The money, which will be disbursed in the coming fiscal year, will go toward:
- Expanding treatment access, evidence-based addiction treatment ($2 million)
- Addiction treatment for incarcerated individuals ($450,000)
- Preventing overdose deaths, naloxone distribution ($300,000)
- Supporting youth and families, early intervention ($1 million)
- Strengthening access for "historically marginalized populations," criminal justice diversion ($500,000)
- Addressing the needs of the whole person, recovery support services ($1.9 million) Recovery housing support ($1 million)
- Engaging the community throughout the process, collaborative strategic planning ($300,000).
"The research points to whole-person care and how important it is to have these support, wraparound services, to help with housing and to help with employment opportunities. So we know that this is evidence-based, and we know it's also the right thing to do. We know that it's more likely that people will be more successful if they have those supports in place," said Commissioner Cheryl Stallings.
"I think the root issue for a lot of people is a lot more complex than just having that addiction. We know there's so many drivers such as poverty, isolation and trauma is a huge driver of substance use and overdose risk," added Alyssa Kitlas, the Opioid Settlement Program Manager for Wake County
Both pointed to the importance of public input in playing a role in how the money was spent.
"We heard stories from family members who share that they were there because they had used naloxone on the loved one several times," said Kitlas.
Ultimately, the county will receive $65 million over the next 18 years stemming from the national opioid settlement.
"We want to do as much good as we can as quickly as we can, but also build a good infrastructure for how we're going to move forward and sustain this work over time," Stallings said.
According to the North Carolina Department of Health and Human Services, suspected overdose deaths statewide increased by 66% between 2018 and 2022, before dropping 5% last year. Year-to-date, they're down another 12%. While acknowledging the progress, Kitlas said there's more work to be done.
"We're seeing certain communities, most notably young people between the ages of 10 to 18 where we're seeing 200% increases," said Kitlas.
NCDHHS reports that in 2021, "more than 77% of overdose deaths in the state likely involved fentanyl, often in combination with other substances."
Wake County has had lower overdose death rates and overdose emergency department visit rates than state averages, though a similar rate of overdose deaths as a result of opioids.
"The ripple effect of overdose impacts the entire family and everybody that loves them," said Freida MacDonald.
MacDonald's son Michael died of a drug overdose in 2016 at 24 years old. She said she believes the death of his older brother Stephen from gun violence led Michael to use harder drugs, including opiates.
"Watching that grief take the light out of his eyes made me feel like we really need to pay a lot of attention to what people are going through when they start struggling. Because we all have our pain," MacDonald said.
Following Michael's death, MacDonald left her job and started the nonprofit Know Hope North Carolina, which focuses on helping those struggling with addiction.
"(It) absolutely can happen to anyone, and I just want people to know that," she said.
She pointed to isolation as a cause behind the spike of overdose deaths during the pandemic, though was encouraged by what she feels is wider awareness of the issue.
"We're going into schools. I mean, we didn't do that before. We're going to a younger crowd. I mean, just waiting to high school is too late. You really need to think a lot about prevention," MacDonald said.