the street. I can remember one time I dropped my kids off to day care at 9 in the morning and went home and got high and fell asleep. I woke up at 10 o’clock at night with the day care worker knocking at my door to drop the kids off. I ended up losing those kids.”

Hipp said she tried heroin, which is cheaper, but it scared her.

“I know plenty of people who died from heroin, and my sister nearly died twice from it. The heroin is really bad,” Hipp said.

Hipp said she later moved on to a combination of crack cocaine and opioids, which “messed her up really bad.” She advised others to stay away from drugs.

“It’s not worth it. Your life is more important than that high you’re gonna get. That high is gonna kill you eventually. It’s only going to lead you one of two places: jail or dead,” Hipp said.

Deaths from heroin have increased in recent days. However, a look at the overall figures for the Twin Counties reveals that prescription opioids still account for the majority of deaths. According to the N.C Department of Health and Human Services, Nash County had 69 “opioid poisoning deaths” from 1999-2015 and 60 of those were related to prescription opioids. Edgecombe County has had 42 “opioid poisoning deaths” in that same period and 36 of those were related to prescription drug use.

The scope of the problem in the Twin Counties is clear. Over the next four days, the Telegram will examine different aspects of the issue in order to educate the community on the problem and the solutions that can be found in this area.