Over the past several years, Columbus County has experienced a concerning increase in drug overdoses, with opioid-involved overdoses driving much of the rise. Local and state-level data indicate that Columbus County’s overdose rate remains higher than the North Carolina average, and overdose deaths have continued to increase over the past five years. This trend represents an urgent public health challenge impacting individuals, families, and the broader community.

Key Factors Contributing to the Overdose Crisis

Limited Access to Treatment and Recovery Supports

A major driver of overdose risk in Columbus County is limited access to timely, affordable substance use disorder (SUD) treatment. With few local inpatient and outpatient treatment options, many residents must travel outside the county for services. Transportation barriers, cost, and long wait times can prevent individuals from starting treatment and make it difficult to remain engaged in recovery.

Stigma and Fear of Seeking Help

Stigma remains one of the most significant barriers to care. Many individuals avoid seeking treatment or harm reduction services due to fear of judgment from employers, family members, or the community. This can delay access to life-saving resources such as counseling, peer support, medication-assisted treatment, and overdose reversal medications like naloxone (Narcan).

Economic Strain and Social Determinants of Health

Economic instability—including poverty, unemployment, and limited access to stable housing—contributes to stress, trauma, and increased risk for substance use. These challenges are compounded by gaps in local mental health services, leaving many residents without consistent support for depression, anxiety, or other behavioral health needs. When mental health needs go untreated, individuals may turn to substance use as a coping mechanism.

Fentanyl and the Changing Drug Supply

While prescription opioid misuse has historically contributed to overdose trends, the current crisis is increasingly driven by illicit opioids—particularly fentanyl. Because fentanyl is extremely potent and is often mixed into other drugs without the user’s knowledge, the risk of accidental overdose has increased significantly. This shift makes prevention and rapid overdose response even more critical.

Limited Prevention Education and Harm Reduction Awareness

Prevention education and public awareness efforts remain limited across the county. Many residents do not fully understand the risks of synthetic opioids like fentanyl, the signs of overdose, or how to respond effectively. Additionally, awareness and availability of naloxone is not yet widespread in all communities, which can delay emergency response and increase the likelihood of fatal outcomes.

Fragmented Response and Need for Stronger Coordination

Efforts to address overdose prevention, treatment access, and harm reduction are often spread across multiple agencies and organizations. When coordination between healthcare providers, public health, law enforcement, schools, and social services is limited, strategies can become fragmented. A more unified, collaborative approach is needed to maximize impact and reduce preventable overdose deaths.

Why This Matters

Understanding the “story behind the curve” is essential to turning the curve on overdose deaths in Columbus County. Addressing root causes—such as stigma, treatment access barriers, economic hardship, and limited prevention infrastructure—will support strategic, data-informed decision making that improves outcomes and saves lives.

Next Steps to Turn the Curve

To reduce overdose deaths and strengthen community safety, Columbus County should prioritize the following strategies:

• Expand access to SUD treatment and recovery supports by strengthening local service options and reducing barriers such as transportation, cost, and wait times.

• Reduce stigma through community education that promotes understanding of substance use disorder as a treatable health condition and encourages help-seeking.

• Strengthen mental and behavioral health services, addressing underlying drivers such as trauma, depression, and anxiety.

• Increase harm reduction efforts, including naloxone distribution and training, and exploring innovative access points such as naloxone vending machines.

• Improve coordination across agencies, building a unified response among public health, healthcare, schools, law enforcement, and community partners.

With coordinated action and ongoing data review, Columbus County can reverse overdose trends, reduce preventable deaths, and improve the health and well-being of residents across the county.

Addressing stigma surrounding substance use disorder (SUD) in Columbus County is critical because stigma remains one of the strongest barriers preventing individuals from seeking treatment and sustaining recovery. When people fear being judged, labeled, or treated differently by their community, workplace, family, or even healthcare providers, they are more likely to delay care or avoid it altogether. These delays increase the risk of untreated addiction, worsening physical and mental health outcomes, preventable overdose, and avoidable loss of life.

Reducing stigma helps create a community culture where seeking help is viewed as a sign of strength—not shame. When individuals feel supported and respected, they are more likely to engage in treatment early, stay connected to recovery services, and access resources such as counseling, medication-assisted treatment, peer support, and harm reduction tools. Addressing stigma also strengthens community resilience by reducing isolation and replacing blame with compassion, education, and understanding.

Goal: Columbus County aims to ensure that all individuals can access substance use disorder care in a supportive environment, free from stigma or fear of judgment. Creating a safer and more inclusive pathway to care will improve engagement in recovery services, strengthen long-term outcomes, and reduce the social isolation that often contributes to continued substance use.

Current State: Many residents who struggle with substance use disorder experience stigma in social, family, workplace, and healthcare settings. This stigma contributes to delayed treatment, underutilization of services, and underreporting of substance use issues, ultimately worsening health outcomes across the county.

Treatment Gaps: Some individuals avoid or postpone treatment due to fear of discrimination or negative perceptions from peers, providers, or the broader community. This barrier reinforces the cycle of substance use and creates missed opportunities for early intervention, recovery support, and overdose prevention.