Substance use across the lifespan in haywood county Patrick Johnson, RN-C, MPA HHSA Public Health Director Wanted to frame it this way (across the lifespan) to illustrate how broadly substance use/exposure affects Haywood County residents. Mention that all the following data pertains to Haywood County residents. Grace Church Social Issue Forum 1/26/19

Substance exposure: Birth & childhood Infants born with positive toxicology screens in 2018: 71 of 345 infants born = 20.5% (Per referrals to HHSA from area hospitals) Children in Foster Care in which substance use is a factor in case: 54 of 105 children = 51.4% Per HHSA Social Work Division case files Infants: Since 2017 hospitals have been required to report positive toxicology screen results to DSS. The stat above includes any substance, whether illicit or prescribed; the testing can come from cord, meconium, urine testing. Not all reports will result in a DSS case (e.g. Suboxone may be prescribed), but they do have to be tracked. This is 1 in 5 babies born in HC with this obstacle already in their life. Foster Care: We started tracking this in 2017 and it has hovered around 50%. 105 children is a high # of children in foster care in HC.

Substance use: youth We do not have good data on youth SU (this requires doing surveys in schools which has been difficult to do as it takes away from instruction time) But we can access state data on school crimes. 16 different crimes have to be reported to NC Dept of Public Instruction, two of which pertain to SU (possession of alcohol and possession of a controlled substance). From a low point in 2010-11 school year, the share of total crimes related to SU has steadily risen. This is a LOWBALL estimate – school policy is to send home students that appear to be under the influence of a substance. This stat only captures POSSESSION on campus. Source: Analysis of NC Department of Public Instruction Reportable Crimes

Substance use: adulthood Through a database called NCDetect, we can pull ED data for Haywood County residents (seen at any ED, e.g. HRMC, Mission, Park Ridge). This one compares the ED visits by Haywood County residents from 2009 – 2018 for the following substances (by diagnosis codes): Alcohol Abuse & Dependence; Acute Alcohol Toxicity; Opioid Overdose; Heroin Overdose; Meth Use. Certain substances (opioids, meth) get a lot more attention and rightly so as they’re extremely dangerous; but alcohol related visits are many times more prevalent. Source: NCDETECT

Viewed another way (table vs. trend) Previous slide viewed another way…

Substance use: End of life Our vital Records staff creates the death certificates; we track them all, especially deaths of despair. These are substance use related deaths (blue: alcohol; orange: drugs; gray – pending medical investigation) since we began tracking them. At least 99 lives lost to substance use. Source: Analysis of Haywood County Death Certificates, 2016-2018

Substance use: Effects on life expectancy This kind of speaks for itself, right? If not, it shows that people dying from substance related causes are much younger than others dying in Haywood County. That is many years of fulfilling and productive life lost and families with children affected. Source: Analysis of Haywood County Death Certificates, 2016 - 2018

Thank you Questions? Contact Patrick Johnson, Public Health Director Patrick.Johnson@haywoodcountync.gov or Lauren Wood, Health Education Supervisor lauren.wood@haywoodcountync.gov