“Western Carolina University completed a study for us in 2016 where they interviewed people coming into the jail — 85.5 percent of people arrested openly admitted to being addicted to alcohol or some other substance,” Christopher said.
The problem has been mounting in recent years as the opioid epidemic reaches the far corners of Western North Carolina. In 2012, the Haywood County Sheriff’s Office made 178 drug arrests. In 2016, the sheriff’s office made 457 drug arrests and that number is likely to be surpassed in 2017.
And when drugs are involved, there’s always ancillary crime that accompanies — break-ins, theft, domestic violence, child abuse and neglect. Nowadays deputies have to not only enforce the law, but they also have to be counselors, medical workers and arm themselves with more than a gun. Dealing with the intricacies of daily contact with those suffering from mental illness and/or substance abuse requires more deputies, more training and more resources.
Root of the problem
According to the National Institute on Drug Abuse, it’s estimated that between 26.4 million and 36 million people abuse opioids worldwide, with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers. An estimated 467,000 people are addicted to heroin.
“We see so many people that have become addicted to opioids because of situations they had — like an injury or an operation or some kind of health related issue that caused a prescription to begin and they just haven’t been able to get off of it for whatever reason,” Christopher said.
Although pharmaceutical companies began pushing doctors to prescribe opioids for pain relief in the 1990s claiming they were non-habit forming, today’s situation makes it clear just how addictive those drugs can be. Being addicted to prescription pain killers is also expensive, which is why so many addicts end up stealing from friends and families to pay for their habit. The most common opioids found in WNC are Hydrocodone and Percocet, and they go for $1 a milligram on the streets.
When opioid addicts can no longer afford the pills, Christopher said many people turn to heroin because it’s a much cheaper opioid. He said the opioid epidemic has now led to an increase in heroin use and an increase in overdoses. Unlike prescribed pills, people buying heroin off the streets can’t be sure what they’re taking isn’t laced with something even more dangerous than the opioid itself.
Once only kept on hand by emergency medical responders, now law enforcement agencies are arming themselves with Narcan, an overdose reversal drug. Officers are sometimes the first on the scene of an emergency call and need to be prepared to save someone’s life if an overdose is in progress. Christopher said Haywood EMS administered 144 doses of Narcan in 2016 while 209 doses have been administered so far in 2017.
Narcan has helped save many lives, but Christopher said it’s also having an unintended consequence now that it’s available over the counter.
“Drug dealers are selling $20 worth of heroin to addicts and giving them Narcan to seem like they’re looking out for them, but really they’re just doing it so the addict lives to buy another day,” Christopher said.
Cost to the county
Once someone is booked into the detention center, it’s the taxpayers that foot the bill for their care — and that care is significantly higher for those suffering from substance abuse.
“The cost to house an inmate is up to $72 a day, and as of today we have 121 people in the jail. When you count those costs to taxpayers in our county it becomes very expensive very quickly,” Christopher said. “So many people we arrest have to have immediate care because they’re so unhealthy. We have to start a detox program with so many of them and that cost is on top of the $72 a day.”
Depending on a person’s level of addiction, it can take seven to 10 days to complete a detox program. The detox process becomes even more expensive and important when monitoring the health of a pregnant inmate.
“Jail is not where these people need to be a lot of times,” Christopher admitted. “But also they have to want to get help and stay clean.”
When the sheriff’s office or any other law enforcement agency takes someone into custody that is a danger to themselves or others, they have to involuntarily commit the person. However, the shortage of behavioral health beds in the state and especially in Western North Carolina puts a strain on law enforcement resources.
“As an agency we have to transport all the involuntary committed patients that leave Haywood to go to other facilities,” Christopher said. “And when that person is released we have to drive back down to the coast or central North Carolina or wherever they are because it’s my responsibly to get them back home safely.”
Deputies use up a lot of man-hours and put a lot of wear and tear on their vehicles performing those transports. But even before they can transport a patient, law enforcement officers often have to sit with the patient in an emergency room following an evaluation until a bed becomes available in a behavioral health facility. Sometimes that can take days.
In 2014 alone, Macon County Sheriff’s Office spent 8,299 hours and $253,625 on involuntary committals. In 2016, Haywood Sheriff’s Office performed 642 involuntary committals. Since law enforcement put the issue to the forefront several years ago, Christopher said the situation is improving.
Haywood Regional Medical Center, which has a behavioral health unit, now has tele-medicine technology in the emergency room and staff that can sit with involuntary commitment patients so law enforcement can get back to work.
“Our local hospital has done a good job with providing service to the IVC patients and our deputies are not having to stay nearly as long as they used to,” Christopher said. “The new CEO (Rod Harkleroad) understands we need to get back on the road as soon as it’s safe to be able to do so.”
Angel Medical Center in Macon County also took over supervising mental health patients in 2015 to ease the burden placed on the sheriff’s office. Even though Angel Medical doesn’t have a behavioral health unit, the Mission Health affiliate started using video monitoring and specially trained staff to sit with those patients. The change was estimated to save the sheriff’s office $200,000 a year.
Christopher said another expansion project at Appalachian Community Services’ Balsam Center in Waynesville will also take some pressure off the sheriff’s office as well as the local emergency room. The Balsam Center recently expanded from 12 to 16 behavioral health beds and will soon become a 24/7 urgent care facility for people with mental health and substance abuse emergencies.
“We’ll be asking county commissioners for another full-time deputy to be placed there at the Balsam Center at no cost to county,” he said “Appalachian wants to pay for that so they can begin receiving patients on a 24/7 basis.”
Christopher has been a huge proponent of treatment and rehabilitation for inmates being released from the detention center whether they have a mental illness, an addiction or just a lack of resources to improve their lives. He was instrumental in helping establish the Haywood Pathways Center, a Christian-based residential program located right next door to the jail. In the last three years, the program through the Pathways Center has helped reduce recidivism at the detention center and also helped people kick addiction, find a home and learn life skills needed to earn a living.
Christopher said someone from Pathways comes to the detention center at least once a week to speak to inmates about the services the nonprofit offers as well as other community resources. But again, it’s up to the individual as to whether they make their way over to the Pathways Center when released.
“They have to want to be clean. So many people have said until they got tired of being sick and that’s when it finally connected with them what they’d been doing is not helping,” he said. “The addiction is so strong that they have to truly in the heart want to make a change.”
If he could wave a magic wand, Christopher would love to have a program inside the jail — perhaps a clinician or addiction specialist who could help address the specific needs of inmates and help them reconnect with friends and family so when they are released they leave with a sense of hope knowing someone cares about them.
“A lot of times people will start to do better when they’re still connected to family — just having relationships can give them hope for the future,” he said.
Christopher said education needed to continue to be at the forefront of the battle. He speaks regularly to students in the school system through the Drugs in Our Midst programs and takes every opportunity to show teenagers the dangers of prescription pills.
“Just today all of the criminal justice classes at Pisgah High came here and toured the detention center and we had drug agents speak with them,” he said. “We want to show them how easy it is for this to happen to them. So many people that did not ever expect to say ‘I’m an addict’ are here. It’s just so easy to start from a prescription given to you.”
By the numbers
Number of involuntary committals performed by the Haywood County Sheriff’s Office. Sheriff Greg Christopher said the dramatic increase is due to drugs arrests, particularly opioid-related arrests.
• 2014: 393
• 2015: 618
• 2016: 642
• 2017: 567 (through November)