North Carolina Counties Expand Harm Reduction Amid Evolving Drug Supply

Rural Western North Carolina counties are expanding grassroots harm reduction initiatives to address an increasingly unpredictable drug supply, frequently containing veterinary sedatives like xylazine and medetomidine mixed with fentanyl. These efforts, including providing safe supplies and drug testing, aim to save lives and combat stigma, as North Carolina recorded an average of 6.8 overdose deaths daily in 2025, with 75% linked to polysubstance use.