"The holidays particularly are hard for people because of the empty chair," said MacDonald.
In 2012, her son Steven was murdered. Four years later, her younger son Michael died of a fentanyl overdose. Both were just 24 years old at the time of their deaths.
"Michael loved Christmas. Michael loved the holidays. Michael really, really struggled with the loss of his brother, Steven. Grief is a monster and I believe that everyone takes their pain somewhere," said MacDonald.
Michael's friend will join the MacDonald family this year for Christmas, a meaningful gesture Freida appreciates.
"He still is making a difference. People still remember Michael," said MacDonald.
Since Michael's passing, she's dedicated her life to helping others struggling with substance use, including starting a non-profit called Know Hope, setting up billboards across the state to call awareness to the issue, and working as an advocate. Know Hope recently posted their fourth billboard, and have funding to keep all of them up through 2025.
"I believe that with all my heart that if Michael had had the support system that he needed at the time, that it could have made a big difference," said MacDonald.
It's why she supports the creation of Wake County's new Behavioral Health Department.
"One of our key efforts that we'll be doing is increasing our education and awareness of behavioral health for youth and for families in particular, and really doing a lot of work in the gaps for folks that are high needs individuals," said Denise Foreman, who is its Director.
The program aims to remove barriers to access and stigma around substance use and mental health challenges. Foreman pointed to the impact from the national opioid settlement, including expanded use of naloxone, as well as mobile units and longer hours from community partners.
"There is a lot of investment happening in behavioral health, particularly post-pandemic from the federal level, from our nonprofit philanthropic partners that understand the value of investing in a person's health and well-being and the opportunities that haven't existed before. I think as a department, we'll be able to leverage our dollars with other resources so that we can really see that impact that we're wanting to see in our community," Foreman said.
Foreman believes the creation of a separate department also serves as a sign of how seriously they're working to address the issue.
"We can elevate the issues around behavioral health and be seen as a resource and a go-to when you don't know where else to turn," Foreman said.
"I'm so incredibly grateful that we have this now. And I do not believe that I would have seen this ten years ago. I do not believe it would have been possible," added MacDonald.
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According to NCDHHS, through August, visits to emergency departments due to overdoses are down by 27% since last year, representing a major drop after five consecutive years of increases.
"I think that having a new department in Wake County shows that there is concern and that there is support and that there is knowledge of how serious a problem that this is. And it not only helps those that are struggling, but it helps every single person in the community that loves those people," MacDonald said.