The 2018 Onslow County Community Health Needs Assessment identified Substance Use Disorders (SUDs) as a top health issue wihin the community. Adult smoking was highlighted as a major health concern, with an indicator score of 2.25 (indicator scores represent a weighted average of comparison scores ranging 0-3, with 0 being the best outcome and 3 indicating the worst outcome). In fact, the adult smoking rate in Onslow County is 19.1%, higher than that of both North Carolina (17.9%) and the US (17%). None of the adult smoking rates met the Healthy People 2020 goal of 12%. Alcohol misuse is another major area of concern, with an indicator score of 2.4. Onslow County has a alcohol-impaired driving death rate of 36.5%, which is again higher than that of North Carolina (31.4%) and the US (29.3%). There was no trend for this observation. Similarly, the rate for excessive drinking in Onslow County is higher at 22.6% when compared to 16.7% in North Carolina and 18% in the US. These rates fall below the Healthy People 2020 goal of 25.4%. Overall, Onslow County has higher rates in every substance abuse category in the table above in comparison with North Carolina and the US.

In an effort to improve services and community resources while streamlining communication between stakeholders, the Onslow County Health Department, along with the partners below, began a Substance Abuse related task force, the Strategic Opioid Advanced Response (SOAR) Team. This taskforce focused their efforts in the areas of concern mentioned above, with an emphasis on the Opioid Epidemic. With the rise of drug overdose deaths in the community due to the COVID-19 pandemic, the taskforce continues to grow and provide the community with knowledge of services and resouces. Recent efforts include a "Street Sheet" that outlines substance abuse resouces in the community, a multi-pronged social media campaign, and the recent proposal of a new Tobacco Rule. 

• Onslow County Government 
• Onslow County Sheriff Office 
• Onslow County Emergency Services 
• City of Jacksonville 
• City of Jacksonville Public Safety 
• Dix Crisis Intervention
• Onslow County Schools 
• NC Cooperative Extension Office 
• Onslow Memorial Hospital 
• Onslow County Department of Social Services 
• Integrated Family Services 
• Sneads Ferry Hope 
• Wilmington Treatment Center 
• RHA
• Trillium Health Resources
• One Place 
• Jacksonville VA
• Caring Community Clinic 
• Coastal Horizons 
• Cohen Military and Family Clinic 
• Peers Family Development 
• True Justice 
• ACT Associates 

The Onslow County Health Department (OCHD) has found that social media, especially during the COVID-19 Pandemic, is a powerful medium that has allowed the agency to engage with the community despite isolation and stay-at-home orders. OCHD has effectively utilized this affordable platform to reach the public and continues to connect with the community. The most recent social media-driven Public Service Announcment (PSA) received high levels of engagement, with 2,643,326 reactions and 118 shares.  

From the 2018 Community Health Needs Assessment (CHNA), community survey respondents identified Substance Abuse as the top issue impacting quality of life in Onslow County. Both English and Spanish survey respondents listed substance abuse prevention as a topic that the community needs more information about. In fact, Substance Abuse was raised ten times in the focus group sessions as an issue in the community, especially as it relates to alcohol use and opioid abuse/misuse. Several participants felt that there is overprescribing of opioids and that there is a belief within the community that addiction will never happen to them. Alcohol use among the active military population was also raised as a concern during the focus group discussions. With the onset of the COVID-19 Pandemic, Onslow County Health Department and community partners have found that continued education, discussions, and outreach is essential in creating a community that has equitable access to vital social services.