Many people in North Carolina cannot get treatment for drug dependence, and many health programs and services refuse to help people who use drugs. As a result, people who use drugs are denied access to help for other health problems, including HIV/AIDS and mental illnesses.

While Medicaid in North Carolina covers some drug dependence treatment, eligibility is very limited. In North Carolina, non-elderly, non-disabled adults without children are categorically excluded from Medicaid coverage. For working parents and their children to be eligible for Medicaid, annual family income must be no more than 49 percent of the federal poverty level, or $8,971.90 for a family a three. This leaves many people in North Carolina, where one in six residents live below the federal poverty level, without access to drug treatment.

Many drug users face multiple, concurrent health problems, including drug dependence, mental illnesses, and HIV, but mental health facilities often refuse to accept drug dependent or uninsured patients. By refusing to accept patients with limited resources or complicated diagnoses, many treatment facilities exclude those most in need of comprehensive, coordinated care. With restrictive Medicaid policies and treatment centers turning away the uninsured and patients with concurrent conditions, many North Carolinians are being denied access to affordable, evidence-based treatment.

Drug dependence treatment presents a window of opportunity for drug users with a high potential for relapse to learn about harm reduction practices in order to reduce the risks of acquiring blood-borne and sexually transmitted infections.

Many harm reduction programs also help drug users gain access to Naloxone, a medication that counters the effects of an opioid overdose.