Substance use is connected to mental health concerns, overdose deaths, adverse childhood experiences, depression, anxiety, liver disease, alcohol-related motor vehicle crashes, lung cancer, COPD, and employment. However, residents have limited options for treatment and counseling options, especially for those who have lower incomes, no insurance, or transportation issues. Despite promising community efforts to address substance use, there is still much work to be done in this area.

• 10% of county residents reported excessive drinking
• 14% of county residents reported using opiates in the past year (with or without a prescription)
• 14% of county residents reported being current smokers (decrease from 23% in 2018)
• 41% of county residents reported that their life was negatively affected by own or someone else’s substance use
• 69% of children in foster care were placed due to parental substance use
• 19% of babies were born to moms who smoked while pregnant

Partners in our Community Health Improvement Process: 

• CARE Coalition
• Blue Zones Project – Brevard
• Healthy Communities
• WNC Healthy Impact

Partners with a Role in Helping Our Community Do Better on This Issue: 

• Meridian
• Blue Ridge Health
• VAYA Health
• CMARC/CMHRP-case management
• MAHEC
• Land of Sky (transportation to AA mtgs)
• Jail re-entry programs
• ABC Board
• SAFE Inc.
• Businesses/employers
• Law enforcement
• People who use substances
• People in recovery

The following actions have been identified by our team and community members as ideas that can work in our community to make a difference on improving substance misuse.

Actions and Approaches Identified by Our Partners These are actions and approaches that our partners think can make a difference on substance misuse.

• Regional work to improve treatment and reduce stigma through media campaign
• Adoption of additional tobacco-free/smoke-free policies
• Distribution of Naloxone to justice-involved and vulnerable populations
• Quitline and its resources
• Training and education for parents to reduce access and availability of nicotine and alcohol for youth
• Increased access to medication-assisted treatment / medication for opioid use disorder
• Re-entry assistance including care navigation and mental health treatment
• Access to behavioral health treatment and services
• Resiliency and coping skills

What is Currently Working in Our Community These are actions and approaches that are currently in place in our community to make a difference on substance misuse.

• Existing tobacco-free/smoke-free policies in schools, government settings, and multi-unit housing
• Substance education in schools (DARE in 5th grade and grade alcohol, tobacco, and other drugs curriculum in 9th grade)
• Tobacco/vaping intervention strategies in schools
• Naloxone access for law enforcement officers and first responders
• CARE Coalition work to reduce access to alcohol
• Distribution of lockboxes to reduce access to prescription medications
• Working to develop infrastructure to use opioid settlement funding
• Resilience skills training and capacity building for youth
• Awareness events and media campaigns to encourage parent involvement
• Social supports and warm handoffs from Sharing House
• Support for grandparents raising grandchildren

Evidence-Based Strategies These are actions and approaches that have been shown to make a difference on substance misuse.

Process for Selecting Priority Strategies

The Transylvania County CHA team worked with community members to better understand the story and root causes behind substance misuse concerns and identify potential strategies including evidence-based strategies, what is working in other communities, and ideas generated by people who are most affected by the issues. Public health participated in meetings of the CARE Coalition and Blue Zones Project – Brevard to select strategies based on feasibility, impact, alignment with community values, and focus on addressing one or more root causes. Public health staff also worked with CARE Coalition staff to help develop performance measures to help us know if people are better off because of the implementation efforts and will be involved in evaluating ongoing implementation efforts and making changes when needed.