In 2017, the Richmond County Drug Endangered Family Task Force (DEFT) was established to address the local opioid crisis, which contributed to neighborhood violence, joblessness, increased child abuse reports, and children living in poverty. Spearheaded by the Richmond County Department of Social Services, DEFT collaborated with community stakeholders, county government, the local health department, and other partners to provide treatment resources and community education. Funding was obtained from CADCA (Community Advocacy Data Coalition Association), CINC (Community Impact North Carolina), and the Sandhills Opioid Response Consortium. Today, the partnership continues to thrive, bolstered by additional funding from the NC Opioid Settlement Fund, and has become even more critical to our community as COVID-19 exacerbated the ongoing opioid epidemic. For more information on State spending on opioid settlement funds, visit State-Level Trends - North Carolina Opioid Settlements. 

What We Do

In 2023, Richmond County received a significant portion of the NC Opioid Settlement Funds. The initial funds were used to establish and maintain a Naloxone bank for emergency medical systems, law enforcement agencies, and other local agencies to replenish their supplies due to product chain logistics. Additionally, the County Commissioners authorized DEFT to develop request for proposals (RFPs) to fund local agencies supporting substance use prevention, treatment, and rehabilitation: this year, 2024, the Samaritan Colony and FirstHealth of the Carolinas. Samaritan Colony will use the grant to support fifteen Richmond County male residents needing treatment and rehabilitation at their comprehensive center. FirstHealth of the Carolinas will provide a peer support specialist to Richmond County Social Services. We hope these programs make a measurable difference in our neighborhoods.

As a collaboration of many local, regional, and state agencies, DEFT promotes Lock Your Meds (LYM) through sponsored events and social and local media advertisements. DEFT focuses on reducing the oversupply of prescription opioids, increasing community awareness and prevention, increasing Naloxone distribution, measuring our impact, and revising strategies based on results.

Who We Serve

Our service area is the geographical boundary of Richmond County, North Carolina, located in the southwestern corner of the North Carolina Inner Coastal Plains, known as the Sandhills Region. Richmond County's estimated population is 42,724 (2022), with 56% White, 30% Black, and the remaining 14% comprising American Indian, Pacific Islander, and Two or More Races. The gender distribution is roughly equal between males and females. Approximately 45.6% of Richmond County's population lives below the 200% Federal Poverty Level, with the most significant demographics in poverty being Black females (19%) and White females (16%). Unemployment rates have dropped by 1.1% to near pre-COVID levels, with the highest rates of unemployment among Native Americans (29.3%), Two or More Races (16.5%), and Blacks (13%).

How We Impact

DEFT impacts the community by providing resources, education, treatment, and prevention to those at the highest risk. Utilizing all available methods, DEFT supports existing systems, identifies goals, and implements strategies and community plans to provide the best harm reduction possible.

Overdose kits, including Naloxone nasal spray, information on the signs and symptoms of opioid overdose, and details on connecting with a certified peer support specialist, as well as other resources, are distributed by peer support specialists, Division of Social Services social workers, law enforcement agencies, and Emergency Medical Services to individuals who may have had an overdose or suspected overdose or to families concerned about a loved one with a substance use disorder.

• Richmond County Department of Social Services DEFT | Richmond County, NC - Official Website (richmondnc.com)
  The Richmond County Drug Endangered Family Taskforce (DEFT) was formed to address the opioid crisis in our local neighborhoods. Community stakeholders, county government, and local agencies have joined forces to provide treatment resources and community education. We are committed to bringing awareness and prevention to Richmond County and its residents by working with local providers to reduce the supply of prescription opioids, increase community awareness and prevention, and supply naloxone to family, friends, and other interested parties who may work, live or know those who may use opioids.  
• Richmond County Health Department Health Department | Richmond County, NC - Official Website (richmondnc.com)
  The mission of the Richmond County Health Department is to help prevent disease, promote health, and protect the environment for all citizens of Richmond County, and to assess and respond to the community's health needs continually.
• Sandhills Opioid Response Consortium Substance Use Disorder | NC | FirstHealth of the Carolinas
  A FirstHealth community coalition committed to reducing opioid-related overdoses in Moore, Montgomery, Lee, Hoke, and Richmond counties. We work with our partners in each county to provide peer support, caregiver support, harm reduction kits, medicine for opioid use disorders, support groups, and syringe exchanges. We also support our partners in building community awareness by providing podcasts, virtual support, and community events like Drop Box locations. 
• Richmond County Partnership for Children Richmond County Partnership for Children | Smart Start (smartstartrichmond.org) 
  Richmond County Partnership for Children (RCPC) helps support families by working with parents and caretakers of young children. Our Circle of Parents group provides parents with a healthy, nonjudgmental outlet to discuss parenting struggles. We also share information with our parents about the effects of their choices on children. RCPC continually offers resources and referrals to other community agencies to support our families in all needed areas.
• Richmond County School System Richmond County Schools 
• The school system teaches drug awareness and avoidance. Richmond County Schools celebrate Red Ribbon Week in the elementary grades each fall, which supports students being drug-free! Each school utilizes counselors and teaching staff to highlight NC curriculum standards and stand-alone activities to promote students being drug-free.
• FirstHealth Emergency Medical Services Emergency Medical Services (EMS) (firsthealth.org)
  FirstHealth EMS is a service that provides transports for 911 patients in Chatham, Montgomery, and Richmond counties. With 40 ambulances and 200 employees, the FirstHealth Regional EMS System is one of the largest ambulance systems in North Carolina, covering more than 3,000 square miles. Each county is unique but provides all our patients with a high level of Advanced Life Support (ALS) care. Together with our Medical Transport Team, FirstHealth EMS transports approximately 23,000 patients annually to various state destinations.
• FirstHealth Outreach Department FirstHealth of the Carolinas: Non-Profit Health Care Provider Network 
  Community Health Services has programs to meet the health needs of adults and children, including school health programs, healthy living classes, tobacco cessation education, and efforts designed to prevent childhood injury. To carry out this work effectively, Community Health works in partnership with other organizations in the region and continuously seeks funding from both public and private sources to initiate and expand these efforts.
• Sandhills Best Care Mental Health Clinic | Sandhills Behavioral Care | Rockingham, NC 
  A comprehensive outpatient Primary Care and Mental Health Clinic that uses a holistic approach to treat the people we support. The mission of the practice is to empower, support, motivate, and encourage patients, clients, and families utilizing BEST practices to help improve the health, safety, and well-being of every person we support.
• Trillium Home | Trillium Health Resources
  An organization manages a network of mental health and substance use providers under Medicaid and state funding, managing both program funds for a 43-county region. We support community stakeholders in their efforts to address mental health and substance misuse issues in their communities.
• Daymark Recovery Services Daymark Recovery Services - Richmond Center
  Daymark Recovery Services is a non-profit organization established to provide comprehensive behavioral healthcare services as defined by those in the community in need of mental health or substance abuse treatment options.
• Samaritan Colony Addiction Treatments in Rockingham, NC | Samaritan Colony
  Samaritan Colony in Rockingham, North Carolina, helps men diagnosed with substance use disorders lead healthier and happier lives. We’re a 12-bed nonprofit residential treatment facility promoting recovery and educating people about addiction across the state, surrounding areas, and the Sandhills.
• Alcohol and Drug Services of Richmond County Alcohol and Drug Services (ADS) | Addiction Treatment Greensboro and Asheboro | Prevention & Intervention Services (adsyes.org)
  Alcohol and Drug Services (ADS) is a non-profit organization that helps to reduce the impact of substance abuse in our community through providing prevention and treatment services to individuals and families impacted by addictive disease. ADS has a commitment to excellence. It is our goal to provide the individuals and families we serve with compassion and support through offering the highest quality services.
• Guardian Ad Litem Guardian ad Litem | North Carolina Judicial Branch (nccourts.gov)
  The North Carolina Guardian ad Litem (GAL) program equips community volunteers to serve abused and neglected children by advocating for their best interests in court, including recommendations for substance use treatment for children and parents.  
• Local Faith-Based Organizations
  Several church congregations in Richmond County are represented by church leaders. 
• Richmond County Sherriff's Department Richmond County Sheriff, NC | Official Website
  Our mission is to improve the quality of life in our county by reducing fear, preventing crime, and enforcing the law while protecting each individual’s freedoms guaranteed by the United States Constitution.
• Juvenile Crime Prevention Council NC DPS: Juvenile Crime Prevention Councils 
  The North Carolina Juvenile Justice section of the N.C. Department of Public Safety, Division of Adult Correction, and Juvenile Justice focuses on at-risk youth and juvenile justice issues across the state. Its mission is to reduce and prevent juvenile delinquency by effectively intervening, educating, and treating youth to strengthen families and increase public safety by providing a seamless, comprehensive juvenile justice system that provides the most effective services to youth and their families at the right time and in the most appropriate setting. 
• Community Impact North Carolina Community Impact North Carolina - Preventing harm of drugs & alcohol (impactcarolina.org)
• To help individuals and communities facing the challenge of alcohol and other drug misuse, Community Impact NC is increasing its focus on building safe, healthy, and strong communities. We believe that strong communities are the best way to prevent future harm. We bring expert knowledge and research into the design and implementation of our programs.
• North Carolina Harm Reduction Coalition NC Harm Reduction Coalition - Dedicated to implementing harm reduction interventions, public health strategies, drug policy transformation, and justice reform in North Carolina and throughout the American South. (nchrc.org)
  The North Carolina Harm Reduction Coalition (NCHRC) is a statewide grassroots organization dedicated to implementing harm reduction interventions, public health strategies, drug policy transformation, and justice reform in North Carolina and throughout the American South. NCHRC engages in grassroots advocacy, resource and policy development, coalition building, and direct services for people impacted by drug use, incarceration, sex work, overdose, gender, HIV and hepatitis, and first responders.

Community Health Improvement Plan: Richmond County communities are free from substance use harms.

Overdose Deaths.  The most recent data (Figure 1) shows that the estimated 2023 Overdose Death rate for Richmond County is 92.8, which represents 39 people who died of an overdose from any substance (NCDHHS, 2024b). This is a 7% increase from 2022. The 2023 opioid overdose rate for Richmond County is 84.6, representing a total of 33 overdose deaths involving illicit opioids, which is an 8% increase from 2022 (NCDHHS, 2024b).  The higher numbers may contribute to the rise of synthetic opioids as well as counterfeit pills in Richmond County.   

Opioid Prescription Rates.  Trend data on opioid prescription rates for Richmond County has continued to decline. In 2016, the Richmond County opioid prescription rate was 31.3 and is now holding steady as of 2022 and 2023 with a rate of 16.0, which is the most recent data available (NCDHHS, 2024b). This may indicate an awareness of providers who prescribe pain medications to use alternatives such as pain clinics and a system/policy change in medication prescribing regulations.   Strategy Percent of Population Receiving Opioid Prescription

Opioid Overdose Emergency Department Visits.  In the most recent data, there is a marked decrease in emergency department visits for opioid overdose, with a 2023 rate of 529.3 visits to a 2024 rate of 358.3 (NCDHHS, 2024b). This may be due to the overdose victims having naloxone on hand with the Drug Endangered Family Task Force (DEFT), Sandhills Opioid Response Consortium, and partners flooding the community with education, awareness, and naloxone nasal spray.

Figure 1

Richmond County overdose death rates and counts with North Carolina comparison

Notes. (NCDHHS, 2024b)

Substance Affected Infants.  DEFT tracks the number of mothers and babies who are tested and found positive for harmful substances at birth. Not all infants born to Richmond County mothers are tested, and not all Richmond County resident mothers giving birth are tested. The Indicator Measure: Substance Affected Infants shows the number of infants (i.e., dark blue line) born with harmful substances in their systems in Richmond County (RCHHSb, 2024).  The year 2018 was the first full year of tracking with 82 infants born with harmful substances, which increased during the COVID epidemic and has slowly declined, with 58 affected substance infants born in 2023 (RCHHSb, 2024). The current 2024 numbers (27 infants) are incomplete and range from January 2024 to October 2024 (RCHHSb, 2024).

Children in Foster Care.  According to the NCDHHS (2024b), there has been a decrease in children being placed in foster care due to parental substance use. Richmond County rates for children placed in foster care for parental substance use in 2023 are 32.9%, which is lower than the pre-COVID-19 2019 rates of 36.7% (NCDHHS, 2024b). This may be due to more access to medication-assisted treatment and mental health treatment programs with the expansion of Medicaid.

Care Management At-risk Children (CMARC). The program is based on a family-centered, system-of-care approach to child welfare by filling a gap in the continuum of child maltreatment prevention programming by health department social workers who work with families who have been reported to child protection services as having substance-affected infants with at-risk for a diagnosis with a disability or special healthcare needs, or social/emotional disorders. Trend data shows that the referrals have declined since spiking during COVID, with 373 referrals (2022) (RCHHSa, 2024). This year’s 2024 referrals were 218, which is still higher than the pre-COVID referrals of 166 (2019) (RCHHSa, 2024).