How Cary, North Carolina Reduced Opioid Overdoses by 40 Percent

6 months of Biobot’s wastewater data helped inform Cary’s opioid response programs, which reduced overdoses by about 40% the following year.

The opioid epidemic has affected communities across the United States, including the 170,000-person town of Cary, tucked away in North Carolina’s Research Triangle. Prior to Biobot’s partnership with Cary, the town saw fatal and nonfatal opioid overdoses increase 70 percent over the previous year. But, local leadership realized that they didn’t have to wait for matters to escalate.

“A Proactive Program”

Biobot’s program with Cary was designed to yield insights on neighborhood-level opioid use and to inform targeted community outreach programs. Biobot worked with Cary to identify 10 different sampling locations, i.e. manholes, that would provide data representative of the town’s population. For six months, Biobot analyzed wastewater samples from these sites and provided monthly reports to Cary officials detailing community trends on a number of high-risk substances, including opioids like fentanyl.

“This is a proactive program,” Deputy Town Manager Mike Bajorek remarked. “What we’re trying to do is not catch people once they’re addicted…[but rather] cut that addiction cycle before people are addicted.”

Community leaders like Bajorek traditionally rely on a mixed bag of delayed data sources to inform them of drug use trends within a community. For example, it can take six months or more to receive autopsy reports that identify the cause of death, and hospitalization records can take a year to reach city officials. Conversely, Biobot provides actionable data on substance use trends each month.

Biobot’s wastewater intelligence is also much more inclusive than traditional public health indicators. Because of the partnership, Cary found that Narcan consumption exceeded overdoses 25-to-1, suggesting that 25 times more people were overdosing than what was reported through emergency services.

Biobot’s reports gave Cary officials timely and comprehensive information to guide community outreach. For example, Biobot’s data distinguished between parent drugs and their metabolites––the marker of a substance having been consumed by someone prior to entering the waste stream. Bajorek highlighted this particular value of the program, explaining, “[Biobot] can tell the difference between pills that were just dumped down the toilet versus pills that were taken and metabolized. That’s really a key factor.”

“[Biobot] can tell the difference between pills that were just dumped down the toilet versus pills that were taken and metabolized. That’s really a key factor.”

Mike Bajorek, Deputy Town Manager, Cary, NC.

It Takes a Village

In anticipation of privacy concerns around wastewater monitoring for opioids, Cary’s Mayor and Town Manager gained community trust for the program through engaging a diverse array of local stakeholders. Soon, the town started a multi-platform engagement campaign featuring social media posts, Facebook Live and Youtube segments, 5 large community events, and 35 presentations to neighborhood and civic groups, churches, and the Chamber of Commerce. As Cary’s website details, “Getting the word out was critical to achieving our goals: starting a conversation about the opioid crisis in our community, and reducing barriers and stigma for those who might want to seek support.”

The community response was encouraging. Cary’s website explains: “Using wastewater data that illustrated the levels of prescription opioid use in our community, we increased our conversations about proper disposal and security of medications.” As a result, Cary disposed of 2.5 times more prescription medications through take back events the following year: from 924 pounds of medication to 2,511 pounds.

These community campaigns, propelled by comprehensive Biobot data, translated into around a 40 percent reduction in annual overdoses.

No Need to Fly Blind

In 2021, the US had a record-breaking number of fatal overdoses. Biobot’s analytics can inform community responses to these alarming trends and ensure that they are guided by data. Specifically, wastewater monitoring for high-risk substances can help evaluate program effectiveness, optimize narcan distribution, equip EMS with real-time knowledge on emerging drugs, and so much more. As the opioid epidemic persists, Biobot will continue expanding its wastewater platform to analyze even more high-risk substances and contribute to more success stories like Cary.

The Biobot-Cary partnership demonstrates that data-driven overdose reduction strategies are possible. They require bold action from community leaders and relevant analytics that reveal substance use realities. Navigating out of the opioid epidemic is a turbulent journey…but communities don’t have to be flying blind.

If you’re interested in learning more about Biobot’s High Risk Substance service, contact hello@biobot.io.