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### A Turning Point in America’s Fentanyl Crisis: North Carolina's Story of Recovery and Hope
#### Kayla's Journey Into Addiction
Kayla’s story is not unique, but it is deeply emblematic of the opioid crisis that has devastated communities across the United States. Growing up in North Carolina, she first tried fentanyl at the age of 18. Struggling with inner turmoil, she recalls, "I felt like literally amazing. The voices in my head just completely went silent. I got instantly addicted." The pills she took—small, blue, and deceptively powerful—were likely manufactured illicitly in Mexico before being smuggled across the border. Like so many others, Kayla never knew exactly how much fentanyl was in each pill, always risking a fatal overdose.
Fentanyl, a synthetic opioid, is about 50 times more potent than heroin. Its potency is a double-edged sword: while it can provide rapid, intense relief for pain, it also dramatically increases the risk of accidental overdose, especially when used without medical supervision. In 2023 alone, the United States recorded over 110,000 drug-related deaths, a number driven largely by fentanyl and other synthetic opioids. The epidemic seemed unstoppable.
#### A Surprising Reversal
Yet, in 2024, something remarkable happened. For the first time in years, the number of fatal overdoses fell nationwide by approximately 25%. That equates to nearly 30,000 fewer deaths, saving dozens of lives every day. North Carolina led this positive trend, recording a 35% drop in overdose fatalities—a testament to innovative policy changes and community efforts.
#### The Shift to Harm Reduction
One of the key factors in this turnaround has been a shift in strategy from punitive approaches to harm reduction. Rather than focusing solely on criminalizing drug use, harm reduction prioritizes the health and well-being of people who use drugs. It accepts the reality that drug use, and especially opioid dependence, is often a chronic medical condition, not simply a moral failing or a crime.
In North Carolina, harm reduction is more than just a catchphrase—it has become a guiding principle. Kayla is a beneficiary of this new approach. She participates in an innovative Law Enforcement Assisted Diversion (LEAD) program in Fayetteville, a collaboration between the local police department and the North Carolina Harm Reduction Coalition. The program’s goal is to divert those with substance use disorders away from the criminal justice system and toward recovery and support services.
Lieutenant Jamaal Littlejohn, a Fayetteville police officer, explains the logic: “If someone’s stealing from a grocery store, we run their criminal history. And often we see that the crimes they're committing appear to fund the addiction they have.” Instead of jail time, eligible participants are offered help—support for their addiction, assistance with housing, and pathways to employment. This isn’t about being soft on crime, Littlejohn insists; drug dealers are still prosecuted. But helping people with substance use disorders allows law enforcement to focus on more serious crimes, while giving those in need a real chance at recovery.
#### Recovery Through Treatment
Kayla’s life has dramatically improved since joining the program. Gone are the days when she resorted to prostitution to fund her addiction. As part of LEAD, her criminal record has been wiped clean. She recently became a certified nurse assistant and now works in a residential home. "It's like the best thing ever. This is the longest time I've been clean," Kayla says.
Central to her recovery, and to the broader decline in overdose deaths, is access to effective treatment. Kayla has been on methadone for nearly a year. Methadone, along with buprenorphine, is a medication used to treat opioid use disorder. These medications reduce cravings and prevent the severe withdrawal symptoms that often drive people back to drug use. Nationwide, medication-assisted treatment (MAT) is playing a vital role in reducing overdose deaths. In North Carolina, more than 30,000 people were enrolled in MAT programs in 2024, with numbers continuing to rise in 2025.
At the Morse Clinics in Raleigh, the state’s capital, people line up as early as 5:30 a.m. to receive their daily medication before heading to work. Dr. Eric Morse,