From 2000-2022, more than 36,000 North Carolinians lost their lives to drug overdose. Randolph County families have been greatly impacted by the opioid epidemic plaguing the United States. Fatalities among residents have risen drastically since 2014.

People with the following characteristics are at greatest risk of experiencing an overdose:

• History of overdose
• History of substance use disorder
• Taking benzodiazepines with opioids
• At risk for returning to a high dose to which they are no longer tolerant (e.g., recently released from jail/prison, patients leaving detoxification facilities)
• Taking higher dosages of opioids (more than 50 morphine milligram equivalents/day)

Factors contributing to the rise in fatal overdoses include fear and stigma which prevents people with substance use orders from seeking evidence-based care. The presence of fentanyl and xylazine identified in numerous samples of drugs tested from Randolph County by the UNC Street Drug Analysis Lab indicates a greater risk of overdose if using. Additionally, people who use drugs may be unaware of local overdose prevention programs that provide tools to reduce risk.

Health care providers, behavioral health providers, community based organizations, faith-based organizations, human service providers

Effective strategies to reduce the risk of overdose deaths include:

• Provide overdose prevention education (e.g., never use alone, go slow)
• Provide overdose prevention tools to identify presence of fentanyl or xylazine in drug supply (e.g., fentanyl test strips, xylazine test strips)
• Offering drug testing in partnership with UNC Street Drug Analysis Lab

There is no data to be collected at this time. As part of action plans, community partners intend to report this data for FY2023-24.