SALISBURY — Every year, around the holidays, families gather to celebrate glad tidings, but for those living with substance use disorders, the holidays can be everything but a celebration.

Hayley Edwards is Rowan County Health Department’s mental health and program manager. She is in charge of overseeing the department’s substance use programs, including The HOPE Program, which is “a partnership between Rowan County Public Health, Rowan County Emergency Medical Services, and the Center for Prevention Services that provides supportive outreach to individuals who use opioids and/or at high risk of an opioid overdose.”

For people living with substance use disorders, the holidays offer a whole host of triggers that can cause them to seek comfort elsewhere.

“Multiple things can cause someone to use more, especially around this time of year,” Edwards said. “The stresses that come around the holidays (include) more partying. Folks could be experiencing holidays without family members, especially if they have suffered a recent loss. It could also be triggering for people who have experienced trauma around the holidays.”

Those issues can make getting through the holidays difficult for anyone and especially challenging for anyone who might be living with substance use disorders.

Edwards pointed out that financial hardships are amplified around the holidays as well, particularly with everyone rushing to get friends and family the latest and often costly gifts.

Another element that might serve as a trigger is the seasonal weather that occurs this time of year. Storms can strand people in isolated environments, increasing the likelihood of substance use. For those who live outdoors without permanent shelter, substance use can be a way to stave off the cold.

When it comes to quantifying the number of overdoses experienced in a certain geographic area during a specific time period, it can be challenging. For instance, while the HOPE program does work with Rowan County Emergency Communications to collect data for its post-overdose response team, some overdoses are not reported. Others can be offset by personal supplies of the drug Naloxone, popularly known as Narcan.

“If someone goes to the hospital and does not report it to 911, then we do not get those numbers (either),” Edwards said.

Edwards added that they will take referrals from other agencies, too, or just anyone who calls them seeking help for themselves or a loved one.

“Even if that individual is just using alcohol, we will work with them and collect that information into our system as data,” Edwards said.

So, where does Rowan County rank when compared with statewide data?
The Opioid and Substance Use Action Plan Data Dashboard from the North Carolina Department of Health and Human Services paints a pretty bleak picture.

In 2022, Rowan County overdose deaths occurred at a rate of 62.6 per 100,000 residents, or roughly twice the state average of 36.9 deaths per 100,000 residents.

That metric includes deaths involving all types of medications and drugs: opioids (commonly prescribed opioids, heroin and synthetic narcotics like fentanyl and fentanyl-analogs), stimulants (cocaine, methamphetamine), benzodiazepines and others.

It includes fatal overdoses of all intents; more than 90 percent of those deaths are unintentional.

Taking in data from the previous year, Rowan County has the fourth-greatest rate of Fentanyl-related overdose deaths in the entire state. Between October 2022 and September 2023, 98 people in Rowan County died from Fentanyl-related overdoses.

Fentanyl is a synthetic opioid used for the treatment of pain. According to the Centers for Disease Control and Prevention, it is 50-100 times more potent than morphine. Its strength and common composition with other substances make it a high-profile killer.

Pinpointing the cause for Rowan County’s above-average substance use is not a simple solution, but Edwards and the HOPE Program aim to get those numbers down through harm-reduction strategies.

“It meets people eye to eye,” Edwards said. “Harm reduction wants to keep people safe and work with that individual to make sure they are decreasing their substance use.

“It might get them to a point where they are willing to seek treatment.”

The program started out in 2019 with a post-overdose response team.

“It has grown more in the last year, especially since we got the opioid settlement funding,” Edwards said.

Her group offers Narcan educational services as well as peer support.

“The biggest part of peer support services is that they have walked in those shoes and understand what it’s like,” Edwards said.

Solving overdoses and preventing unnecessary deaths won’t be easy, but with the work of the HOPE Program and other community efforts, hopefully, that loved one struggling with substance use disorders will be around for many holiday seasons to come.

“It takes a community to come together and make a change,” Edwards said.

And remember to call your loved ones, family and friends to check on them this holiday season.