2023 was historically bad for homicides in the Piedmont Triad, as its two biggest cities suffered the most in a single year in recorded history. Even though key metrics are leveling off, opioids are still claiming thousands of lives each year in North Carolina as well. The impact on the families of the deceased is obvious but the emotional trauma stretches far beyond that to people who make a living responding to horrific scenes on an increasingly regular basis."There's a lot of stuff that we see that most folks don't want to see," said Chief Joey Hundley, director of Forsyth County EMS. His EMTs and paramedics are also seeing it more and more often.In 2023, the city of Winston-Salem reported 46 homicides, a new record. That represents an increase of 39% from the year before and was also more homicides than in all of 2012, 2013, and 2014 combined. Hundley says his team responded to most, if not all of those calls last year.Drugs also continue to be a huge problem statewide and in the Triad specifically.According to the North Carolina Department of Health and Human Services, 4,036 people died from a drug overdose in 2022, statewide. While this was the first time in four years that the number of drug overdose deaths did not increase from the prior year, it was just five fewer deaths than the record 4,041 reported in 2021 and also a 72 percent increase from 2019's total.In 2022, Forsyth County alone recorded 182 drug overdose deaths, averaging one every other day, which equates to a rate of 46.7 for every 100,000 people. "We've lost several folks to personal-related issues. Some cited mental health, some cited stress, some cited just the operational tempo that we've had over the last couple of years, and so, those things are real. Fortunately for us, our staffing numbers are starting to come back up," Hundley said.In 2020, the county was able to run an average of 15 ambulances during the day shift, which runs from 7 a.m. to 7 p.m., and 10 ambulances at night, covering the hours of 7 p.m. to 7 a.m. Each ambulance has either two EMTs, two paramedics, or one of each on board.In 2021, the numbers dipped to 12.8 per day and nine at night, and by 2022 it fell to 11.3 during the day but rose to 10.5 at night. Last year, both categories rebounded to an average of 12 ambulances on the day shift and 11.1 at night."I'm always going to be optimistic about the future. I think we've got a lot of work to do still, but at least I know from the emergency services perspective, we're assembling the right team," Hundley said.In the next few weeks, Forsyth County plans to use opioid settlement money to add four peer support specialists. These will be trained professionals who help people experiencing an emergency get to the right place. Hundley believes that not everyone needs to go to the hospital. Some just need to get on a different path.