SALISBURY, N.C. — Rowan County health officials are warning residents about a worsening opioid crisis after new state data showed a sharp increase in overdose-related emergency department visits and one of the highest fentanyl-positive death rates in North Carolina.
According to the Rowan County Health Department, suspected opioid overdose emergency department visits more than doubled between April and May 2026. The county recorded five overdose-related emergency visits in April and 11 in May, a 120% increase that exceeded the county’s average monthly total over the previous six months.
Most of the overdose patients were from Salisbury, primarily in the 28144 and 28146 ZIP codes. The majority were adults between the ages of 25 and 44. Cases were evenly split between White and Black residents and occurred more frequently among men.
State mortality data also placed Rowan County second in North Carolina for its fentanyl-positive death rate. The county recorded 24.1 fentanyl-positive deaths per 100,000 residents, more than double the statewide rate of 11.8 deaths per 100,000 residents. Only Robeson County reported a higher rate.
Year-to-date data from the North Carolina Office of the Chief Medical Examiner shows Rowan County recorded 15 fentanyl-positive deaths through April 2026, compared with 14 during the same period in 2025, a 7% increase.
“These numbers represent our friends, family members, neighbors, and coworkers,” said Hayley Edwards, substance use and mental health program specialist with the Rowan County Health Department. “While overdose deaths continue to impact communities across North Carolina, Rowan County’s ranking among the highest in the state is a reminder that we must all work together to prevent overdose deaths and connect people with lifesaving resources.”
Health officials also warned about changes in the illicit drug supply, including the growing presence of medetomidine, a veterinary sedative that has recently been identified in Rowan County through laboratory testing. Officials said the drug is increasingly being mixed with fentanyl and other illicit substances, including cocaine, methamphetamine and counterfeit prescription pills.
When combined with opioids, medetomidine can cause profound sedation and increase the risk of a life-threatening overdose. Officials emphasized that naloxone, commonly known as Narcan, should still be administered whenever an opioid overdose is suspected because it reverses the effects of opioids. However, naloxone does not reverse the sedative effects of medetomidine, meaning overdose victims may require additional emergency medical treatment and monitoring.
The health department is encouraging residents to carry naloxone, use fentanyl and medetomidine test strips when available, avoid using drugs alone, call 911 immediately if an overdose is suspected, remain with the individual until emergency responders arrive, and seek treatment for substance use disorders.
Naloxone is available without a prescription in North Carolina, and free supplies are available at multiple public access locations throughout Rowan County, including the Rowan County Health Department, Rowan County Library Headquarters, East Spencer Town Hall, Spencer Fire Department Station 75, the Rowan County Detention Center, the Rowan County Annex, several churches, fire stations and other community sites.
Health officials said the increase in overdose visits highlights the continued need for prevention efforts, public education and expanded access to overdose-reversal medications and testing supplies.
Residents seeking information about free Narcan, fentanyl test strips, treatment options or recovery services are encouraged to contact the Rowan County Health Department.
