Advocacy for expanded access to substance use disorder treatment is an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in substance misuse in our community. This is a new program in our community.

The priority population/customers for this program include people with substance use disorder, families and friends of those who have substance use disorder, decision makers, and general community members. The program aims to make a difference at the intrapersonal/interpersonal and environmental change levels. Implementation will take place in community venues and on broadcast and social media.

Transylvania Substance Awareness Team is working to host events to promote community understanding of how stigma impacts folks with substance use disorder and creates barriers to appropriate support and treatment. The team will also be providing community presentations about the causes and impacts of substance use, as well as evidence-based treatment and harm reduction strategies.

Transylvania Public Health and the CARE Coaliiton will be supporting a regional communications campaign led and developed by WNC Health Network. This campaign is a strategy to support local efforts to address stigma and cultivate support and compassion for people most affected by substance misuse and their families.

The partners for this program include:

The "Story Behind the Curve" helps us understand the causes and forces at that work that explain the data behind access to substance use disorder treatment and the resources the coalition plans to commit to address the health issue.

What's Helping What We Do? These are the positive forces at work in our program that influence how much we do or how well we do it.

• Regional support for anti-stigma campaign - and past regional communications partnerships
• Strong community participation in TSAT workgroup, including individuals with lived experience and county leadership
• Funding and staffing to support work - including new re-entry counselor

What's Hurting What We Do? These are the negative forces at work in our program that influence how much we do or how well we do it.

• Stigma limits resources available to support people who use substances
• Beliefs that MAT/MOUD is "enabling" use or leads to misuse and crime
• Limited resources for substance use treatment in our county/region

What's Helping Communities Served/Customer Change? These are the positive forces at work in our program that influence customer change.

• Increased awareness of available services 

What's Hurting Communities Served/Customer Change? These are the negative forces at work in our program that influence customer change.

• Ingrained habits and beliefs can be slow to change.

The following actions have been identified by our coalition as ideas for what can work for this performance measure to make a difference on emergency department visits related to substance use.

Actions and Approaches Identified by Our Community These are actions and approaches that we think can make a difference for this performance measure.

• Develop infrastructure to use opiate settlement funding

No-cost and Low-cost Ideas Identified by Our Community These are no-cost and low-cost actions and approaches that we think can make a difference for this performance measure.

• Involve people with lived experience and their families
• Use social media to share messages

What Our Communities/Customers Think Would Work To Do Better These are actions and approaches that our communities served/customers think can make a difference for this performance measure.

• Address myths and stigma associated with substance use disorder and treatment options

List of Questions/Research Agenda These are questions to follow-up on for this performance measure. 

• none at this time

Efforts are underway to support MAT/MOUD access for county residents through the CARE Coalition's TSAT workgroup. CARE provided trainings from MAHEC on substance use disorder to providers and community members.

Transylvania County's jail-based re-entry program helped to create access to support services in the Transylvania County Detention Center. This partnership between the Transylvania County Sheriff's Office and CARE Coalition received funding in 2022 through a federal grant from the Bureau of Justice Assistance and hired 2 staff positions located within the local detention center. These staff provide case management, behavioral health assessment and counseling, and in-jail programming, as well as connections to community treatment providers and other resources upon release. 

CARE Coalition hosted "Transylvania CARES: Stories of Addiction and Hope" to raise awareness of how stigma impacts people who use drugs. The event was attended by 70 individuals and featured 5 panelists who discussed the ways that stigma affects lives from their personal and professional perpectives. Transylvania Public Health and CARE are also working with WNC Health Network to develop anti-stigma communications intended to reduce barriers to help seeking behaviors.

CARE staff and volunteers developed and finalized community presentation content on substance use that will be presented to churches, volunteer groups, nonprofits, and businesses upon request.

WNC Health Network formed an advisory group and coordinated efforts to develop an anti-stigma communications campaign. In 2022, this group held listening sessions, identify audiences, determined key messages, designed sample content, and tested messages.

In addition, CARE Coalition received a grant to plan for the best use of opioid settlement funds. This process may identify activities that can help increase access to substance use disorder treatment.

CARE Coalition staff and coalition members began presenting community information sessions on substance use disorder and treatment to community groups. In 2023, presentations were made to law enforcement, non-profit agencies, and church groups. Coalition member Jim Hardy also presented "Understanding Trauma: The Path to Healing" which highlighed the impact of trauma in mental health and substance use.

In its first year of operation, Transylvania County's jail-based re-entry program. served a total of 283 detainees with case management and/or reentry programming within the detention center. Of the 181 inmates screened for substance use disorder, 74% were positive for at least 1 SUD and 64% met criteria for multiple SUDs. Staff identified a need for SUD treatment upon release for around 39% of detainees. The re-entry coordinator initiated 64 applications for in-patient substance use treatment, and 38 applications were accepted. Staff are also participating in a community-based re-entry council to help support detainees with practical needs and ease the transition after release, and advocate for additional resources.

CARE Coalition staff created and distributed resource cards with information on SUD treatment and recovery services to officers in the Brevard Police Department and the Transylvania County Sheriff's Office.

WNC Health Network received funding to conduct a pilot of its "See Me WNC" anti-stigma communications campaign and selected Transylvania as 1 of 4 pilot counties. Staff from Transylvania Public Health and the CARE Coalition provided feedback and selected 4 ads that ran on Facebook and Instagram in October and November 2023. These ads were then incorporated into the regional "View From Here" communications campaign. 

In addition, CARE Coalition staff also took the lead in developing recommendations for the local use of national opioid settlement funds, helping community members understand the process, and managing compliance with state reporting requirements.