The "Story Behind the Curve" helps us understand why the rate of death due to unintentional poisoning 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 are work in our community and beyond that influence this issue in our community.

• Use Naloxone
• Education of Naloxone
• Diversion to reduce prescription drug abuse (drug drops)
• Monitoring of MDs who are prescribing
• School pledges from students
• Work-group oversight
• Faith-based awareness
• Providers have policies which are community encompassing to decrease "drug seekers"
• Town hall meetings

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

• Cost of Naloxone
• Standing orders/pharmacist
• Education for veterinarians
• Education for dentists
• More drop-boxes
• Working with pharmacists for drop-boxes
• Drug tack back policies/procedures
• Open dialogue among providers
• Need detox facilities

Partners in our Community Health Improvement Process:

• Addiction, Recovery, and Prevention (ARP)/Thrive!
• Blue Ridge Community College
• Blue Ridge Community Health Services
• City of Hendersonville
• The Free Clinics
• Henderson County Chamber of Commerce
• Henderson County Courts
• Henderson County Department of Public Health
• Henderson County Manager's Office
• Henderson County Public Schools
• Henderson County Sheriff's Office
• HopeRx
• Mainstay
• Margaret R. Pardee Memorial Hospital
• Mountain Area Health Education Center (MAHEC)
• October Road, Inc.
• Park Ridge Health
• Partnership for Health
• Project Lazarus
• United Way
• Western Highlands
• Wingate University
• WNC Healthy Impact

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

• Blue Ridge Community Health Services
• Community Care of Western North Carolina
• Family Preservation
• First Contact Addiction Ministries
• Henderson County Department of Health and Human Services
• Henderson County Department of Public Health
• Henderson County Sheriff's Office
• HopeRx
• Margaret R. Pardee Memorial Hospital
• Parents
• Park Ridge Health
• The Free Clinics
• Thrive
• Vaya Health

Partnerships We May Be missing:

• Dentists
• Department of Juvenile Justice (DJJ)
• Henderson County DSS
• Henderson County Public Schools
• Judicial/Drug Courts
• Retail Pharmacists
• School Counselors
• Treatment Accountability for Safer Communities (TASC)
• Treatment Facilities
• Veterinarians

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 the rate of death due to unintentional poisoning.

• STAR Program
• “We Are Hope” Week
• Diversion to reduce prescription drug abuse (drug drops)
• Naloxone available at The Free Clinics
• HopeRx
• Medical (MAT) - BRCHS
• Work group for oversight - BRCHS

Evidence-Based Strategies These are actions and approaches that have been shown to make a difference on the rate of death due to unintentional poisoning.

• Follow direction on medication
• Store medicines in locked cabinets
• Provide health, counseling, psychological and social services to meet the needs of students at schools
• Supervise children at home and on the playground

Source: North Carolina Institute of Medicine. Healthy North Carolina 2020: A Better State of Health. Morrisville, NC: North Carolina Institute of Medicine; 2011.

To select and prioritize interventions, our substance abuse action team, along with partners, conducted a “Whole Distance Exercise”, which is a disciplined thinking process that moved our group from results in mind to specific actions that address the issues, while using the common language presented by Results-Based Accountability™.

The process started with identifying the results we want (the life conditions we want for Henderson County residents) based on the health priorities identified in our Community Health Assessment (CHA). Next, a discussion took place on how we would recognize/experience the conditions of wellbeing we are trying to establish in our community. We also selected indicators for each result to enable us to measure these experiences. In addition, a data development agenda was created to identify data that are not currently available, but that we would like to develop to help us monitor progress on our result. We also created a baseline for each indicator to review where we have been and where we are headed if we do not do anything differently. The story behind the baselines were thoroughly reviewed in order to understand both “what’s helping” and “what’s hurting” behind each indicator. Since no one organization can do it alone, our action team identified partners who have a role to play in doing better and considered each possible contribution. Research was also reviewed for what has worked in other places, along with insights from “story behind the baseline”. Lastly, after considering all options, including no-cost and low-cost ideas, out action team made a list of possible interventions and prioritized them based on four criteria: Specificity, Impact, Values, & Feasibility. 

We are keeping an eye on the rate of death due to unintentional poisoning as a way of telling how we are doing as a community in addressing substance abuse and build a community where all Henderson County residents are free from prescription drug abuse. We have also identified other data that is not currently available, but that we would like to develop to help us monitor progress on this result:

• Use of Naloxone by law enforcement
• How often Naloxone is used
• Number of prescriptions filled
• Medical examiner/pathology reports more specific
• Infants born with addiction systems (Mission and MAHEC)
• Medicare resources for data
• Incident reports to Smoky Mountain from providers
• People are educated/Awareness raised