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In North Carolina, the number of opioid overdose deaths has increased by nearly 800% between 1999 and 2016 [1]. Prior to 2010, over two-thirds of opioid deaths were the result of prescription opioids, but since 2013, prescription opioids have been responsible for less than 45% of opioid overdose deaths, and opioid deaths by illicit drug use have increased dramatically [1].One goal of North Carolina's Opioid Action Plan from June 2017 is to reduce the number of deaths from opioid overdose by 20% by 2021 [1]. County level mortality trends must be examined to effectively deploy resources to achieve this goal. This analysis characterizes the dynamics of the opioid epidemic with regard to heroin overdose deaths in North Carolina. The purpose of our analysis is to investigate whether there is variation in the pattern of heroin mortality among counties and identify counties within North Carolina that may be used to inform both potential solutions and areas of greatest need.Calculating Opioid Overdose MortalityWe calculate and report the crude rate of death per 100,000 persons. Opioid poisoning deaths from 1999 to 2016 were obtained from the North Carolina Division of Public Health Injury and Violence Prevention Branch's county level poisoning data [2]. Our analysis primarily focuses on ICD-10 code T40.1 (heroin), but we include a comparison in some models to ICD codes T40.0-T40.4 (which includes methadone, opium, opioids, and other synthetics). Only unintentional deaths were included, which used the code X40—X44. Deaths were counted in county yearly totals with any…

The article announces that English teacher Amy Spitzer has received the 2019 Teen Ink Educator of the Year award.