Opioid Overdoses, Fentanyl Deaths Decrease in North Carolina Triangle

Two-year decline in emergency department visits and fatalities linked to state's use of opioid settlement funds

Published on Feb. 19, 2026

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An analysis of state health data shows that opioid overdose hospitalizations have decreased by more than 20 percent in the last year, marking two consecutive years of declining emergency department visits in North Carolina. The same data source shows similar trends for fentanyl-related deaths, which decreased by 24 percent in the last year.

Why it matters

The decline in opioid overdoses and fentanyl deaths comes as North Carolina has directed $750 million in national opioid settlement funds to local communities to upgrade opioid abuse prevention and harm reduction efforts. These funds have enabled new initiatives like syringe exchanges, naloxone distribution, and community-based substance abuse programs.

The details

Statewide, North Carolina recorded 4,960 emergency department visits related to opioid overdoses in 2025, a 21% decrease from the previous year and a 48% drop since 2024's record high of 9,624 cases. The data also shows a 24% decrease in fentanyl-related deaths over the last year. Rural counties have seen some of the largest per capita reductions in opioid hospitalizations.

  • North Carolina received $750 million from the national opioid settlement funds in 2023.
  • The state's opioid overdose hospitalizations decreased by 21% in 2025 compared to 2024.
  • Fentanyl-related deaths in North Carolina decreased by 24% in 2025 compared to 2024.

The players

Dalton Barrett

Edgecombe County's Opioid Settlement Program Director, overseeing $5 million in settlement funds distributed between 2023 and 2028 to support substance abuse prevention and harm reduction initiatives.

Cordain Yancy

A community advocate in substance abuse prevention for the last three decades, now working as a healthcare navigator with the Wilson County Substance Prevention Coalition, a role made possible by the county's opioid settlement funds.

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What they’re saying

“A lot of people with addiction have been treated wrong by healthcare workers and first responders. So us trying to establish as a harm reduction unit has been difficult.”

— Dalton Barrett, Edgecombe County's Opioid Settlement Program Director

“The good news is that we didn't have anybody under 25 die from an opioid overdose. Previously we had some deaths in that age range. and substance abuse starting in that age range too.”

— Dalton Barrett, Edgecombe County's Opioid Settlement Program Director

What’s next

The judge in the case will decide on Tuesday whether or not to allow Walker Reed Quinn out on bail.

The takeaway

The decline in opioid overdoses and fentanyl deaths in North Carolina's Triangle region highlights the positive impact that state-level opioid settlement funds can have on local harm reduction and substance abuse prevention efforts, especially in rural communities that have historically struggled with the opioid crisis.