When Gov. Roy Cooper signed the Strengthen Opioid Misuse Prevention or STOP Act into law last month, he called it an essential tool in the fight against an opioid epidemic now gripping the state.
The law imposes limits on the prescription of opioid pain medications – no more than a five day supply of the pain medications on an initial visit. It also requires doctors electronically submit the prescriptions they write as part of a reporting system to prevent over-prescription and drug seeking behavior.
For some people struggling with addiction in Wilmington, ground zero for opioid abuse in the state, doctor shopping is a way of life. They go from doctor’s office to hospital to treatment center – some widely known as “pill mills” where it is easy to score – maintaining habits for years or decades without ever breaking the law.
“I did it for decades, just pills and alcohol,” said Jonette Greenwell, 51. “I knew where to go, I
knew what to say to get pills. And when I couldn’t get them from a doctor, I could buy them somewhere else.”
With a husband and three kids and an outwardly functioning, successful life, Greenwell said it was not difficult to hide her habit – at least at first.
But as her addiction spiraled out of control, it slowly ruined her marriage, family relationships and health until there was nothing left but the habit.
Now four years sober, Greenwell manages the nonprofit Fleming Recovery House for Women in Wilmington. She sees plenty of people just like her – “soccer moms gone bad” as she says – and people whose experiences have been much worse.
Between 1999 and 2016 more than 12,000 people died from opioid-related overdoses in North Carolina – and more than 1,200 just last year. That figure is shocking to many people – but not to those like Greenwell, who barely survived her own addiction. Or to those who are still struggling every day.
At just 33, Amy has been living on the street in Wilmington for nearly two years. She’s been in the grip of opioid addiction for a little more than six years. She says it began after a car crash that led to back surgery That’s when she was introduced to OxyContin – a highly addictive opioid painkiller. She began by using it as directed but soon found she couldn’t tell the difference between what was needed to ease physical pain and what was needed to feed her growing dependence.
“It just sneaks up on you is the best way to say it,” she said in an interview this week. “I thought I needed it for the pain, but pretty soon I needed it just to function.”
When her prescription ran out, she said it wasn’t difficult to find doctors who would provide various pills – more Oxy at first, Vicodin, Percocet, Percodan and Lortab. In Wilmington, there was such a thriving black market that if she even found it easy to get the pills without a prescription.
“The pills are a real problem here,” said Joshua Swift, deputy director of the New Hanover County Health Department. “We’ve recognized that and we’re working with doctors and hospitals and with the public on it.”
Swift’s department has helped set up a series of pill boxes where people can safely turn in pills they’ve stopped using or those of deceased relatives – drugs that might otherwise end up on the black market or thrown away unsafely.
The county has also produced a series of public service videos dealing with various aspects of the opioid epidemic.
Slowly, over the course of more than two years, Amy said her entire life began to revolve around getting and taking more of the pills until everything else began to fall away. She had trouble functioning at a good job she had as an office administrator at a property management company, so she took a lower-paying job at a call center. Soon she was showing up late or missing days at that job, too.
“It gets harder to care about anything, and harder to concentrate on anything that isn’t just feeding the addiction,” she said.
Soon she had gone from a good job and a nice apartment of her own to taking whatever temporary work she could get and maintain, living with three roommates in a small condo – all struggling with addiction: two to opioids and one to alcohol.
Before long it was more expensive and time consuming to get the pills she needed – and heroin was cheap and plentiful throughout Eastern North Carolina.
“When I started it, you could get a bag for $10, maybe $15,” Amy said.
A “bag” is typically between 30 to 100 milligrams, depending on purity. Varying in quality, heroin in Wilmington can easily be found on the street today for between $10 and $20.
“I was spending more money on cigarettes every week than that,” Amy said. “But it got more expensive the longer I did it, more I used.”
Alternating between pills and heroin, Amy said her habit got to be $150 to $200 a day. That led to her stealing from friends and family members, even breaking into houses and cars. She lived and had sex with a couple of dealers just to keep her habit going, she said.
“I would never have through just a few years ago I would have ever done any of that,” she said. “But it gets so you’re just surviving. It just feels like you’ve got to do these things to survive.”
Amy says she’d like to get free of addiction. She has even gone stretches of weeks or months without using. But she’s now convinced she’s going to have to leave Wilmington to do it.
“It’s just too easy here,” said said. “It’s too easy to get pills. It’s too easy to get heroin. It’s too easy to know where to go and who to see. Even if you don’t know who to see and where to go, it’s too easy to find out.”
She’s now planning to move to Virginia to live with some family who want to help her – some of the only family she has left who haven’t given up on her, she said.
“I know they’ve got to do something about this problem,” she said. “I know I’ve got to take my responsibility for my problems, but there’s a lot of us here and we need help. Something really has got to be done and everybody knows that.”
The recently passed state budget improved funding for the state’s Controlled Substances Reporting System and funneled $10 million in federal grants to treatment services.
But it was well under what the governor called for in his suggested budget and only about half of what was called for in the bi-partisan Strengthen Opioid Misuse Prevention (STOP) Act.
A small pilot program to treat opiate overdoses was funded in Wilmington.
But many – from state lawmakers and New Hanover County officials to those struggling with addiction and working in recovery here – say it’s too little too late and are calling for a stronger commitment.