Substance use, in its many forms, continues to impact individuals nationwide in epidemic proportions: Many can name a peer, a community member, a family member, a friend, a neighbor, or an individual who has fallen victim to substance dependence, substance use disorder, or even death by overdose. In 2022 alone, Polk County had 9 documented overdose deaths involving illicit opioids (heroin, fentanyl, and fentanyl analogues), a 350% increase from the previous year (2 deaths), according to state DHHS data. Beyond the documented mortality attributable to opioid use, "Other Unintentional Injuries" are among the top four leading causes of death in Polk County for ages 00 to 64. Deeper analysis of these figures tells the story behind the data: In 2021, the leading unintentional injury was unintentional poisoning, 96% of which were due to medication or drug overdose, NCDHHS finds. We see Polk County individuals and families continue to suffer greater impacts of substance use, directly or indirectly, as time passes without accessible or sufficient resources to meet community needs.

We intend to counter the physical and emotional effects of substance use on the Polk Community through strategies to build resilience, promote education, reduce stigma, and improve service availability and accessibility.

Planning Process

The selected strategies, activities, indicators, and results are a product of a collaboratively-produced logic model, whereby a team of community stakeholders with interest or expertise in Substance Misuse voted upon evidence-based strategies and developed plans to implement them.

The following document depicts the logic model with potential strategies, which we consider as the blueprint for our process: Components of the logic model, such as inputs/resources needed or desired outcomes (like results), inform our strategic actions to improve Polk County's substance use outcomes:

**CLICK THE FOLLOWING LINK TO DOWNLOAD THE LOGIC MODEL: (SubstanceMisuseLogicModel.docx)**

Strategies Considered

The following is the complete list of partner-provided strategies (some evidence-based) that were considered as ideas for "what can work" to improve substance use outcomes and voted upon. Although not all strategies could be implemented through our Community Health Improvement Plan, some are still being considered for implementation in the community beyond this cycle:

• Naloxone education and distribution program
• Prescription drug monitoring programs (PDMPs)
• Mobile health for mental health
• Housing First program
• Fentanyl test strip distribution programs
• School-based support:
  • School-based health centers
  • School-based social and emotional learning
  • School Community Liaisons
• Youth education
  • In schools, taught by a certified Health Educator, coupled with community-level strategies
  • Campaigns like Talk it Up. Lock it Up! TM
• Nurse Family Partnership
• Alcohol outlet density restrictions, or other environmental strategies
• Peer support specialist
• Social/emotional support to parents/caregivers to prevent cyclical nature of childhood trauma
• Drug Courts
• START Model
• Syringe Services Programs

Our efforts to improve substance misuse-related health outcomes connect to HNC 2030's substance-related Desired Results, including 10 (Decrease drug overdose deaths), 11 (Decrease tobacco use), and 12 (Decrease excessive drinking). One program, the START Model, also links to Desired Result 5 (Improve Child Well-Being), as we also intend to decrease adverse childhood experiences attributable to the effects of substance use on their families. We believe that our work will generate significant and lasting improvements that not only benefit our community, but contribute to positive change at the state level in accordance with the HNC2030 plan.