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

Substance misuse has been identified as a top priority in the 2012, 2015, and 2018 Community Health Assessments. Social attitudes and political and legal responses to the consumption of alcohol and illicit drugs make substance misuse one of the most complex public health issues. Unintentional opioid overdose deaths in Henderson County have been steadily increasing yearly, now standing at 26.4 deaths per 100,000 residents. This accounts for deaths by all types opioids. However, illicit substances such as heroin, fentanyl and fentanyl analogues are increasingly contributing to overdose deaths. In 2020, 83.9% of all overdose deaths in Henderson County were contributed to illicit opioid involvement.

Unintentional injury, which includes unintentional poisoning and drug overdose, is the third leading cause of death overall in Henderson County and the first leading cause of death among residents ages 20-29. The unintentional injury and unintentional poisoning mortality rate trends per 100,000 population have been increasing in Henderson County, the region and the state since 2010, pointing to substance misuse as a leading cause.

The Hope Coalition Stakeholders (formally HopeRx) make up the action team responsible for addressing substance misuse in Henderson County. In an effort to have a unified approach to reduce opioid and substance use in the county, in Spring 2022 the Henderson County Commissioners also elected to re-engage the Henderson County Substance Abuse Task Force. The Task Force, an appointed group of community leaders and community members with lived experience, was first gathered in 2018. At that time, the group presented recommendations via the Task Force on Substance Abuse Report for how to use county funds to address root causes of substance misuse. The group was modified and re-engaged in 2022 to present recommendations for effectively spending the Opioid Settlement Litigation Funds in Henderson County.

The organizations and individuals that make up the Henderson County Partnership for Health, Hope Coalition Stakeholder group, and the Henderson County Substance Abuse Task Force are addressing this priority collectively. These partners include:

• AdventHealth Hendersonville
• Blue Ridge Community College
• Blue Ridge Community Health Services
• Blue Ridge Literacy Council
• City of Hendersonville
• Council on Aging, Henderson County
• Crossnore Communities for Children
• Family Preservation Services
• First Contact Addiction Ministries
• Henderson County Department of Public Health
• Henderson County Department of Social Services
• Henderson County Public Schools
• Henderson County Sheriff's Office
• Hope Coalition
• MAHEC
• NC Harm Reduction Coalition
• Pardee UNC Health Care
• The Free Clinics
• Thrive
• True Ridge
• United Way of Henderson County
• VAYA
• WNC Source
• Community members: Dr. Medina, Stephen Mace, Jason Harris

Substance Misuse and the related result, "Residents of Henderson County are free from substance misuse", 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
• Excessive Drinking- Decrease excessive drinking

The following actions have been identified by the Hope Coalition and Henderson County Substance Use Taskforce as ideas for what can work for our community to make a difference on Substance Misuse.

(A) Actions and approaches identified by our partners. These are actions and approaches that our partners think can make a differene on substance misuse.

• Action to be identified in future planning meeting

(B) 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 misuse.

• Diversion Control (drug take-back events)
• Prevention and Education Programs- We are Hope Week
• Peer Support and Recovery Groups
• Tobacco Control Policies
• Handle with Care
• Naloxone Distribution
• Substance Use Navigation
• Community Trainings
• Post-Overdose Response Team
• Medication-Assisted Treatment

(C) Evidence-based strategies. These are actions and approaches that have been shown to make a difference on substance misuse.

• See list above. Many of these strategies are also evidence-based.

The Substance Use Action Team, led by Hope Coalition through most of 2022, serves as the shared space for addressing substance misuse in Henderson County.

Hope Coalition's Recovery Community Center (RCC) opened its doors in August 2022 as a peer living room dedicated to adults in recovery. The Center is a safe space for individuals recovering from substance misuse and other traumas to find support. The RCC has had a significant impact already, connecting clients with housing, transportation, and job placement. The Action Team continued education, prevention and recovery through drug take-back events, naloxone distribution, and support groups.

Moving forward, a top concern for the Action Team is informing how Henderson County's portion of the Opioid Litigation Settlement funds will be spent. Over the past year, stakeholders identified four priority areas for spending from the list of allowable activities. Through action planning in early 2023, led by the REAL Academy, specific initiatives within each of these priority areas will be selected and funded.

The Substance Misuse Action Team serves as the shared space for addressing substance misuse in Henderson County and has a variety of participants, representing a well-rounded group of professionals and individuals with lived experience.  This Action Team provides support for the Opioid Settlement Funding strategic plan, offers collaboration and an opportunity to serve and contribute.

A strategic plan for Henderson County’s portion of the Opioid Litigation Settlement has been completed, through action planning in 2023, led by the REAL Academy. The strategic plan has identified specific initiatives within each of these priority areas to be funded. The Substance Misuse Action Team will work on using that strategic plan to decide on program measures and how the data will be collected for each strategy in 2024. This information will be updated throughout 2024.

  ViewFromHereWNC View From Here - Henderson County: Social Media Campaign (Facebook & Instagram) August 7, 2023—September 29, 2023
In 2023, Henderson County joined the #ViewFromHereWNC social media campaign led by the WNC Health Communicators Collaborative. The ad campaign addresses several health priorities in Henderson County, including mental health, substance misuse, and physical activity/nutrition. Geo-targeted ads, which featured Western North Carolina residents, garnered 60,600 impressions, 1,549 ad clicks, 44,659 video plays, and 21,568 engagements in Henderson County’s first cycle. Initial online survey results showed 62% of respondents found the ads helpful and 72% sought more information on the health topics. The next campaign cycle starts in spring 2024.

Substance Misuse
You could be the hope someone needs. If you have a friend, family member, or loved one experiencing substance misuse, reach out for support today in Henderson County. #ViewFromHereWNC
Reach: 9,344
Clicks: 465
Impressions: 20.963
Video Plays: 14,264
Post Engagements: 7,193