Public Health Alert: Increased Overdoses From Heroin, Fentanyl and Fentanyl Analogues

The North Carolina Division of Public Health (NC DPH) identified a significant increase in overdoses from heroin, fentanyl, and fentanyl analogues in August 2017. Given this increase as well as the continuing opioid epidemic, NC DPH recently distributed an alert to provide information on this situation and ongoing guidance to clinicians treating patients with opioid overdose and related conditions.

NC DPH identified an increase of 136 opioid overdose emergency department (ED) visits from July to August 2017. There were 646 opioid overdose ED visits during August 2017, compared to 510 during July 2017. This is the highest count of opioid overdose ED visits compared to previous months in 2017.

The majority of these August 2017 opioid overdose ED visits were among patients who were white (85 percent), male (64 percent), and between the ages 25 to 34 (42 percent). The highest rates of opioid overdose ED visits occurred in Cabarrus (26.3 per 100,000 residents), Rowan (22.9 per 100,000 residents), and Lincoln (17.2 per 100,000 residents) counties, and 73 percent of the August 2017 opioid overdose ED visits involved heroin. Review the data.

NC DPH recommends the following actions:

  • Prescribe/dispense naloxone to patients discharged home after an opioid overdose to prevent death from future overdose.
  • Per CDC guidelines, clinicians should also consider offering naloxone for patients with history of overdose, history of substance use disorder, on higher opioid dosages (≥50 MME/day), or with concurrent benzodiazepine use (
  • Educate family and friends that naloxone can be dispensed at participating pharmacies under NC’s standing order for naloxone. Information on participating pharmacies and use of naloxone can be found at
  • Provide information on syringe exchange programs: Syringe exchange programs are effective in decreasing the transmission rates of HIV and hepatitis C, as well as connecting users to treatment.
  • Screen patients to determine risk for or presence of opioid use disorder, and connect to treatment services. Information on 24/7 crisis lines can be found at

Read the official health alert.


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