Nationwide, drug deaths are on the rise. For several years, the leading cause of accidental death in the country has not been shootings or fatal traffic accidents, but overdose. Topping the list of drugs causing those overdoses are prescription pain medication and another opioid — heroin.

Since 1999, the number of opioid deaths in the U.S. has quadrupled, according to the Centers for Disease Control. Opioid abuse and overdoses in America have moved into epidemic territory. North Carolina and Beaufort County are not immune to what has become a public health crisis.

“Anecdotally, I hear more and more in the news about the problems (with opioids). I’ve been hearing a lot more about professional groups monitoring it, that are concerned about the numbers,” said Jim Madson, Beaufort County Health Department director.

The numbers make the case for a growing substance abuse problem in Beaufort County: admissions to substance abuse programs rose from 62 people admitted in 2008 to 292 in 2012, a 371-percent increase, according to a five-year study by the North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services.

From January to August of this year, nine Beaufort County residents were taken to the emergency department at Vidant Beaufort Hospital because of heroin overdoses; 33 people visited the emergency room for other heroin-related issues; 19 for opioid overdoses; and 100 for other medicine or drug overdoses, according to Madson.

Between 2010-2014, the county had four heroin deaths, nine deaths due to other opioids, three deaths from methadone, three deaths from other synthetic narcotics and another from an unspecified narcotic, according to North Carolina Department of Health and Human Services State Center of Statistics.

Opioids haven’t always been such a problem in the county. That came in 2011, according to Lt. Russell Davenport, head of the Beaufort County Sheriff’s Office narcotics unit. A 19-year veteran of the drug unit, Davenport has witnessed the change in the drug scene.

“Back then, our biggest dealings were in crack cocaine and cocaine. We only had, maybe, 2 percent of our cases back then were heroin or pills,” Davenport said.

That changed around 2011.

“2011 is when we started seeing a big influx of pills and heroin.”

Of the drug unit’s 286 cases this year, 119 of them involved opiates — heroin or pills. In 2011, the total number of cases involving opiates was 81, he said.

“On a daily basis, we’re investigating people selling heroin, selling pills, using heroin, using pills; we get reports from concerned relatives,” Davenport said. “They’re wondering why they’re strung out on heroin and we have to explain to them that once they have that addiction, and they can’t get the pain pills, they have to resort to heroin so they can get the same effect.”

Madson said many people’s addictions start with legally prescribed pain pills for pain management. Accessibility to both legal and illegal drugs is one cause of the problem, he said.

It’s a problem that does not discriminate, according to Davenport.

“Drugs don’t choose. It doesn’t matter what race, what gender; doesn’t matter what age. We’re dealing in the last few months with a 13-year-old, right on up to people in their sixties — and that’s pills and heroin,” Davenport said.

The rise of heroin and prescription pain pills has changed the drug scene in Beaufort County, Davenport said: the cocaine and crack users of 10 years ago are now using heroin and pain pills; drug unit investigators are arresting users to create an information network to go after mid-level dealers; and the drug unit is spending more money making controlled buys in order to prove their cases in a court of law and stop the distribution of drugs.

“We’ve been spending more money the past couple of years, because the price of the pills is a dollar a milligram,” Davenport said. “I can’t prove that you’re selling your prescription pills if you’ve got a prescription. The only way I can prove it is to buy it from you. So we have to buy it.”

While the drug unit has ongoing investigations into the distribution of opioids in the county, from the public health standpoint, BC360 — a collaboration of local agencies, organizations and individuals tracking issues in the county — has established a task force to look at the county’s opioid abuse problem, Madson said.

“It’s certainly something that we’re very much concerned in public health, and it’s one of the growing epidemics that we need to be focusing on right now,” Madson said. “And when I say ‘we,’ I mean everybody in the community.”

Sept.18-24 was National Opioid Awareness Week.