According to figures shared with the county Board of Commissioners by Dr. Shuchin Shukla, a physician and opioid crisis educator with the Mountain Area Health Education Center, Buncombe’s rate of overdose deaths has exceeded the statewide average since at least 2016. In 2021, the county suffered 45.2 deaths per 100,000 residents, compared with 35.8 deaths per 100,000 for North Carolina as a whole.