- State of Recovery was made possible by financial support from-- [music playing] - We resolve to do more-- to listen, understand, and act, and to see that you get the care you need.

Blue Cross and Blue Shield of North Carolina-- we resolve to make health care better.

[music playing] - We are in the midst of a crisis.

- I tried it, and the best feeling I ever had in my life.

- The drug culture has changed.

- It's not the plan you had for your child to become a drug addict.

- The opioid epidemic, you can't hide it.

It's everywhere.

- We had a child perish because of it.

Where can we get the help that we need?

- The community has to be involved.

We're not going to rest till we handle this problem.

- Let's treat the addiction.

- Please don't ever say, not my child.

[music playing] - It's important to understand fully the differences between the different types of opioids.

So prescription opioids can be really helpful medications.

Anybody who's had an acute injury or an operation where opioids was part of their pain management strategy, often they're very appreciative of the kind of relief you get.

- In the 1990s, we saw what's called the prescription opioid epidemic.

And this was related largely to prescription of opioids for pain.

That was the first wave we saw.

In 2010, we saw that wave change into heroin wave.

People who were addicted to prescription opioids shifted to heroin.

And the most concerning wave was in 2013 and is still ongoing.

And that's called the synthetic opioids or the fentanyl wave.

And that battle is they increase in opiate overdose deaths, which we see today.

- So opioids can be used by many people without the development of addiction.

But they are very addictive drugs.

- We think they are 90,000, 100,000 people who are dependent on these pills on a daily basis.

So it's a huge number.

About 1,700 died of an opioid overdose last year.

This is a very distributed crisis, meaning that it's in every county in North Carolina.

And it's in every community in North Carolina.

[music playing] - My name's Gary Quick.

I'm a lieutenant with the Craven County Sheriff's Office.

I work investigations.

I oversee our criminal division and our narcotics division.

So about six to eight years ago, it started with the pills in Craven County.

And there was a overabundance of pills being brought into the county and the area.

So we try to grasp a hold on this by stopping it coming into the county through interdiction or traffic stops.

We do undercover buys, take it off the streets.

These items are seized by our deputies, whether it be narcotics patrol, canine, or crime suppression unit.

These are weapons that are taken off the streets.

This is money from a traffic stop, also some drugs from other traffic stops.

- Do have your driver's license on you?

- No, I actually don't.

- So the traffic stop she just made, there are some indicators to her that she thought maybe narcotics were present.

So they're stopped on a traffic stop.

They're arrested.

They go to the court system.

And the court system will mandate an option for treatment because the goal is to get people off of the drugs, not just incarcerate them.

- On the enforcement side, we are aggressively going after the drug traffickers and drug distributors.

But we also have to sort of change the way we approach.

If somebody's crime is because of their addiction, let's treat the addiction.

Let's get them out of the criminal justice system into the health care system where they can get healthy and well.

- So it's a multi-front on this.

You have to do enforcement.

We're not going to rest till we handle this problem.

The community has to be involved-- community leaders, the churches, organizations.

It's a multi-tier approach to this.

- Literally, there is something that every single person in North Carolina can do to fight this.

One thing you can do is just go check your medicine cabinet.

40% of all pills came from Dennis for wisdom teeth removals.

Or they get them, the extra left over at their parents' or their grandmother or their aunt and uncle's medicine cabinet.

So we're trying to get all those leftover pills out of people's medicine cabinets.

Athletes are especially prone to this.

A high school athlete gets prescribed medication for some injury.

They want to power through it and get back on the field or get back on the court as quickly as possible.

We want to make sure that the parents, the athletic directors, the coaches, all understand the real risks of opioids.

Make sure that there are no leftover pain pills there because you would not leave a loaded gun in your medicine cabinet.

You should not leave these pills in your medicine cabinet.

- So this is our pill drop operation.

We have one here at the Sheriff's office.

We do this every few months in the community.

This is stuff that keep drugs out of community.

They're in law enforcement places.

We go to the community with our boxes every few months and have a gathering and pick them up ourselves.

It's going to take law enforcement to work together on this.

And it's because drug dealers don't have boundaries or county lines, city lines.

They go wherever.

So for this to work, law enforcement is going to have to work together to make this happen.

- I would say the most critical next step in addition to continuing to push forward on the law enforcement moving people out of criminal justice into treatment, we have to do a better job treating people who are sick with opioid use disorder.

[music playing] - We are pretty much a normal family.

Amber enjoyed school.

She enjoyed her friends.

And she got in later to a drill team.

She was pretty active.

Amber, I'd say, around 25 is where all this started taking place.

- My prescription medications became a problem.

I noticed it was being overused like once I was reliant on it.

- The big wake up call for me as to what was going on with her is when she had that first accident on the bridge.

She had hit the barrier where the lane veers off to the right.

She was standing in the road looking for her cell phone, not even realizing that her child, her young son, was in the back seat of the car.

She was ordered to get involved in a drug rehabilitation program.

The program helped her.

This lasted a year.

- I was completely clean and you know what I'm saying, doing good.

I had made that choice to do that.

But I feel like once you're an addict, you're always an addict.

And you struggle with that through your life.

- I think where things slipped up is when she found this doctor that was willing to write prescriptions without even checking to see if she was red flagged on the computer.

She had a problem with the pills.

You don't even realize that you're addicted when you're addicted.

When I saw the signs the second time, she wasn't the same Amber.

And Amber loved her children.

- She was the perfect child from birth.

Like, she never cried.

She was amazing.

She was my princess.

She was the epitome of a perfect child.

- Well, we had Christmas, 2012.

- I made something.

- Amber didn't come home.

I talked with her on the phone, explained to her it was Christmas, you need to be here.

Of course, she never showed up.

- I got the Barbie.

- We were able to have a good, successful Christmas for them.

They had so many things that a lot of them still weren't open when the accident happened.

And the accident happened February 22, at 4:00 PM, 2013.

And a chain of events that took place led up to that.

She got the prescription.

She got the drugs.

She had another accident.

And we had a child perish because of it.

- 7835 Code 6.

- I had just got home from work.

She asked me if I had heard about the accident.

I says, no.

What's going on?

She goes, well, Amber's been in a bad accident.

I said, what about little Blaze?

Is he OK?

And they said, well, he's been transported to Craven Regional.

He seems to be OK.

But they want to check him out.

And I asked about Alanna.

And they said, well, she's nonresponsive.

It's like the worst nightmare that could possibly ever happen to anybody, any family, losing a child.

She was so numb from her addiction, it didn't even seem like she was sorry for what had happened.

And I realize what the drugs do to people.

But she just was numb like she was waking up from a bad dream, like she never even realized what had happened.

- Waking up at first, like, it was completely surreal.

Like, I was in like a psychotic stage of denial, like didn't even feel like my life was real.

- But basically, we went from five people to two.

You know, Amber's in the prison system, the Raleigh Women's Center.

Her term was 12 years.

She's on year seven.

- It took a lot of time.

But since then, I've had to try to accept the fact and accept responsibility for anything.

Whenever I get out, like, I can't imagine going backwards, specifically if for no other reason than what I've lost.

Like, what my choices and past addiction has taken from me, I feel like is a crucial price to pay for an extensive lesson.

- Her son's staying with her aunt.

And of course, Alanna, she's just down the road a little bit.

We go see her all the time.

The biggest concern that I have and everybody out there would have is where can we get the help that we need?

- Since being here, of course, you know, being in an institution, whether you intend to or not, you basically of course get clean.

However, someone who is trying to utilize any resources, like, there are basically none here.

- It's easy to say, well, they need to be in a program.

There was two things wrong with them.

One, they were ineffective.

And the second one, it cost a fortune.

And there's still no guarantee.

The programs that we need in place have to be intense.

Amber has got a long way to go.

But she's eager and ready to try and put her life back together.

- Now I'm going to have to do a lot of catching up, make up a lot.

It has impacted my family.

Like not only my accident, but me being gone as well, like, it's basically just taking everything away from my entire family.

But if I now could say anything to her, I would tell her thank you for teaching me everything that she taught me and making me-- or for helping me grow into the person that I am today.

- I still have a lot of fear.

We all that have dealt with this have a fear of her returning.

I just have my guard up.

I wonder, like any parent, I want her to be restored.

I want to see her smile again.

I want her to get past what has happened and become all that she can become.

- It shouldn't be illegal to be an addict.

It's not always their fault they're an addict.

I mean, yes, you have a choice.

My parents always thought I had a choice.

And no one had a gun to my head that night, saying, if you don't put this needle in your arm-- Your brain just overrides.

Your brain takes complete-- just, you're powerless over your addiction.

- One way people look at it is if you are choosing that, then you can also choose not to use drugs.

That's a very simplistic way people look at this.

And the way to kind of counter that, in my opinion, is to see what the opioids do to the brain.

So the first thing that happens is when you use a drug is you increase the level of a chemical called dopamine, which is a reward chemical and a part of your brain.

Now, when we eat, we watch TV, sexual activity, that all increases that.

So that's a normal reward pathway.

But that gets hijacked by the drugs.

And if that happens, the drug seeking is compulsive.

- There's always a choice.

But at the same time, it gets to that point where it's taking a toll on you, like, it's hard saying no.

You know what I'm saying?

- So universally, what we see is one of the biggest risk factors for addiction is early use of drugs or alcohol.

One study, for example, looked at if you used drugs before the age of 11, if you followed them into adulthood, there was a 38% higher risk of being addicted.

Now, the front of your brain, that area is responsible for decision making.

And that's the last to mature, OK, which is in your mid-20s.

So you can imagine in adolescence, when they start experimenting or using drugs at an early age, your frontal part of the brain is not developed, so they are not able to understand the risks and act more impulsively.

I think when you educate people in that context, some of the stigma about saying, well, everything you do is a choice, people start look at it in a different manner, that it's driven by what's happened in the brain.

It does not mean that they should not be responsible for the consequences.

The consequence people are responsible for.

But the drive is coming from what's happening in the brain.

[music playing] - So last year in Craven County, we had 226 overdoses.

Across the state, there were over 4,000 overdoses.

That's just the ones that are reported.

The main goal is to get people off this, to stop this.

How do we get them in these programs to get them off the streets and get them away fro the heroin and the drugs?

- The new year begins with a new law in North Carolina that many are hoping tackles one of the roots of the opioid crisis here in our state.

- The thing that worries me is we're talking a lot about the opioid crisis.

And there's been a ton of attention on that.

- Leaders from across the state are here in Raleigh to address the opioid epidemic.

- And I wonder, you know, what are we going to see in the next 10, 15, 20 years from the children who have been impacted by this?

How many children are growing up without a parent because their parent died from an overdose?

- I've been doing OD where a person goes in a gas station bathroom, overdoses, and come to find out his child's in the car by himself, his infant child.

- It's pretty easy to look at those parents and have an emotional reaction, you know, like, how could they or that's so selfish.

And you're going to look at that kid in the back seat.

And you're going to say, my god.

You know, you got a lot of compassion for this kid.

You know, what could I do to help this kid?

What do you think the kid's risk is for ending up in the front seat like the parents?

If a kid has parents with diabetes, the standard of care is that the pediatrician's going to assess for risk factors for diabetes.

If we just change the scenario slightly and say, there's a kid, and we know that one of his parents has a history of addiction, we really need to be focusing a lot on the multitude of risk factors for children that have been impacted by this latest crisis.

[music playing] - My journey with my son Carson inspired me to start the Triangle's first recovery high school.

- My friends began smoking weed.

And I wanted to try it.

- We found out he was smoking marijuana.

But we just noticed there was a difference in his behavior.

There seemed to be something.

- My addiction went from here to here.

- There's approximately 43 recovery high schools nationwide and approximately 1.5 to 2 million adolescents who struggle with substance use disorder.

[music playing] It's exciting to be the Triangle area's first recovery high school.

It's exciting.

But there are lots of challenges for something that people don't know about.

And on top of that, you're fighting the stigma.

[music playing] - Labeling a person with a disease that they suffer is completely unfair.

They are people first.

They might be people with an opioid use disorder or a person with addiction.

But they are people, not addicts.

- There's so many things that would tie together to help break the stigma.

But we've got to start somewhere.

We've seen this before.

But I really wanted to kind of stress it again.

If you're not familiar with terms, even the word overdose, you know, really, correct, it's drug poisoning, you know, again, just trying to help break the stigma.

You know, I've been guilty in the past of using words like addict, alcoholic, drug use, overdose-- those words in particular.

But through my education and realizing, those are stigmatizing words.

Language is very important because again, it goes back to giving value to the person.

- My son, he's really more doing 12 step work.

They refer to themselves as alcoholics.

And he said we all refer to ourselves as alcoholics in his group, whether it's drug use or alcohol.

But he also uses the word allergy a lot.

- Each person is going to have their own definition and how they're going to explain it.

And some of the criteria of being an alcoholic or an addict, I mean, you're going to go through like the phenomenon of craving.

It's an allergy.

I'm going to have an adverse effect to it, which makes the difference between what happens to me when I drink versus, like, Jimmy who doesn't have a problem.

Things are going to go really bad for me.

I'm not going to drink one.

So it's kind of their own reasoning and thinking behind it.

- No one chooses the disease of addiction.

And understanding that and using the right language to not stigmatize someone.

Just changing our language is going to help break the stigma.

[music playing] We are very excited to announce we were approved for our location.

Inspections are all clear.

It is a reality.

We will have the Triangle area's first recovery high school at Open Table United Methodist Church, downtown Raleigh.

Guys, thank you so much for your support.

We hope you have a blessed, wonderful day.

Have a great one.

Thank you so much.

Bye.

So today, I'm really excited.

We're meeting with Will Guest.

He sits on our board.

And we're meeting today, so I can really talk to him specifically about our recovery program and what that looks like.

[music playing] - My name is Will Guest.

And I am a substance abuse counselor.

- So when you think of adolescent recovery, what are some key components that we're going to need to make sure that we have for WMA?

- I do think what's going to be really important is that the approach with the school from the day one has been not only the educational part but the recovery aspect.

So I do think the teacher needs to be there for the educational part of the school, but also, the relatability to be able to connect with the students.

But then also, I think, and what's always really, really important is can the students then relate to the teacher themselves, like the staff at the schools.

- Right.

- I can relate to the students that would possibly actually start going to the school or would be going to the school.

Myself, I got sober when I was 18.

So I think there's different types of people who use drugs.

I think there's people who are just never going to do it because it's illegal.

It's bad for you.

I think there's a second type of person who is going to try it one time.

And it's just not their deal.

There's a third type of person who's going to use drugs and/or alcohol and really like the effects of it.

But if you were to provide them a consequence or give them a good reason to not do it again, they really would follow through.

What's tricky is there's this fourth type of person who doesn't like getting high.

They absolutely love the feeling that it provides for them.

Then that's my experience.

They're also the people given a good reason to quit, provided a consequence.

They're going to say the same thing as that third person, is I'm going to quit.

Yes, you're right.

Like, I won't do that again.

I feel really bad.

But they're the person a week later who's going to be using again.

I definitely am not the one to talk about the curriculum or the educational components of it, which is important.

But I think it's, you know, how do you make this all gel and work because those two things a lot of times, recovery and school, don't mix too well.

But there is a way to do that.

[music playing] A lot of long term success with people in recovery is finding a positive peer support system.

It's other like minded people who are doing the same thing that you're doing that you can relate and connect to.

- We have found out that recovery's best in community.

- There's not a lot of success with if I'm trying to get sober for me to hang out with people who still continue to use to any level.

The success rate of me staying sober is not the best.

It's kind of one of these ideas if I want to get really, really good at basketball, I'm not going to go hang out with the soccer team.

I need to find people I can relate and connect to who are doing the same thing I was doing.

- Ideally, what we want for these kids is they would go to the recovery high school during the day.

Then they'd go to their APG in the afternoon.

And it continues on the weekend.

So what is happening is those adolescents are constantly in recovery.

- With Wake Monarch, I mean, a big component of the school is going to be involvement in an APG.

So there's going to be weekly meetings that you're attending.

And they're not talking about school.

They're talking about your recovery.

- What we noticed with him is that he would go to an adult AA meeting.

He would look around the room and immediately, if he did not see other adolescents close to his age, he would sit in the chair.

He would be there because we were supporting him and saying, you need to go.

But he would totally tune out.

- I am not like these people.

I do not deserve to be here.

And I hear their stories.

And just, I just can't relate to any of them.

I guess I've been through addiction but not addiction like they have.

I haven't seen the consequences they have seen.

- An adult getting treatment, getting sober, they've had maybe decades of use.

And they could see, well, I've lost families.

I've lost jobs.

- I was the youngest guy in the program.

I was only 18.

The youngest guy closest to my age was like 24.

So I was like, oh, my gosh.

I'm like, this is not for me.

- One of the great things about most APGs, you know, is that everybody has a desire to want to be there.

So everybody has the same goal.

It is to stay sober.

They can get better.

And people do recover.

And people are getting better all across North Carolina.

- You have to continue working on strengthening your community, your recovery community, you know, working on the things to continue you moving forward.

[music playing] - The World Health Organization has declared coronavirus a public health emergency.

- Interesting times, challenging times for most people, whether you're in recovery or not in recovery, whether you have addiction or don't have addiction.

These are stressful times.

And stress impacts people in a lot of different ways.

And substance use is one.

- This is the most restrictive measure we have seen in our area yet.

Durham Mayor Steve Schewel us the stay at home order is coming tomorrow morning.

- The folks that we serve tend to be more vulnerable to homelessness because they've come out of homelessness.

At the same time, you got people living together who have been asked to not have contact with people from the community.

And then another thing that's kind of a unique kind of variable in this is the stimulus check.

And so the stimulus check can create an obstacle to somebody who may be using and thinking about getting help but now having gotten a stimulus check, that's going to fuel kind of continued use and prolong getting access to services.

You know, like pre-COVID, people have kind of referred to people's tax returns, you know, they say rapid refund check.

And people with addiction in recovery start calling it rapid relapse check.

You know, a few years ago, we saw an individual get their tax return.

You know, and that prompted them to leave on a Thursday.

And on Saturday, they had died from an overdose.

- You know, when COVID-19 hit everyone.

It hit everyone.

- The first month of COVID, I blew through a lot of my savings for food, for other stuff that I needed.

You know, I wasn't working at all.

- We had a son that now we-- we're on a budget.

And we didn't plan to pay rent, for him to lose his job.

He didn't plan for it, either.

Business wound in my lap that just-- that I needed to do to like, this could bring income into our family.

So I actually had to step away for a little bit to be able to support my family.

- This is affecting a lot of different aspects of life.

You know, the schools were never meant to run 100% on distance learning.

But now it looks like that will be the only way kids learn for the rest of this academic year.

- Just walking by faith because of what to do next, you know, and being OK with myself to just step away for a little bit, kind of regroup.

[music playing] - Quality public television is made possible through the financial contributions of viewers like you who invite you to join them in supporting PBS NC.