In Robeson County, substance use disorder (SUD) has represented one of the primary issues impacting the health and well-being of its residents for several decades. Since 2011, issues related to substance use have been identified as a primary health concern by residents of the county in the Community Health Needs Assessment. Data published on the Opioid and Substance Use Data Dashboard by the North Carolina Department of Health and Human Services indicate that in 2022 the rate of drug overdose deaths in the county was more than double the state average (78.9 versus 36.9 per 100,000). Similar trends could be found with overdose emergency department visits (466.2 versus 161.5 per 100,000) and newborns affected by substance use (13.9% versus 3.7% of live births). Dispensation data from the North Carolina Controlled Substance Reporting System also indicate that in 2021 county residents were dispensed more opioids (19.8 versus 14.5 per 100 residents), had more prescriptions (107.4 versus 58.8 per 100 residents), and more pills (64.5 versus 34.4 per 100 residents) per resident than the state average. This data also reveals that county residents are dispensed stronger opioids (i.e., higher morphine milligram equivalents) than the state average (1 versus 0.8 per 100 residents).  In 2021, children in foster care as a result of parental substance use was 69.7% (366 children), a rate higher than the state of North Carolina at 45.7%. Incarceration is also a byproduct of SUD, with incarceration rates in the county also trending higher than the state average in 2020 (396.6 versus 286.6 per 100,000 residents) [NCDHHS Opioid Data Dashboard, 2023]