Substance Misuse and the related result "Residents of Swain County are healthy, safe, and thriving" are aligned with the following Healthy NC 2030 health indicators and desired results. 

• Drug Overdose Deaths - Decrease Drug Overdose Deaths
• Tobacco Use - Decrease Tobacco Use

How would we experience residents of Swain County being healthy, safe, and thriving in our community?

Swain County would be healthier and happier by way of deduction of substance abuse/misuse. According to previous years' community listening sessions, community members would experience the following: 

• No needles
• More treatment 
• More participation in the community 
• No cigarette butts 
• Fewer funds being used 
• Empowered by discussion 
• Less smoke pollution 
• Not holding breath to go into buildings
• Not hearing about overdoses
• More communication 

What information led to the selection of this health issue and related results?

The Community Wellness Action Team and the Coalition for a Safe and Drug Free Swain County processed the community health assessment data. Both groups were provided information about the relevance, impact, and feasibility around substance misuse, specifically looking at opioid, tobacco, and alcohol data. The community members in attendance then unanimously voted to move forward with the substance abuse priority as a result of evaluating the primary and secondary community health data. These being long-term issues they are being continued in 2021. 

Known risk factors for this issue are as follows: 

• Family
• Social Networks
• Peer Pressure 
• Income Level
• Educational Attainment 

Partners include:

• Swain County Health Department
• Coalition for a Safe and Drug Free Swain County
• Mountain Wise
• Swain Community Hospital
• QuitlineNC

The following actions have been identified as ideas for what can work for our community to make a difference in Substance use.

Actions and Approaches Identified by Our Partners: Our partners think these actions and approaches can make a difference in Substance use.

• Lock Box / DropBox Campaigns
• Quitline

What is currently working in our community: These actions and approaches are now in place in our community to make a difference in Substance use.

• Lox Box Distribution
• Naloxone Distribution
• Medication Drop Boxes
• Syringe Drop Box
• Quitline Promotion

Evidence-Based Strategies: These are actions and approaches that have been shown to make a difference in obesity as it relates to chronic disease.

Process for Selecting Priority Strategies

The Community Wellness Action Team (C-WAT) reviewed the community health assessment data in September and October 2018. Following those meetings, the whole distance exercise was completed by walking through the results-based accountability format in selecting actionable items. The whole distance exercise was conducted over two meetings. The group worked through the exercise and landed on the "what will work". Each group member in attendance voted on a strategy that met the three identifiable principles -- data power, proxy power, and communication power. In 2021, Lock Box / DropBox Campaigns and Quitline were voted to be continued as priority strategies.