‘we’re Gonna Be There’: Nc Counties Rethink Overdose Response

By Rachel Crumpler

When an overdose is reported successful coastal Carteret County, 911 dispatchers nonstop emergency responders racing to nan segment carrying naloxone — nan opioid reversal medicine that tin bring personification backmost from nan brink of death. 

At nan aforesaid time, nan county’s six-member post-overdose consequence team — composed of a squad head and 5 adjacent support specialists — gets an alert. Their purpose is to respond successful existent time, 365 days a year, offering contiguous and continued support aft nan overdose. They’re capable to meet group wherever they are, physically and emotionally.

Launched successful August 2023 pinch an initial allocation of $700,000 successful opioid colony funds, nan squad provides dedicated follow-up support to group pinch constituent usage challenges — sometimes successful their homes, sometimes astatine nan doctor’s agency aliases moreover astatine a state station. The extremity is to thief link group to resources they request — harm simplification services, detox programs, betterment meetings, medications for opioid usage upset and much — each tailored to each person’s needs and readiness for change.

“When we initially spot them, they mightiness person conscionable been Narcan-ed,” said Brooke Lane, Carteret County’s post-overdose consequence squad manager, referring to a personification receiving a dose of the opioid reversal medication. “They mightiness beryllium angry, confused, successful symptom — they’re experiencing withdrawal and they don’t want to talk. But 2 days later, they mightiness person immoderate clip to reflect, aliases they mightiness wish that they would person had entree to service. We’re gonna show up again. We’re gonna beryllium there.”

It’s a awesome displacement from nan county’s erstwhile approach.

“It was benignant of like, ‘Hey, you’re gonna live. See you later,’ and that’s it,” Lane said. “We were putting group backmost into nan aforesaid environment, expecting a alteration successful behaviour — pinch nary resources to thief pinch that change, which is beautiful common.”

But it didn’t work, she said. In 2022, Carteret County classed among nan highest overdose decease rates seen successful North Carolina, losing 39 lives. That translated to a decease complaint of 56.3 per 100,000, compared pinch nan statewide complaint of 40.6 per 100,000.

Since nan squad began operating, overdose metrics successful nan region person improved a lot. Lane said that nan region has seen a 77 percent alteration successful overdose deaths and astir a 90 percent alteration successful overdose 911 calls from 2022 to 2024. More than half of nan individuals nan squad has worked pinch person entered immoderate shape of treatment, she said.

Over an 18-month play that ended June 30, 2025, Lane said nan post-overdose consequence squad served 492 clients — 393 of them were caller — not each of whom knowledgeable an overdose. The squad besides accepts referrals by telephone aliases email from group seeking thief pinch constituent use. Over nan aforesaid period, nan squad distributed much than 1,300 naloxone kits and completed complete 17,000 follow-up contacts — that’s in-person meetings, telephone calls, texts, immoderate it takes to connect.

The effort is already earning recognition: Carteret County’s post-overdose consequence team, housed wrong nan county’s consolidated quality services’ wellness department, received a 2024 North Carolina Association of County Commissioners Excellence successful Innovation Award.

Carteret County’s squad is 1 of astir 60 post-overdose consequence teams successful various stages of implementation crossed North Carolina, according to Micha Belden, a interrogator astatine UNC Chapel Hill studying these teams done a North Carolina Collaboratory grant. Post-overdose consequence teams person emerged successful agrarian and municipality counties to supply a much robust consequence to overdoses — and their maturation is being fueled successful portion by funding from nationalist opioid colony dollars.

At nan Opioid Overdose Response Teams: Best Practices Summit successful Asheville connected Oct. 8, Nidhi Sachdeva, head of strategical wellness and opioid initiatives astatine nan North Carolina Association of County Commissioners, said post-overdose consequence teams are among nan apical strategies counties are choosing to fund. So far, astatine slightest 51 section governments person approved opioid colony spending plans that see backing these teams, according to a state dashboard search opioid colony spending. They’re one of 12 high-impact opioid abatement strategies recommended for colony money investment.

A representation showing nan 51 section governments that person approved opioid colony spending plans that see backing for post-overdose consequence teams. Rural and municipality counties are choosing to money this opioid abatement strategy. Credit: CORE-NC

“We’ve proven that it useful to beryllium nan connector,” Lane said. “Just show up for personification and show them that there’s options, and besides travel done connected getting them to those options.”

A shifting approach

Other counties are seeing nan aforesaid request — and adapting their consequence to overdoses.

Historically, EMS unit person been trained to administer naloxone and connection carrier to nan infirmary and that was it.

“Traditional EMS was ‘you call, we haul,’” said Edgecombe County organization paramedic Dalton Barrett. 

But galore group who past overdoses garbage infirmary transport, and moreover those who spell to nan emergency room whitethorn not get their withdrawal symptoms treated aliases person medications for opioid usage disorder. Without further support, repetition overdoses — and moreover deaths — are common.

“There’s a batch of group successful EMS that person seen years of responding to overdoses. They’ve been disappointment pinch that, and they’re like, ‘Isn’t location thing much we tin do?’” Barrett said.

In 2024, EMS agencies crossed North Carolina responded to 25,389 suspected overdoses, according to information provided to NC Health News by nan N.C. Department of Health and Human Services. So acold this year, arsenic of Oct. 17, 2025, North Carolina EMS agencies person responded to 17,901 specified calls — a motion of an ongoing situation and an opportunity to intervene.

That’s wherever post-overdose consequence teams travel successful — galore of which are based astatine EMS agencies — to supply follow-up support and connections to resources.

Research shows that group who past nonfatal overdoses are astatine precocious consequence of consequent overdoses. That intends nonfatal overdoses tin beryllium a pivotal clip to link patients pinch harm simplification services, curen and different support services.

Dalton Barrett (left), a organization paramedic successful Edgecombe County managing nan county’s post-overdose consequence team, which launched successful May 2023. Credit: Courtesy of Dalton Barrett

Barrett leads Edgecombe’s post-overdose consequence team, which launched successful May 2023 utilizing opioid colony funds. Now, he and different organization paramedic travel up pinch personification aft an overdose — wherever they are. 

They connection harm simplification supplies, including overdose reversal supplier naloxone and sterile syringes. They behaviour on-site humor tests for hepatitis C, HIV and syphilis, and different wellness checks. They tin moreover trial thoroughfare narcotics to fto group cognize what’s successful their substance, which tin incorporate harmful additives for illustration fentanyl or xylazine. 

And if nan personification is interested, Barrett and his partner tin connection to initiate buprenorphine — a medicine to thief dainty opioid usage upset by reducing supplier cravings — connected nan spot. Thirty EMS agencies successful North Carolina are approved by nan state Office of Emergency Medical Services to administer buprenorphine for up to 7 days to negociate a person’s withdrawal and support early betterment arsenic a span to a semipermanent curen provider, according to a DHHS spokesperson.

This post-overdose consequence squad exemplary marks a displacement for EMS: from responding to contiguous wellness emergencies to besides offering follow-up and a way toward recovery. 

Edgecombe County’s organization paramedics travel up pinch group wherever they are post-overdose and besides thief those struggling pinch constituent usage disorders. Credit: Courtesy of Dalton Barrett

“As EMS and wellness attraction is evolving, we understand that connecting group to nan correct assets astatine nan correct clip is arsenic as important arsenic — if not much important than — conscionable taking personification to an emergency room and dropping them disconnected and waiting for them to overdose again because they weren’t really connected pinch nan resources they needed,” said Mike Campbell, training section main astatine Stanly County Emergency Medical Services.

Stanly County has operated a post-overdose consequence squad since 2019. Back successful 2018, Campbell said nan agency was responding to astir 60 to 75 opioid overdoses each month. That number, he said, has since dropped to less than 10 calls astir months.

Campbell credits that diminution to respective factors, including increased community-wide naloxone access — and nan county’s stronger post-overdose support system.

“It could beryllium 2 months later, and we planted that seed, and possibly they’re fresh for betterment then,” Campbell said. “They spot that business paper [for nan post-overdose consequence team] sitting connected their bedside table.”

Tapping into lived experience

Justin Hall struggled pinch an addict addiction for astir 14 years. One time successful 2010, his constituent usage led to an overdose successful Wilkes County, and EMS was dispatched to revive him. 

“I was met pinch judgment,” Hall said. “You could show they were like, ‘Here’s different one.’” 

That infinitesimal could person been a turning point, he said, but alternatively became a missed opportunity. His constituent usage continued for different six years. 

Justin Hall, programme supervisor of Buncombe County’s organization paramedic program, which operates nan post-overdose consequence team. He’s besides a adjacent support specialist. Credit: Courtesy of Justin Hall

Now Hall is portion of reshaping nan consequence to overdoses successful Buncombe County — an attack that he said could person helped him find betterment sooner. Hall started connected Buncombe’s post-overdose consequence squad arsenic nan first adjacent support master erstwhile it launched in late 2020, drafting connected his ain experiences to support and guideline others toward recovery, if they’re fresh for it.

“I decidedly wanted to make changes successful my life good earlier I started to make those changes, and a large obstruction to that was not knowing nan guidance to move in,” said Hall, who is now programme supervisor of Buncombe County’s organization paramedic program, which operates nan post-overdose consequence team. 

“You don’t cognize what that first measurement to return needs to be,” he continued. Having personification that tin really locomotion you done nan process and assertively link pinch you wherever you are — virtually successful nan section — to promote you on that way and beryllium location to beryllium pinch you and advocator for you and thief you fig retired which adjacent steps request to beryllium taken successful what bid tin really make a difference.”

Peers play a important domiciled successful building those connections, Hall said.

Supplies, specified arsenic nan medications naloxone and buprenorphine, carried by Buncombe County organization paramedics connected nan post-overdose consequence team. Credit: Courtesy of Justin Hall

“I can’t show you really galore times I watched personification ne'er make oculus interaction pinch anybody that came and tried to talk pinch them — moreover nan group that had conscionable saved their life — until I walked up and said, ‘Hey, man, I’ve been there. I cognize what you’re going through. Let’s talk astir immoderate ways to thief support really you’re emotion correct now,’” Hall said. “That was nan first clip they moreover looked up aliases made oculus interaction pinch anybody.”

Other region post-overdose consequence teams echoed nan value of peers — who tin often amended prosecute folks. It’s nan “secret sauce,” said Jason Powell, unit main of Catawba County’s post-overdose consequence team. He’s besides a adjacent support master successful semipermanent recovery.

Building momentum

Hall and others opportunity they are encouraged by nan momentum for these teams. Fueled by nan successful experiences of existing teams and an infusion of opioid colony dollars, much post-overdose consequence teams are emerging crossed nan state. 

Among nan newest is nan 1 successful Mecklenburg County, which started operating this month, according to WFAE. 

Some of nan effect these teams are having is already showing up successful nan yearly reports that counties taxable describing their opioid colony spending. In Carteret County, for example, 1 personification who overdosed successful 2023 began gathering regularly pinch a adjacent support master afterward. Together, they developed a betterment scheme that included going to detox centers, starting medications for opioid usage upset and attending play counseling sessions — steps that led to a “remarkable turnaround successful a short time,” according to nan report.

A Buncombe EMS organization paramedic offers to link a diligent to betterment resources, including medications for opioid usage disorder. Credit: Courtesy of Justin Hall

For others, willingness to get curen whitethorn not beryllium arsenic immediate. That’s why post-overdose consequence teams tailor their attack to each person.

“If they’re still struggling pinch constituent usage and they’re not really fresh to wholly extremity everything, we’re going to displacement our attraction from curen to harm reduction,” Hall said. “Our extremity is to support group alive, and hopefully we’re keeping them live agelong capable and encouraging them capable to want to participate recovery.”

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