*Note that the above maps examine alcohol-related injuries for 13-29 year-olds only.

Substance-associated injuries involve any 911 Orange County EMS response within a given geographic block of the Chapel Hill community in which alcohol or other substances were present, usage was disclosed, or deduced. This indicator captures the most acute cases of substance-related consequences, alluding to a much larger systemic issue of substance use and high-risk drinking behaviors underlying the Chapel Hill community. 

A growing concern amongst the national, state, and local landscape is the rise of psychiatric events associated with synthetic cannabinoid use. Observations, shared in Summer 2025, from the local UNC Hospital Emergency Department reflect those concerns. E.K., a former UNC Psychiatric Emergency Department Social Worker, has observed a notable increase in cannabinoid-associated psychosis over the past two years, primarily among young people aged approximately 16 to mid-20s. These synthetic cannabinoids are widely accessible, relatively unregulated, and have been associated with an increased risk of psychotic episodes, and even schizophrenia amongst genetically predisposed individuals ^{1, 2}. 

E.K. has remarked that many of these adolescents suffering from psychosis have experienced acute symptoms—such as delusions and paranoia—so severe that they pose a physical danger to themselves and others. E.K., as well as other health professionals in the field, emphasize the need for education for parents surrounding synthetic cannabinoids, and the importance of providing youth populations with healthier strategies and tools for managing stress and hardships. These efforts are key to preventing prolonged or dependent use of synthetic cannabinoids amongst youth populations. 

• Aguilar, D. D., Giuffrida, A., & Lodge, D. J. (2018). Adolescent synthetic cannabinoid exposure produces enduring changes in dopamine neuron activity in a rodent model of schizophrenia susceptibility. The International Journal of Neuropsychopharmacology, 21(4), 393–403. https://doi.org/10.1093/ijnp/pyy003
• Yeruva, R. R., Mekala, H. M., Sidhu, M., & Lippmann, S. (2019). Synthetic Cannabinoids-"Spice" Can Induce a Psychosis: A Brief Review. Innovations in Clinical Neuroscience, 16(1–2), 31–32.