Substance use was identified as the top quality of life issue by Craven County residents that completed the CHNA survey in the spring of 2021. Suspected drug overdoses and deaths have continued to rise in Craven County since 2018. The rate per 100,000 for Craven County emergency department (ED)overdose visits in 2021 was 183.1 compared to North Carolina at 149.9. For 2021, the rate for overdose deaths in Craven County was 56.8 while the state was 35.8. Craven County is currently ranked as one of the highest counties for overdose related ED visits and overdose deaths in North Carolina. Substance use disorders often occur simultaneously in individuals with mental illness, usually as a coping mechanism. The lack of treatment facilities, high cost for treatment, and extreme decrease in substance use disorder providers in Craven County all contribute to substance misuse and overdose deaths.