The "Story Behind the Curve" helps us understand why the data on people dying from 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.

A listening session was held with a group to discuss the substance use issue. These discussions highlighted the relationship between early childhood experiences and drug use.  Participants shared reasons why they began using, which included: drug use by their parents (generational), abuse as a child, and feeling inadequate, alone, or hopeless.  There was a consensus around the lack of resources for youth to be engaged in healthy and productive activities; therefore they find relief from stress in drug use (Graham County CHA).

There is also a stigma around drug use and therefore some efforts to help the problem are not always effective.  They feel that healthcare providers and counselors make you feel bad for using and act as if the problem is your fault.  Focus group participants discussed the syringe drop boxes.  One statement from the discussion was, “We want syringe drop boxes at the library, health department, and urgent care.  People won’t use the park drop box because of the cameras. They think the Sheriff’s office will pull the tapes and arrest them when they see them on camera.  People are afraid of arrest when dropping needles in the courthouse boxes as well.” (Graham County CHA).

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

• Celebrate Rocovery 12 step program
• Celebrate Grace and Church Mouse thrift stores provide employment for those in recovery
• Appalachian Community Services substance use counseling
• Peer Support Specialists
• Community Linkage to Care

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

• Lack of resources for mental health and substance use
• Lack of sober living activities
• Stigma
• Lack of living wage/steady employment

The partners for substance use include:

The following actions have been identified by our team and community members as ideas for what can work for our community to make a difference on Substance Use Disorder.

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

• Strengthening Families program held at the Robbinsville United Methodist Church
• Substance Use Coalition work
• ACE's training for teachers
• Community Linkage to Care

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 Disorder.

• Celebrate Recovery 12 step program
• Grace Place, A Community Table
• WNCAP

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

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

• Reduce stigma
• Increase access to treatment
• Improve job availability
• Increase housing availability

Process for Selecting Priority Strategies

During our group process, the following criteria were applied to the issues listed above to select priority health issues of focus for our community over the next three years: 

• Criteria 1 – Relevant – How important is this issue? (Urgency to solve problem; community concern; Focus on equity; Linked to other important issues)
• Criteria 2 – Impactful – What will we get out of addressing this issue? (Availability of solutions/proven strategies; Builds on or enhances current work; Significant consequences of not addressing issue now) 
• Criteria 3 – Feasible – Can we adequately address this issue? (Availability of resources (staff, community partners, time, money, equipment) to address the issue; political capacity/will; Community/social acceptability; Appropriate socio-culturally; Can identify easy, short-term wins)

 
Participants used a modified Hanlon method to rate the priorities using the criteria listed above.  Then dot-voting techniques were used to narrow to the top 3 priority health issues.