NEWS & OPINION FEATURE

not even necessarily being followed by the letter,” she added. “We still have those being arrested for paraphernalia that they should be covered under. So I can’t imagine adding a law like this to the books, what that’s going to look like for our folks.”

What the data shows

North Carolina’s death by distribution law — which the latest legislative proposal seeks to strengthen — was passed in 2019 and went into effect Jan. 1, 2020.

In 2019, law enforcement agencies and district attorneys said they needed the death by distribution laws to put dealers behind bars and curb drug overdoses in the community. Advocates, including Carroll, told lawmakers at the time that death by distribution laws would decrease 911 calls during an overdose and would lead to a more unstable illegal drug market and more fentanyl entering the drug supply.

At the time, no one could have predicted a global pandemic, which substance use experts and people on the ground said also greatly disrupted the drug supply and increased overdoses. Whatever the combination of factors, fentanyl-involved overdose deaths have only climbed since 2019.

The number of overdose deaths in which fentanyl was detected more than doubled from 1,490 in 2019 to 3,062 in 2022, according to the North Carolina Office of the Chief Medical Examiner.

The NC Department of Health and Human Services’ Opioid and Substance Use Action Plan Data Dashboard shows a decrease in reported law enforcement overdose reversals across the state since 2018. While not all counties have reported their law enforcement reversal data to the state, those that did show a decrease over time.

In the fiscal year spanning from 2019–’20, there were 10 death by distribution cases filed by district attorneys statewide, according to data collected by the NC Administrative Office of the Courts. In 2020–’21 there were 35 death by distribution cases, and in 2021–’22, there were 46 cases.

A review of the data from the Administrative Office of the Courts shows that Harnett County prosecuted the most over the three-year span, with 11 total cases. That county has seen a 142% increase in overdose deaths from 2018 to 2021, according to state data. The latest available rate of overdose deaths in Harnett was 52.2 per 100,000 people, while the statewide rate of overdose death is 38.5 per 100,000 people.

Closure for families

District Attorney Lee told senators gathered in a committee in March about a case he prosecuted in 2016 after a woman in his county came to him and asked him to charge the person who sold the drugs that killed her loved one. North Carolina has had a form of a second-degree murder charge on the books for drug distribution since the 1980s.

“I worked for the Onslow County sheriff at that time and we were able to bring charges against an individual after extensive investigation to prosecute that case,” he said, “And he was convicted of seconddegree murder. And so I’m very passionate about this.

“I have people calling me continuously: What can you do to help my son? What can you do to help my daughter? What do you do to help my family?” Lee said.

The North Carolina Sheriffs’ Association also released a statement supporting Senate Bill 189, saying it would protect law enforcement officers and the public.

“I thank the committee for standing up for supporting the families today and families across North Carolina [who] have lost family members to these overdoses and fentanyl poisoning,” Rockingham County Sheriff Sam Page told one senate committee.

Carroll, along with researchers Brandon Morrissey and Taleed El-Sabawi, surveyed North Carolina prosecutors to better understand their reasons for pursuing death by distribution cases, also known as drug-induced homicides. NC Health News reviewed their findings, which are in the peer review process.

Two-thirds of survey respondents reported having charged someone with a drug-induced homicide in the past. Respondents indicated that two of the highest-rated reasons for bringing death by distribution charges were “justice for the deceased” and “justice or closure will be obtained for the family of the deceased.” Carroll added that the respondents were less confident that death by distribution cases would stop overdoses.

“We found that one point prosecutors really agree on is that these laws will bring some sort of closure to the family,” Carroll said. “That is not a valid use of prosecution.”

In Madison County, Bryce said she knows many local residents who have lost loved ones to overdose who do not want closure in this way.

“Who’s gonna feel better that their son-in-law’s suddenly arrested for murder after they’ve lost their daughter?” Bryce said. “I know a lot of folks locally who have lost someone to overdose, and I don’t know anybody who’s gunning for vengeance on the person who provided the drugs in the first place. That’s not really a top priority. I think the top priority is ensuring that there’s safety available if that person is looking for it.”

What will help?

Advocates for people who use drugs want to see the same energy and money put toward public health solutions that have been shown to reduce overdose deaths.

“It is time for lawmakers to recognize the failings of the Drug War and come to the realization that we cannot punish our way out of the overdose crisis,” reads the statement from the Urban Survivors Union.

“Instead, we must prioritize a communityinformed, culturally competent and evidencebased approach to finally address this public health crisis,” the Union added. “That means investing in accessible, humane drug treatment, funding harm reduction strategies and passing a stronger Good Samaritan Law that aligns with the problems facing North Carolinians today.”

Other countries have dealt with drug overdose epidemics in the past and have taken seemingly radical but effective strategies to reduce deaths, get people into treatment and weaken their illegal drug markets.

Carroll said the United States has been using a criminal justice approach to drug use for decades and it’s not working.

“If it was going to help, it would have helped by now,” she said. “They are basically positing a … strategy for reducing overdose that is ignorant and wrong.”

“It would be really, really great if the same energy went into things that we actually know reduces deaths — that we actually know keeps young people safe,” Carroll said, “and that we actually know brings people out of crisis if they are living with substance use disorder.”

This article first appeared on North Carolina Health News and is republished here under a Creative Commons license. North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org.