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Asheville/Buncombe County - Opioid Addiction Symptoms & Treatment

Opioid Addiction Symptoms & Treatment image


In 2018, there were 265 opioid overdose emergency department visits in Buncombe County.

79 Buncombe County residents died from unintentional opioid overdose deaths in 2018.

606 community Naloxone reversals were reported in Buncombe during 2018.

Today in North Carolina, you are more likely to die of an overdose than a car crash.

Addiction is a disease and can happen to anyone. Whether you or someone you know is impacted by opioid addiction, help and hope are closer than you think.

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The Opioid Epidemic

Opioids are chemicals that are either produced from the opium poppy plant or created in a lab to have the same effects.

Some opioids are prescription painkillers, such as oxycodone, codeine cough syrup, Percocet, or Vicodin. Some opioids, like heroin and fentanyl, are produced illicitly and are illegal drugs.

Opioid drugs work by binding to opioid receptors in the brain, spinal cord, and other areas of the body. They reduce the sending of pain messages to the brain and reduce feelings of pain. They are also highly addictive and can be deadly.

The Bottom Line: your risk of addiction increases every day that you take prescription opioids.

You can keep up with opioid related news and ways to be involved by visiting the News section on this page.

Prescription Painkillers (Opioids) can include: Oxycontin, Oxycodone, Percocet, Tylox, Demerol, and Fentanyl, among others. Heroin is also an opioid. Lock up or hide your medication, and properly dispose of old, expired, or unused medicines.

Prescription Painkillers (Opioids) can include:
Oxycontin, Oxycodone, Percocet, Tylox, Demerol, and Fentanyl, among others. Heroin is also an opioid.

3 Ways to Help

Ways to help: Option 1 - Talk about this as a health epidemic to your children and friends.
Ways to help: Option 2 - Decrease the number of painkillers in use in our community. Ask your doctor for other ways to deal with pain. Secure your painkillers. Safely dispose of unused painkillers.
Ways to help: Option 3 - Know the signs and symptoms of addiction and support those who want to begin their recovery.

Symptoms of Substance Misuse / Addiction

  • Reduced sense of pain
  • Agitation, drowsiness or sedation
  • Slurred speech
  • Problems with attention and memory
  • Constricted pupils
  • Lack of awareness or inattention to surrounding people and things
  • Problems with coordination
  • Depression
  • Confusion
  • Constipation
  • Runny nose or nose sores (if snorting drugs)
  • Needle marks (if injecting drugs)
  • Regularly taking an opioid in a way not intended by the doctor who prescribed it, including taking more than the prescribed dose or taking the drug for the way it makes a person feel
  • Taking opioids "just in case," even when not in pain
  • Mood changes, including excessive swings from elation to hostility
  • Changes in sleep patterns
  • Borrowing medication from other people or "losing" medications so that more prescriptions must be written
  • Seeking the same prescription from multiple doctors, in order to have a "backup" supply
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Community Response

Buncombe County and partners throughout our community are coming together to address substance use disorder and the impacts of addiction and opioid overdose in our area. Buncombe County is pleased to partner with other public organizations, health care providers, faith groups, nonprofits, the business community, and community advocates as we work together to stem the disease of opioid addiction and overdose deaths.


  • Inter-agency planning teams
  • Communicable disease outreach & vaccination
  • Training for prescribers and medical professionals
  • School-based outreach

Harm Reduction

  • Drug take-back events
  • Safe disposal for medications and injection supplies
  • Overdose reversal medication
  • Syringe exchange services

Public Awareness

  • Speakers bureau
  • Community town halls
  • Bus ads
  • Opioid student summit
  • Training and materials


  • Public nuisance lawsuit against painkiller industry
  • Law enforcement
  • Justice system coordination

Treatment & Wellness

  • Overdose follow-ups
  • Peer support and mentors
  • Medication asssisted treatment
  • Outpatient treatment
  • Residential programs
  • Transitional housing
  • S.T.A.R.T. Child Welfare

Cross-Community Response Includes:

  • Student Opioid Summit: Designed & led by students, the Student Opioid Summit focuses on prevention of substance use disorder and awareness involving schools, students and parents. Now in its second year!
  • Faith Based Outreach and Engagement: Over 60 leaders from the faith community came together in September 2017 to learn more about substance use disorder and commit to action. Faith leaders will reconvene in April 2019 to learn more about harm reduction and treatment options.
  • Drug Take Back Events: The Partnership for Substance Free Youth in Buncombe County coordinates regularly with the Buncombe County Sheriff's Office, The Asheville Police Department, Asheville Fire Department, the NC State Bureau of Investigation and pharmacies across the county to host take back events – making it easier for residents to safely dispose of their unused medications.
  • Continuing Physician Education: Over 1,000 medical providers have been trained via MAHEC on safer prescribing practices.
  • Web-based toolkits: the Partnership for Substance Free Youth is working to provide resources to school administrators and parents regarding substance use disorder.
  • School Health Trainings & School Health Nurses involvement: MAHEC School Nurses continue to be involved with the Student Summit and are equipped with Naloxone in schools.
  • Abba's House offers transitional housing for new mothers in recovery with peer support and safe housing along with their newborn.
  • Sobriety, Treatment and Recovery Teams: START Team is a special unit of social workers in BCHHS partnered with parent mentors. They intervene quickly to get parents into treatment, provide peer support and actively partner with parents and children for better outcomes for the entire family unit.
  • Project CARA: BCHHS Social Work team partners with Mission and MAHEC to provide supports to pregnant and new mothers with substance use disorder so that they can make a safety plan, understand how to care for themselves and their newborn safely, and access appropriate levels of treatment for substance misuse.
  • Filing a public nuisance lawsuit against the drug manufacturers and wholesale drug distributors that made the opioid epidemic possible.
  • Syringe Services Program opening at 40 Coxe Avenue summer 2019. The program will provide sterile injecting equipment, Naloxone, hygiene items, peer support services and referrals to primary and mental health care.
  • Buncombe County Health & Human Services Social Workers are currently being trained in Naloxone administration and will have Naloxone available to voluntarily carry for clients at risk of overdose.
  • Syringe Disposal Units going up spring of 2019 at 40 Coxe Avenue, Pack Library, and 35 Woodfin Street.
  • SAFER: Community education and awareness campaign on safe needle disposal and reducing harm.
  • Leading an inter-agency coalition, Buncombe Community C.A.R.E. team to explore and implement community based strategies on combating the disease of opioid addiction. Let us know if you would like to be a member!
  • Pairing community members with medical experts to educate our community on opioid basics, addiction, harm reduction and treatment.
  • Want to learn more about the epidemic of overdose deaths and the impacts of opioids in Buncombe County? Request a speaker from our Speaker's Bureau.
  • Request Closer posters and Alternative Pain Relief bookmarks from us!

Looking for Treatment?

When looking for addiction treatment, it can be hard to know where to start. Visit to take a brief assessment to understand the best treatment type for you or a loved one. Search for and compare treatment facilities across North Carolina, using trustworthy information on treatment quality. Learn more about what to look for in addiction treatment facilities and read reviews from actual patients and loved ones.

Make no mistake: All teens are at risk

Nearly half of young people who inject heroin start by using prescription drugs. More than 90% of adults with substance use disorders started using before age 18half of these cases started using drugs before age 15.

A growing number of student athletes are also at risk of becoming addicted to painkillers after being prescribed pain medication for an injury. Common drugs that are given are: Vicodin, OxyContin or Percocet.

Students also encounter these drugs outside of the doctor’s office either through a friend or by stealing medications from someone else. With the changing drug landscape, any pill NOT obtained from a pharmacy can contain the deadly synthetic opioid, fentanyl. Regardless, all opioids should be considered addictive and deadly.


Talk to your children and teens about drugs and about taking pills. Kids who learn about the dangers of drugs at home are up to 50% less likely to use drugs. As you talk with your child about the dangers of drugs, do not lose the important opportunity to discuss the danger of taking pills.

Prescription painkillers are a last resort – talk before you take! Advocate for your child in the doctor’s office by talking with your child’s medical provider about non-addictive forms of pain relief. As a young person grows, their brains are not fully formed until the age of 25. The longer you can keep a young person from using any drugs or alcohol, the more likely they are to avoid issues with substance misuse use as an adult. This flyer talks about the risk of painkiller addiction in students, and has been distributed to students and parents in Asheville City and Buncombe County Schools.


If you need help dealing with substance use for yourself or someone you care about, your school nurse or guidance counselors can help. Recovery is possible and support is available.

Youth at Risk Graphic: Young girl playing softball

Alternative Pain Treatment

The truth is while evidence supports short-term effectiveness of opioids, there is insufficient evidence that opioids control chronic pain effectively over the long term, and there is evidence that other treatments can be effective with less harm.

Research has shown taking a 500mg tablet of acetaminophen and one 200mg tablet of ibuprofen taken together up to 4 times a day with food and water is most effective for treating acute pain. Ask your doctor and/or healthcare provider about the risks of opioid based pain medications and what alternative pain treatment is available.

Image of alternative pain treatments
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Unused Medication Drop Off & Disposal

Learn How & Where to Dispose

Learn How & Where to Safely Dispose of Unused Medication

Most abused prescription drugs come from family and friends. You could be a drug dealer without even knowing it. Everyone in Buncombe County should take the following steps:

  • Count the number of painkillers in your home
  • Keep your medications in their original labeled containers, this will help prevent any accidental misuse.
  • Keep opioid medications out of sight, preferably in a secured location, such as a locked box or cabinet and out of the reach of children and teens.
  • Properly dispose of unwanted, unused, or expired medications. Buncombe county has several locations with secure drop boxes.

When discarding unwanted, unused, or expired medications, please follow these instructions:

  • remove identification from all medications.
  • separate pill, liquids and inhalers.
  • use a different disposal paper or plastic bag for each type of medication.
  • empty dry pill medications into a bag.
  • leave liquid medications in their original container and place in a separate bag.
  • NO radioactive medications such as cancer medications, needles or sharp objects accepted. Find needle disposal units in Buncombe County.

Drug Drop Box Locations

There are several drug drop boxes located throughout Buncombe County. Interact with the map below for address and time information:

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Get Help Now

Treatment Information, News Articles & Videos

Treatment, Recovery, & Support

Treatment and recovery are possible and closer than you think. Our community has multiple partnering agencies that are well-equipped and experienced at providing resources that you or your loved one can access to take that critical first step towards better health and/ or recovery.

Science has proven that substance use disorder is a chronic brain disease that can be managed with medical treatment. We must reduce the negative public perception of addiction to remove barriers to getting help. Because right now, only 1 in 10 Americans with a substance use disorder receive treatment.

Medical Emergency: Call 911

National Suicide Prevention and Crisis Lifeline: Call 988

  • Call AMCHC at (828) 257-4745 for primary care, Medication Assisted Treatment (MAT), Hepatitis C and HIV treatment.
  • Call MAHEC at (828) 257-4730 for primary care, Medication Assisted Treatment (MAT), MAT for pregnant or postpartum people, Hepatitis C and HIV Treatment.
  • Call MAHEC at 828-771-3488 if you are in need of Hepatitis C and/or HIV treatment
  • Call VAYA Health at 1-800-849-6127 for referrals for outpatient substance use individual or group counseling.
  • Peer Support Services:
    Research shows that Peer Support Services work! Call VAYA at 1-800-962-9003 to be connected to Peer Support Programs in Buncombe County.
  • Dial 252-HELP for connections to support resources in Buncombe County and across Western North Carolina. If you are a first responder or medical provider, this card could come in handy during experiences with someone who has overdosed
  • Seek Healing Listening Line, The Listening Line provides non-crisis emotional support between community members. Call or text any time to connect with another Seeker. Call or text: 828-547-4547; hours 8am-11pm.
  • Safer is better! The State of North Carolina has created this helpful health resource guide for our region. If you are in Buncombe County, be sure to look up Region 2 resources!
  • More information is available from the NC Opioid Prevention and Awareness initiative