The "Story Behind the Curve" helps us understand why the data on people with drug overdoses 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.

• Social Workers
• Naloxone
• Lock boxes for meds
• Madison Substance Awareness Coalition
• Madison County Health Department- Medication for Opioid Use Disorder 
• Drug Free Communities Grant
• Hepatitis C Education and Testing
• Medication drop boxes
• Medication take back events
• Drug court
• Support groups
• Schools/Madison Patriots Prevention Partners (MP3)
• Broadband internet
• Transportation to specialists
• Churches
• Holler Harm Reduction
• Mental Health Training/Schools
• Telehealth
• Madison County 4-H
• Funding for substance use disorder costs

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

• Transportation problems
• Lack of job opportunities 
• Geographically isolated areas
• Poverty
• Stigma
• Lack of available, quality and needed resources
• Access/lack of providers
• Barriers to obtaining care and treatment
• Lack of funding for un or under-insured (treatment/medications)
• Response time to crisis calls
• Wait time to see providers
• Difficulty treating clients with complex mental health/substance use disorder needs
• Need more student support within the schools
• No Medicaid expansion
• Lack of support within the community
• Lack of community education about Medication Assisted Treatment
• Lack of sober living homes
• Lack of detox or inpatient treatment programs
• Lack of counseling and support
• COVID-19 Pandemic

What do people most affected by this issue say?

• Court issues play a major role
• Financial pressures/barriers
• Lack of Medicaid
• No transportation to access community resources
• Isolation
• Stigma
• Trauma history
• Emotional neglect
• Growing up in dysfunctional family/generational cycle
• Low self-esteem; feeling of acceptance when using
• Lack of or loss of recreational activities

Partners in our Community Health Improvement Process: 

• Madison Substance Awareness Coalition (MSAC)
• Madison County Health Department
• Madison County Schools  (SHAC)
• Abiding Hope
• White Insurance Agency
• Madison County News-Record & Sentinel
• Prevention Resource Centers | RHA Health Services
• Vaya Health
• GracePoint Asheville
• Madison County NC Sheriff's Office
• My Sisters Place
• NC Department of Public Safety
• Holler Harm Reduction
• Drug Court

Partners With a Role in Helping Our Community Do Better on This Issue:  

• EMS
• Law Enforcement
• Local Health Providers
• Pharmacies
• Churches
• Parents/Grandparents
• Youth
• WNC Healthy Impact
• MAHEC Triple P
• Community Leaders
• Madison County Department of Social Services
• Mars Hill University

The following actions have been identified by Madison Substance Awareness Coalition and community members as ideas for what can work for our community to make a difference on Substance Use and Mental Health.

Actions and Approaches Identified by Our Partners These are actions and approaches that our partners think can make a difference on Substance Use and Mental Health.

• Medication Assisted Treatment (MAT)/Medication for Substance Use Disorder 
• Expand education from middle school and early college to high school and alternative school 
• Teen Intervene classes
• Funding for substance use disorder
• Support Groups
• Awareness and education on mental health issues

What is Currently Working in Our Community These are actions and approaches that are currently in place in our community to make a difference on Substance Use and Mental Health.

• Narcan education and kits
• Medication Drop Box promotion
• Medication Lock Box education and distribution
• Medication Take Back Events
• Youth Education (schools) and Empowerment (MP3)
• Madison Substance Awareness Coalition (collaboration)
• PRIDE survey collection
• Community survey collection
• Drug Court
• Substance Use support groups
• Triple P
• Stigma education
• Health-e-Release program/Telehealth in schools and jail
• Resilience Training, suicide prevention training and mindfullness/mental health classes in schools
• Drug free community grant
• Medication Assisted Treatment (MAT)/Medication for Substance Use Disorder 
• Expansion of internet/public hot spots
• Child Fatality and Protection Team efforts

Evidence-Based Strategies These are actions and approaches that have been shown to make a difference on Substance Use and Mental Health.

What Community Members Most Affected by Substance Use Say These are the actions and approaches recommended by members of our community who are most affected by Substance Use.

• Recovery education classes
• Peer/Family support
• Sense of community
• Avoiding places and people that trigger Substance Use
• Employment/access to jobs
• Community service-the sense of giving back and purpose
• Community resources
• Church involvement
• Recovery housing
• Access to 12 step meetings
• Reduce stigma
• Safe activities/spaces
• Financial assistance

Process for Selecting Priority Strategies

Madison Substance Awareness Coalition discussed root causes for substance use and mental health and explored various evidence based strategies to address both issues.  Factors considered in the discussion insluded feasibility, resource requirements, as well as community will and values.  It was determined to continue Medication Assisted Treatment (MAT) as a strategy for 2021-2023 and to add Teen Intervene.  We believe both strategies could make a positive difference in Substance Use and Mental Health in Madison County.