Opioid Overdose Option: Naloxone

Carolina Focus
Wednesday, April 25th
Dr. Russ Kerns with Atrium Health, Former Governor Pat McCrory and Former NC HHS Director Dr. Aldona Voss discuss Naloxone to save opioid overdose victims.

Transcript - Not for consumer use. Robot overlords only. Will not be accurate.

I'm mark Thomas misses Carolina focus on who's talking 1110993. Defeat the key. 1079 the length. 1025610. WFNC. It's where we look at issues offensive happening to affect the Carolinas the Charlotte region and you welcome. And we're glad you could join us here this morning on Carolina focus if you listen to us for any length of time you know that. One thing that we've tried to touch on a lot of it it's an issue that affects. Not just the Carolinas but the entire country and that is the hope Buick crisis and recently the journal of American Medical Association on it when it's online postings. Had a were. Or that said that the increase in oh Buick related mortality between 202015. Is 320%. And in early April that the media Center for Disease Control came out with another statistics stating that from July 2016. Through September 17. We've had an increase of 30% in all parts of the United States and joining us now to address this issue is former governor Pat McCrory. Good morning governor good morning glad to be here and we have doctor Russ Kearns who is with atrium health Carolinas medical center and is a professor. Toxicology. And is. Will call him an expert in this particular area and forward. Head of the Department of Health and Human Services for the state of North Carolina held off loss good morning ms. moss. Glad you could all join us. I guess these statistics that have been put out by Gemma and the CDC. If there if they don't indicate a problem I'm not sure what does. We all have heard about this the hope Buick crisis the open or an epidemic. And it doesn't seem to be getting any better. And so that's what we're we're here today to talk about what things can be improved in this area. And one of those to start off with is a thing called moloch zone. And it's an anti overdose drug were gonna get into that indeed tail but up first of all when I asked you doctor kerns in. Just exactly you know we talk about hope you're overdose and oh Buick deaths. How does how does opium kill you. That maybe seem like a simple question but I'm for as from a layperson standpoint. Just exactly why is that a problem and and and what's the problem with the overdoses. It will. OBO Lloyds. Many people might be more familiar with that term as narcotics. But these are pain medicines. Analgesics. And they do provide good pain relief. After operations. Injuries. Illnesses. But if you take excessive amounts. Causes coma. Stops you from breathing and natural where mortality comes from. Excessive use too much too much of an effect. And I guess my question is and the next question would be. Why has this become such a problem. Since the year 2000 what happened in 2000 that that changed in the entire medical community and the use of opiates. Or find ourselves at this point today. Well first. Oh PO would abuse is not this is not new. When I was when I was a resident thirty years ago. We took care of heroin overdoses. Daily. The agents that people abuse now has changed over the years. You know in that in the eighty's and ninety's with the government. Mandate for better management of pain. Patients started using more OP you'll Lloyds. And also mirrors unscrupulous. Practitioners. Who opened. Pain clinics. That were really just pushing pills. So people grew an addiction to the medications we use for pain. Now what's changed. In the last few years it is with recognize there's an issue with prescribing excessive amounts of OP Lloyds. The governments of the practitioners have in the government has realized that so word decreasing the amount. Of prescription OP awards that are prescribed and available. And now we're seeing a resurgence of error one. And not only just Irwin. But far more potent agents. That are mating claim to Stein labs. Now. That no car fan Knoll. And a whole host of other tongue twisting fentanyl named. Agents. So it's it's really kind of grown out of you wanna address the pain. But. These doctors who were prescribing more. In the last few years this has not been you know pill pushers who she described an earlier visit. Where is this just normal medical practice that you wanna leave the pain. Correct I mean we want their you have to have a balance between. Alleviating pain with Al putting patients at risk for addiction. And a government Corey your reaction to that. What you as far as you see the from a governmental standpoint I think this is one of the most. Important issues facing our nation base in every state. Face in every city we're having people die every single day. Due to drug overdoses I sometimes don't use the award Oprah you void because some people don't we've kind of started from maybe a political. Calculation using that term. We're the old term was just drug overdose or heroin we often use that word. For whatever reason that terminology through the media and maybe the medical community has gone to open awaited. But I'm afraid a lot of people don't know what that is the commonly person doesn't know what that is. But the issue of addiction. Is I think one of the most critical issues facing our nation. We see it in our emergency rooms we see it in our homes we do our schools. And the cost of that addiction. Is impacting budgets across our nation in government and Medicaid Medicare. And emergency rooms and that's one reason that doctor a down of all sewers by secretary of health and human services. Just stressed to me that addiction. In fact she uses other types of terminology Al don't you might be be able to do your more qualified to explain that I am but. Right I don't know or by doctor Stan right point it was huge. And and I wanna bring doctor hundreds of millions of dollars I want to bring doctor vause into the into the conversation here as well as you know someone who ran the Department of Health and Human Services. And candid as I guess in a sense oversees the entire medical community. From that standpoint. Has the Department of Health and Human Services been able to have any sort of impact in how the doctors are prescribing or how. These drugs are being administered. Well mark for Taiwan to. Our eyes grew after current time is not. It is very important part oh and governor about this point when we speak about it. Oh you abuse act so that everyone understands what that means. Oh at. Back to mention it's really clapped and drug that is used and had been used for years. To lead UK. In Mecca. And it is something that is and you needed to do it. Part of our obligations as citizens to do that. With that that the OLE. A drug problem that we have right now is divided into what aspects and that goes against your question mark. The first part is is in the category of these current boards on Oprah question that the doctors actually write prescriptions for. To treat. Another part is. Something that the Doctor Who mentioned that you know which are called collectively manufactured. And I pack and different derivatives. And the third is physically leave its heart it's illegal old. Eat at street category. The old. Art art is different act different strategy and different way of dealing with it. Mark your question why and added to the Department of Health and Human Services. For its part in that department how to answer. Conservatives do or what happened that while quite a lot. For that part in reference to the prescription. Oh like problem. There has been late nineties that positions in the medical community have been told app in nature patients are not in pain. And eager to continue that on the block and not. Turn up what exactly true because they realize they are addictive. And the financial amount of treatment and the squad killed by doctor accused. Of black. What we have to do educate not only the medical community which we all arguing. But to educate the general population. When you're fourteen seniors that you know get there to witness to take out. And you have to note the parents to question what is it that the prescription for and that might out that we needed. The educational component active beats everyone in the general community not to the medical community. And yet there are apt to back in the U that the description unlocked but it is not include. But. Cry. On the court that multiple program now in the nation in different states. Weathered this app called ordering management strategy from what that means an in normal time back. Get encryption or 98 world that. Can't do. Whether the companies or so. This state like. We are able to. Create the amount that it actually did the right positions. I'm so it went at it for the state. Is that Corey. That our administration during the governor Jerry part stated that. That that app and how substance abuse and drug overdose. On their focus from day one when he entered opt. And that we track what happened in the states and 2013. And we have in 113 there. On the merits lock out but at its peak electric light into happened. And what happened there and it's starting 23. Is that. Not one summoning. The ambulance and not one court at least have someone help you because a friend of yours look overdosing. What that is good or not 2013 and it is that you know what they weren't when not at patents. A lot like culpable my. Or court at the immunity if you call 911. Without went out came that there are. The range today that at bat and it. And so that started in 23. And I were talking to doctor Al tone of loss former head of department health and human services here. In North Carolina along with the former governor Pat McCrory and doctor Russ kerns who's atrium hell about the open your crisis. The the solution I we've got a lot of problems but the one thing that did change in the past few years. Moloch sewn witches and anti overdose drug. Has become more available now asked doctor kerns. Is it something that you see used on a daily basis in emergency rooms first the ball and has it been around for awhile. Is this is oh longstanding. Antidote. That works by directly counteracting. The effect. Analgesics OPO would hear one. In the receptors in the brain. That's extremely effective is it kind of luckily safe is the kind of like him and that means sort of maybe that's not the best no word to describe it but it is a subject to counteract because you said you go into a coma when you overdose. Too so how does how does that counteract that. It and needed in layman's terms rated directly. Reverses the effects of OP Lloyd's. On the sectors in the brain. Allows the patience to Waco and more importantly store robbery. And that's one of the critical things news you go into the combing your breathing stops. For now is that a a mosque a sure thing. It's it's it's. It stops the brain from signaling you robberies OK something we don't think about right in this is my account and I'm they may seem like very you know simplistic questions but I think a lot of people you know. Personally I don't under. I didn't get an alien biology neutered and neither did most politicians. And so I had to be educated on this when I was governor. And it was a down of all my secretary you have to medical doctor like doctor here and mark that that was a big issue of had a we prevent more desk as I think we were loose and I don't have the exact number 2000. People a year in North Carolina the mortality. In the last few years has changed tremendously either roughly. 250. Deaths. In North Carolina in 2011. Or twelve. And it 2006. Team and there was almost 12100. Confirmed deaths from Irwin. And her win like drugs well and put that in even to cut the numbers down even smaller. According to the US surgeon general in their release that they put out on April 5. 115 Americans. Die to an opiate overdose every day. Two wooden acting very simple terms. So. And what that it is and what a fascinating in its patents thirteen when. At the beginning of the Macquarie administration. As we have a day it came back in this state that went out of control and whale from it's. I billions and Eric at the very beginning what was right he. I'm here economical impact with striking and an absolutely how in varying age and what that we were banging at Iowa being. And at the beginning 2013. Medicaid money on hepatitis. Treatment so what's fascinating. It feet. That app pat hit it one bit at her parents could you know I would say at. What that government or an economic impact. What eight Buick being that will be because people were used these drugs intravenously. I lacked the calculate and Harrell and and and in the it's been on tactics and all of that app. That they are spreading handing them out. What hepatitis CIA HIV equipment and it is back at the hepatitis C. Cost of treatment that was just a thought on seeing. In fact. Now go to see a doctor balls before and you have to go a little early but. You had to convince me is governor you might want to explain the politics of that you wanted me to change the statewide policy on needles. In north Carolina's barrier myself in the City Council Democrats Republicans refuse. To look at any clean needle program but. You're extremely convincing him you might wanna talk about the politics of that the clean needle program because of the hepatitis. People lose their life and the cost. Well act act a little tree that that can spot them and and appointed you. That is seen it does mean that the disease is kept at it. The age right the and be weren't threatened by and in the date in her back out. Oh on an experience. And and Harrell and illegal oh wait it expands. Willie. RY. You can't say how. People how do. Well and that there are idle when then they need from gravity. You will be able to impact all arms and be quiet. It started. I. No convincing miss a better word you had to convince me because I was or the old school go and I'm not gonna give give needles out there it was. That would be we'd be encouraging more drug use. I am debating this with you and you convince me otherwise and we ended up by getting legislation passed doctor wins our occurrence. Yes. This at my beginning a little had the conversation but one of the unanticipated. Benefits. Of syringe programs. And community distribution of the blocks and it is higher willingness to be tested for HIV. And hepatitis C. And actually. There's hot there's give a five time increased chance of entering a drug treatment program. If you if you participate in wanna be sponsored programs syringes or distribution. There were talking with doctor Ross turns from atrium helpful with former governor Pat McCrory. I'm former head of Department of Health and Human Services in North Carolina a don't know boss here in Carolina focus on your host mark Thomas. And I know doctor vause only has a couple more minutes with us. Saw one Sawyer wanna ask her one question in in before she leaves us. So what you're saying in effect is the laws that were in effect preventing these people cheering for you from. The needle programs are being implemented. If those laws were not there would that would certainly help in community rating the problem not only in North Carolina but across the country. And why. Arm up at the we're not quite a bit disease and Pat The Bat and required at its hey. And oh yeah. And and it's tainted and it would FY 2013 for the ax its. That you quit called the police offer letters. In order. To app out with I know without being and an argument Eric block. Also in 2013. Chains and that practitioners doctors. Right individual prescription. Standing orders a patient who actually didn't need that like eating not only mentioned there. That that. That relative. And that adopted would issue called third party prescribing that you're writing perception occupation. Occupations. Out or friends or parents. Or a relative. Eight that locked when he thirteen actually. How to beat you could use an unlocked what. It's the same person liked it when not in the medical community. And then that ended at 26. Bill again and it Macquarie administration. What an act that aren't these at that point. And it will be. Actually 20151. More on the bill that a pilot program. I'm useful. That. What it is you could bring legally you mean the trite but at the drug. And and gave it away and you went on to you that you were opposed to giving it to someone out that we use and that without it contaminated. What a Disney's. And then that left of that and into the twenty single. I am a lot well right now we have a meaningless that aren't you can actually get that. Gotten a lot and the light saving medicine would that respects. And that is app will be phenomenal for trying to increase. The awareness being used for the life saving. Patient advocate saying I'm as back to current mentioned. It is secretly seeing the likelihood of people. Because it not to try to you know. That they are not increasing. And the possibility of spreading HI VK aids and hepatitis. C. And they're also encourage the same time because of the program. Opera opportunities. Can get information and can get help. Because it not just. And needle Ed O'Neill part and and that truck parts there would act or are all. Of the unplug. How do they end up being as bad as they calculate and note that they would be your program. We can guide people to equate that with factor in whether offering. How they look like popped a mental health illness. Whether it make little or a bat out. We have access into the world area the weather in medically whether. Well and doctors from having overlap with the question giving to people. What weren't hurt people with the help of a it's like alcohol and all the is intertwined with the blocked its start in its searching for the state of what Carolina. Through it at 2016 and maybe. Mainly benefit and it will lately we wondered if you stayed ahead of the curve in the United States with these that marriage law. Doctor Al don't know vause I know you have to only this but we appreciate your input here are Carolina and as she does I want to thank her for her incredible leadership she talked this governor. In a change his mind on some of these issues and making it our number one for Horry so we are very lucky to have a great sector Pelton services during those years and I'll forever be grateful over I think people lives are being saved because of her leadership. Doctor Ross refer you to be in your Carolina focus. On Iraq. And how I guess I won out turn the discussion around a little bit more. Two to moloch so and in particular at this point because. That's something that is she is doctor vause mentioned. Can now be dispensed by. A pharmacy without a prescription. So doctor -- does that mean that you know mark promises a citizen I can walk into my local Rite Aid or CBS and go to the shelf and right there alongside the Ibuprofen and acetaminophen I can pick up some know oxen. Simplistic yes it's it's it's it's not on the counter stuff to get from pharmacist. The legislation allows the pharmacists to dispense that without an individual. Physician or other practitioner prescription. Similar to suit fed. You right behind the counter right is behind the cut won't let me ask you this and I'm not an expert you know you get. Doctor you're the doctor. I'm not a doctor packet can or Uga. I I had to I had via most politicians have to be educated but that habit but that's but that brings up a point from a legal aspect which does bring the government into it. Do I have to give my name like I do with sue defendants some of these other antihistamines that are now even though not technically prescription. I have to go in and say hi I'm mark Thomas on them by. You know X amount of an antihistamine today and if I do it next week and then the week after regardless of my intentions for use. They're attracted me and that is this something is tracked like that. It. I don't know the exact answer to that I think not I don't think there's a Bork can place advantage of someone I am in the buy this or that drug is used for any other purpose. Like a suited fed by views. To make other types of drugs so I don't think there's any web Iraqi but the reason I ask is do we talked about you know the having the clean needle programs available. And people were willing to get tested for HIV they're more willing to get treated for their addictions because they're not there's not a criminal penalty. For Danica was saying. I'm an addict because I mean let's face it if you know we were to stand up if I were to go out and say. You know I'm mark and I take fentanyl every day. I get arrested. Plain and simple. A senior year. Because to have these drugs in your possession is a felony is it not. Governor. Too heavy legal drugs in your yeah well I've ever that award to have on on. That's prescribed drugs today have someone else's drugs in your possession that you may have stolen right we're gonna miss that's that's my legal but having put my boy good which helps you save yourself from. Or save someone else's right lately but my point is you know people are not overdosing. From opiates that they're receiving on their prescriptions as such that is to say if I go to the Dennis and I get some oxy code own and I take that for a weaker to. That isn't where the real problem with all the opiate abuse then open a crisis has come on in it's the secondary. You know your child takes it for someone gets it or someone gets the illegal fentanyl or someone goes up by heroin because they can no longer get the prescription that they've now become addicted to. It will. There is a certain amount of risk with taking. Amid the oatmeal woods through prescription. We know with certain pop percent of the pot revelation. That is just taking it therapeutic Lee as the trigger. For that person become addicted so that that is a problem. But idol. Army from a criminal standpoint they're not gonna they're not gonna be criminally liable because they have legal prescription and generally those aren't the people that are actually overdosing at that point. It's when they go beyond the legal prescription. Level. And then say I am and I am addicted. And I can no longer get legal prescription that swear. The overdoses are coming more wrecked more what's happening is a thirteen year old kid gets a prescription says they have a shoulder operation. Like the doctor just. And they're given that are given some of pre order painkiller. There's certain amount of people that have a genetic composition. And disposition to get addicted to that great and like alcohol by the way there's certain people. Who have that genetic. Background that can addictive if they get addicted to it that they'll start taking more than they need or they'll start in other prescriptions through other doctors. Or they'll start stealing or they'll start take it heroin. That's usually the trend that's occurring when young teens and adults start getting pain medication a certain amount. A certain percentage those people can't take any of that and a tree some some the minute they start taking any. They start getting addicted others if they meet within them what the bottle says you should take your fine. He had the problem is. There are some addictive addictive nature in the doctor can better explain this where. You know certain people can't drink company they just can't drink at all or they get addicted. And I is that correct doctor correct me if I'm wrong you know yes and you know we don't fully understand whose pre disclosed but there is a population. And it's more of a genetic thing it's not something that. We're still are we we don't another read we don't really know. We both its top holy genetic or there's other influences. There has to be social influences well. Okay we're talking with doctor rest currents are atrium health. Professor of toxicology. And as well as former governor Pat McCrory here in Carolina focus. And once again we're addressing the OP or crisis here in North Carolina I guess in the sense across the country. But I wanna get more into the moloch sewn here in just a minute. Because. That seems to be somewhat of a light at the end of the tunnel and in this particular case it's not a train. Come in the other direction or at least hopefully it's not so it'll give people the opportunity to help address some of these issues that. Currently you know plaguing our society that you are listening to Carolyn focused on news talk Olympics in 993 WBT. 1079 in the went. One of 25610 W evidence the it's also available for podcast that have to be T dot com. You are listening to Carolina focus on who's talking 1110993. To compete. 1079 the link. 125610. WFANC. It's also available podcast at the TVT dot com on your host mark Thomas so glad you could join us here this morning we're looking at. People Buick crisis once again this is a topic that we've touched on. Numerous times here in Carolina focused because it is such a. Problem and it does affect so many families. Across the board and some might say well that only affects. Those kind of cameras and those kind of people and that's really not the case. Joining us now here in studio doctor Russ currents from atrium health a professor of toxicology. And also former governor Pat McCrory and also mentioned that Kelly Myers from 1079 the link is here as well. She is. Is the one that prompted me to actually bring up this particular aspect of this problem. And how to address it and we've talked about some of the things in the last segment about. How we got here. And not like to talk more where we can go on what we can do and we dimensional locks on and we mentioned that it is available now without a prescription. And that you can't get it not necessarily over the counter but if you go to the pharmacist desk. And asked the person in the white lab coat to get some. Chances are you can bet according to Kelly that's not always the case. Where she was because of her particular situation was wanting to get some and was denied by one pharmacy. And doctor governor. This has not supposed to be happy. Now a state law should require all pharmacies that do this. Com and nation we've gotten great cooperation from the pharmacies when we did instant this'll all infected doctor also has some issues about the cost him. If he does a lot of the people who buy this drug or to users themselves. It's often family members or friends or people trying to deal with the addiction issue. Of family friends relatives you name it co workers that work. So it's usually the people that are. Trying to provide some sort of help and guidance to people who were addicted to these drugs and trying to get amended treatment at the same time and trying to save their lives because they love them. And they'll do anything to help them so. The darker Doug tell us some of the prices of some of this and and but how much are you saving two by using this drug is an enormous. If the general cost if you if you go to the Internet. Two good RX. And search for no locks. And get a coupon you can often by edit one of the retail pharmacies for twenty to forty dollars a dose. Someplace is a little bit higher and this is for the nasal spray. That's easy to use. Lay persons can easily be trained in recognizing. Oh Buick overdose. When and how to administer. It's very safe. And you say it's you have a nasal spray that's is that the most common I understand it's also is an injectable as well you can you can get injectable bull were. Transitioning away from that just because. It's easier to use the nasal spray. And for laypeople. And you. If you don't use the new fuel delivery device correctly. Can cause harm although even. If you look at the whole picture that you've got to gel yeah on the locks and it is also relatively. Dollars but there from the standpoint that the damage you can do isn't isn't nearly trying to use bad as the damage is going to happen if you don't do anything at all correct. And if you go to one of the web sites of North Carolina health and human services. Www. No locks on saves dot org. They have a list of North Carolina pharmacies that stock a locks down. And that includes 170 pharmacies and Mecklenburg count. So there it is available and hopefully readily available to be to actually do need it right that's on the retail side. There's also oh. Mechanisms. If you cannot afford that there's also mechanisms. For some individuals to get this through free distribution programs. For example the North Carolina harm reduction coalition. If you go to their website. Www. In CH RC dot org. They have criteria. For some individuals who can get this free of charge. They also. Oh. Facilitate distribution to law enforcement and there's look. They rule give you directions to your nearest locality where you can get from the blocks. But as you said the the fact that. The law enforcement criminal justice system penalties have been rescinded. Drug prohibition has been rolled back if you will in these cases that's helping. To address this problem is not a yes in the in the last four years there's been. 8000. Community uses. This is this is bystander and law enforcement. 8000 community uses. Not walks. Reported to the North Carolina. Health and human services. And his doctor vause mentioned in the last segment. Good samaritan laws you people are getting going to be thrown in jail because. Their loved one is overdosing. They give them a lock zone and call EMS they come out and and others in some parallel in around. They're not going to be thrown in jail because there in the vicinity of what would normally be a fellow teacher correct. That's correct so that's that's helping as well. Now only that but on the sidewalk or someone collapses in the first its American walls was to help other doctors applied to any emergency where they were has sentence doctors forget to suit showing up at the scene of a car accident help and someone and they get sued. For that the practice of the provided someone who may have been behind him or save their lives and they got sued. Now there are laws that prove that don't allow doctors be sued. Who come up to an emergency situation try to make the best decision camp regardless of any type of act and in not to go down a rabbit trail but doesn't that also applied like CPR. As well. If you gonna someone slowly progresses you know knows CPR and that's that at the first good samaritan house applies to anyone who's trying to help save a life and a scene where immediate decisions have to be made. And some people were avoiding helping because they were afraid there is going to be legal liability in the long run and so. I'm proud to say that loans change. And 2000 are getting rid I guess in essence and get rid of legal penalties for helping people. And you know treating people who have problems. That's gonna help us treat more people. I mean it just a from a simple layman's standpoint it would seem you know. Pretty fundamental and anatomy of crazy ambulance chasers try to save someone's life well someone saw armor saved someone from bleeding. And more or is as we mentioned earlier you know with the clean needle programs you know facing arrest if you help someone in a case like this. Base. I mean. I think the general population used to think that. These measures might facilitate increasing drug abuse. We note that they're actually beneficial. I mentioned before that. These folks are more more apt to be willing to be tested for infectious complications. HIV hepatitis C. And they're actually more apt to enter into treatment programs that's from the but also from the North Carolina harm reduction in fact I was one of the politicians who when I was mayor until I became governor doctor Paul sings bomb on when there's no way giving needles it's acceptable because we encourage drug use and there is an argument there. But the greater argument was that hepatitis. Seep problem was expand and as such a rate. And and by the way cost the taxpayers. Hundreds of millions of dollars and it was Boston or Medicaid budgets. And and so much that we work. Able find money to provide necessary medical care because so much money was being spent and new hepatitis C patients up and and I is a financial need also from a conservative viewpoint you triggered another thought though. I know a number of years ago it was the case words if a doctor was treating pregnant mother and found out that she was on some sort of illicit drugs. That he had called bullies. And because it was a criminal I'm not aware. And I'm not aware of I sponsored that's another may be certain issues about if there is harm being done to a child pregnant person. Well and that could be some and that is legal issues where if a mother is mystery in. A baby there could be some legal issues they're that you're report but I'm not qualified to talk about that but it's been it's been the the idea that you know people are going to be facing criminal prosecution for admitting what addiction for example. Because by admitting addiction or listener you're engaging with. You know whether it's cocaine or her anyway doing the opposite now we're right we're during the providing drug courts now where. If people do a benediction and and up to that addiction that's what we want people to do so that we can now workers seek help but we've got a tremendous shortage. And drug courts and also drug rehabilitation I mean. We have to put more money into drug drug courts for one thing because about mark right now. I would say at a conservative estimate 60% of people that we arrest. Have addiction issues and we're not resolving an addiction issues in our county jails or state prisons. And when they come out of prison often especially at a panic shields as the arrests and they go right back on the street. Most of or break chance. The car break in the house spray cans are usually people looking for money to. Hell right there addiction issues or brake and your caller or even find pills now by the way you now before going to the drug cabinets. When breaking into houses here in Charlotte so well I was got to deal with this issue by interviewing one of the candidates for the north Carolina state house just recently. And his point was that he wanted to roll back some of these things because. You know we're giving you know criminal records to people and then when they get out they can't get tired so they can't find legitimate employment so that their back in the system again there there isn't there is an Asia regarding the rehiring of people who have gone through drug addiction. And there's also. Liability issues employers are reluctant to hire people who've had addiction because then if something happens say in the trucking industry. There's a possible for lawsuits news there're some. There are well below are the legal system the legal system is in needs to be looked at as a way to kind of maybe get out of the way like we talked about you know not making no locks on nonprescription. And making it not necessarily over the counter but perfectly legal for you to go and and by. And again to talk about. Killing Myers and her experience she did have to provide identification when she did get us. So it's not something that they're just gonna set yet here you go and give it to you what you pay in India on your way. But are there other things that we can do doctor from a medical standpoint. To help would help with this as well as is I know this is a good starting point where do we go from here. What that mean you touched on EMS among yes what you know about Islam. Changes. In Mecklenburg County first no walks and has been available through. For medics to use on scene treatment. For. As long as a practice. But they are now. Going to be part. And the locks zone rescue distribution program. They received a grant from. Cardinal pharmaceutical. And also grant from the North Carolina office of EMS. Where they have. They're gonna get roughly 15100. Rescue kids. That they can distribute. On the scene of a call. Or actually if and affected individual walks up to two a medic building. They can they can distribute no locks and rescued kits to that person. That's in process and should be starting soon so that would be an additional. Avenue beyond. Going to a local drugstore right. Because these are these are no cost no cost no dogleg going to do you are. Our first responders the fire department. Has been trained and does use the locks. And Charlotte Mecklenburg police department. Is going to have focused training for officers. In certain high risk areas. Of city and county as well and their I believe. They're in training. For that and as is a professor of toxicology in all this are there other things that were not. Utilizing at this point that that might help further. Resolve this issue. From your perspective as a medical doctor. I don't put you on the spot and asking you doctor solve the world's problems. Have pretty good knowledge about how to treat these folks. I don't know that it. On the expert. On the root of the all the socioeconomic. And and I'm not a silly ass in a socio economic issues but from a medical standpoint. The moloch so as you say has been here since as long as you've been practicing medicine and that's been. Only about ten or fifteen years may be little more. I can thank you expect a young man like you. But are there other things that are being used in hospitals and hospital setting that currently are available. That could help the could be added to this list to go because no locks on right now. We got one item on the list of things that people can use. Without prescriptions and easily administer. By late persons who have not been medically trained are there other things that might come into that in that supply chain if you will. That you're aware is there is there anything like that. Their salute. Focus. And interest in having more physicians that are appropriately trained and practicing addiction medicine. We have and that we have an addiction medicine team. Through the behavioral health center in Carolinas medical center. That can initiate. Medical assistant that are the using. It used to be methadone. Known as methadone clinics. There's other medications that are being substituted there are. Safer than methadone I was just had methadone is kind of like. It's Peter it was supposed to be your secure and help but it really. It's not living up to the advance billing. There's probably need from war. Clinics and manage. Chronic addiction. Does this not just a matter close. Giving the patient substitute medications for addictions. Or medicines to keep them from going into withdrawal. Counseling is also important. So for no locks on to help law and an immediate on immediate life for a life threatening faces which we know it which we know ago but it doesn't address the root problem right this is not a tree it is not a treatment for. The long term issue of addiction it's gonna save a life but it's not gonna cure an addict correct. To. Governor yeah probably two other issues that need to be mentioned one is some mental health. You know what comes first addiction or mental health it's it's a chicken and a type of thing but we have tremendous shortage of mental health beds. Throughout our nation it's bipartisan belief in his effort President Obama president trump. This governor of the current governor of the past governor we've all talked about it tremendous shortage of mental health. Facilities we have a lot of people that are sitting in emergency rooms were serious mental health issues. Emergency rooms can't really do anything with them and often just walked out after waiting 567. Hours and they go right back on the street and often. Then they take drugs to deal with her mental health the legal drugs or prescription drugs the other issue was enforcement I mean we've got a serious heroin. Problem since I've been when I was mayor we start see a lot of what they called black tar heroin coming into the city. And if it's a huge problem. And this heroin addiction among all ages of people among all incomes of people among all colors of people. Is an escalating addiction that we're seeing more and more and the amount of the cartels that are selling this heroin. Is increasing come across the border up I 95 court or an 85 border or the 77 quarter or. Coming from other distribution centers and it's not just an urban problem by the way. It is a rural problem also regarding this addiction and it is increasing and it's going to be I think one Imus series generational issues. Of of the United States worth. If it is an all aren't there yet and no question practices. If it goes across all ages. Ethnic roots discriminate so nobody absolutely equal opportunity and we would you would think. That this is more of a metropolitan issue but there were four cities in North Carolina that were named the top 25. Rate of the field abuse cities in the United States in their ball mostly. Wrote it's as small relatively small town Charlotte wrong they are not on the list so a lot of them are a couple more on the I 95 corporal warlock. Drug trade is being. Well in the from Florida up through all the way to new York and North Carolina isn't perfect what can we talk about the massive views depending on the statistics and I've looked into the a little bit and I heard once that which. Has been shown to be. Arguable. But on even on oh a lower bases. The US has four point 4% of the world population yet consume 57%. Of the world's morphine. We're taking this the morning anybody else that particular aspect of there was another one that was even greater than it made it look even much worse than that. But suffice it to say there's a lot of wedding there's a lot of money in this business well the US all of the money more glorious than anybody else right in. You know that has to be tempered a little bit with a lot of countries. Don't. Medications. Common medications. To use their anti pharmacies that are that are here that are war grabbing on the surgeries that right provided here. Yeah it's we have we have easier access to a portrait medications that some countries don't. Now this also want to comment on heroin while Irwin is stool. The number war on Carlson mortality probably the highest abuse drug. Including North Carolina. We're seeing an increasing incidents all. The synthetic. Fentanyl derivatives you might ask what's what is causing this transition. Because it's easier to make. Synthetic drugs in a small one. Than it is to farm. Poppies. Which is where error when it comes right and that's in and that takes is that. Amnesty and I don't wanna go down that rabbit trail right now I'd do what you wanna may only have a few minutes and one other thing to other alcohol. It's right up there by the way the addiction of alcohol is still extreme answers. And cocaine. Were we've been a major campaign issue when in Charlotte. And and I'm gonna throw one more thing out here marijuana by the way don't don't let that fool you it is addictive well I'll tell you what is governor Google's obvious you walked into something that I was gonna bring up because I initially started off talking about how much. It is increases the journal of American Medical Association. Article talking about the increases since 2000 OP would abuse this was part of a study that they did. That they publish talking about the associations is the title the association between US medical cannabis laws. And all Buick prescribing. In the medical Medicare part. I don't understand all Medicare part. This this is why I'm not a doctor. But the bottom line that they came up with a conclusion and it's a long study. The conclusion and relevance says medical campus laws are associated with a significant reduction in oak Buick prescribing in Medicare part. And it's particularly strong in states that permit dispensaries and for reductions in heidrick Cotto and morphine prescriptions. So those. Opiate prescriptions are the initial clause that lead people down this path. And they're saying that medical marijuana is something that's going to reduce those initial prescriptions is that something that we need to take a hard look at. To having medical marijuana in North Carolina. Governor you change your mind on The Beatles I'll miss well I'm real divided on this because the term medical marijuana becomes recreational marijuana very quickly rescued tourists and if you go back go to Denver right now. Where they have marijuana. The homeless rate is insistent horrible horrible that are all over the place you go to San Francisco where. Everyone's at the homeless rate because you CU can't hire people and that's an issue that we talked about a while affordable housing quite a bit there and if you don't if your guy if you don't it doesn't matter if they have affordable housing you can't get get him to stay in the Al's but I thought I wanna get doctor -- reaction to that. Is that something that from a medical standpoint do you think it's. Something that needs to be looked at. I'm probably not qualified expert to see. Whether or not. Medical marijuana is a good substitute. For chronic pain management rather than open it and I think it's an associate I think it was it was in conjunction with for what looks. It may decrease. Open you were prescribing right on the you know that's. In way out of my subject area. Mean I have I share concerns about medical barrel on. Becoming. More recreational marijuana you listen a little concerns before you'd you'd give give India kind of OK I understandable doctor gross earnings. Former governor Pat McCrory we appreciate you being here at Carolina focused doctor currents give that web site out once again if you could. For the programs if people were looking for blocks own wanna make sure people understand that is available OK without a prescription in its not. And possibly. In the near future some in some zones instances at no charge. Okay the first website this from the North Carolina harm reduction coalition. That's WW WNCHRC. Dot org. And also the North Carolina health and human services web site WWW. The locks on saves. Dog to work. Doctor Russ currently atrium health and former governor Pat McCrory we appreciate you being here on Carolina focus group tomorrow.