The "Story Behind the Curve" helps us understand why the data on emergency visits for drug-related concerns is the way that it is in our community. When we understand the root causes of our community problems, we have a better chance of finding the right solutions, together.

What's Helping? These are the positive forces at work in our community and beyond that influence this issue in our community.

• Work to reduce access and availability of substances including alcohol, tobacco/nicotine, prescription medications, and ilicit drugs.
• Understanding by some community members of the importance of harm reduction strategies for people who use substances.
• Local emergency department facility set up to address mental health and substance use concerns. Access to mental health services in the county.

What's Hurting? These are the negative forces at work in our community and beyond that influence this issue in our community.

• Stigma associated with substance use. Stigma around seeking services for substance misuse and/or denial that services are needed. Social acceptance of behaviors that contribute to substance use, including poor mental health outcomes, violence, or risk-taking behaviors. Relunctance to accept opportunities and services from "outsiders" and a preference to rely on own self and kin network for support.
• Barriers to needed substance use treatment (inpatient facilities, outpatient facilities, prescribers or MAT/MOUD, and therapists or counselors), including costs, lack of insurance coverage, long wait times, limited capacity, lack of transportation, and simply not knowing how to access care. Very limited or delayed crisis reponse resources and no availability of co-response teams for law enforcement.
• Social, economic, and environmental factors that increase risk of poor mental health outcomes, such as poverty, unemployment and underemployment, homelessness and housing concerns (including cost and substandard conditions). Lived experiences such as violence, trauma, and adverse childhood experiences (ACEs). Connections between mental health concerns and substance use. Connections between incarceration/crime and substance use.