What do the numbers say about substance use?
Western North Carolina (WNC) Data:
Approximately 46% of residents in North Carolina report that their life has been negatively affected by substance abuse (by self or someone else). Some residents are more affected than others, including:
- Adults aged 18-39 years (54%)
- Very low income (57%) or mid/high income (48%)
- Those identifying American Indian/Alaska Native, Indigenous (62%)
(WNCHN – WNC Healthy Impact Community Health Survey, 2021)
Differences in health outcomes across social groups, economic status, and racial/ethnic identity are closely linked with disparities in social determinants of health, which disproportionately burden individuals and communities who experience systemic disadvantage and/or discrimination. See our data story on the Social Determinants of Health to learn more about how the conditions in which people are born, live, work, play, learn, worship, and age can influence their ability to achieve good health for themselves and their families.
Life Negatively Affected by “Substance Abuse” 2021
Source: WNC Healthy Impact Community Health Survey, 2018-2021
| wdt_ID | County | 2018 | 2021 |
|---|---|---|---|
| 1 | Buncombe | 50.20 | 47.60 |
| 2 | Cherokee | 51.00 | 48.30 |
| 3 | Clay | 50.50 | 41.70 |
| 4 | Graham | 46.20 | 52.00 |
| 5 | Haywood | 38.00 | 36.30 |
| 6 | Henderson | 40.40 | 42.20 |
| 7 | Jackson | 47.00 | 55.30 |
| 8 | Macon | 57.80 | 50.10 |
| 9 | Madison | 46.10 | 56.70 |
| 10 | McDowell | 43.40 | 42.50 |
| 11 | Mitchell | 61.50 | 54.00 |
| 12 | Polk | 37.70 | 55.10 |
| 13 | Rutherford | 54.80 | 47.10 |
| 14 | Swain | 49.40 | 55.40 |
| 15 | Transylvania | 41.60 | 41.30 |
| 16 | Yancey | 48.00 | 43.20 |
| 17 | WNC | 47.40 | 46.50 |
| County | 2018 | 2021 |
Opioid Use
In 2021, approximately 13% of adults in WNC used opiates/opioids in the past year with or without a prescription.
(WNC Healthy Impact Community Health Survey, 2021)
Percent of Adults in WNC Using Opioids, by Year
Source: WNC Healthy Impact Community Health Survey, 2018-2021
North Carolina created the Opioid and Substance Use dashboard to address the opioid crisis in North Carolina.
The Opioid and Substance Use dashboard provides “integration and visualization of state, regional, and county-level metrics” to track progress toward reaching goals focused on reducing opioid and substance use in North Carolina.
State and National Findings
There were 2,686 opioid overdose deaths in North Carolina in 2020. This accounted for 83.4% of all drug overdose deaths in the state.
Deaths due to drug overdose increased from 72,000 deaths nationally in 2019 to over 93,000 deaths by 2020.
Cigarette Use
The percentage of adults who smoke cigarettes in WNC has declined from 19% in 2018 to 14% in 2021.
(WNCHN – WNC Healthy Impact Community Health Survey, 2021)
The percentage of adults in WNC currently using vaping products (such as e-cigarettes) has declined from 7% to 5% from 2018-2021.
(WNCHN – WNC Healthy Impact Community Health Survey, 2021)
Nearly 1 in 10 (9%) adults in WNC have breathed someone else’s smoke at work within the past week.
(WNCHN – WNC Healthy Impact Community Health Survey, 2021)
Percent of Adults in WNC Smoking Cigarettes, by Year
Source: WNC Healthy Impact Community Health Survey, 2018-2021
State and National Findings
As of 2020, more than 16 million Americans were living with a disease caused by smoking.
Each year, the United States spends more than $225 Billion on medical care to treat smoking-related disease in adults.
Alcohol Use
In 2021, 52% of adults in WNC drank at least one alcoholic beverage within the past 30 days with 18% of those adults considered excessive drinkers.
(WNCHN – WNC Healthy Impact Community Health Survey, 2021)
Percent of Adults in WNC Excessively Drinking, by Year
Source: WNC Healthy Impact Community Health Survey, 2015-2021
Excessive drinking reflects the number of persons aged 18 year and over who drank more than two drinks per day on average (for men) or more than one drink per day on average (for women) OR who drank 5 or more drinks during a single occasion (for men) or 4 or more drinks during a single occasion (for women) during the past 30 days.
Explore the NC Alcohol Data Dashboard for more data on excessive alcohol consumption rates, immediate- and long-term impacts of excessive use, and cost to communities.
State and National Findings:
Excessive alcohol use is the third leading preventable cause of death in North Carolina.
(NC DHHS, 2019)
Nationwide, approximately 14.5 million individuals age 12 or older had an alcohol use disorder.
The annual economic impact of substance misuse is estimated to be $249 billion for alcohol misuse and $193 billion for illicit drug use.
What did the region say is the story behind the substance use numbers?
The items below are paraphrased themes that emerged from a 2021 regional survey of key informants. These responses do not necessarily:
- Reflect accurate or scientifically validated information about health determinants, outcomes, and/or strategies for change.
- Represent an exhaustive list of factors that can help or hurt efforts to address this key regional health issue.
(WNCHN – Online Key Informant Survey, 2021)
The information in this section should be interpreted and used with care. It should be used only to help local health departments and agencies begin to understand community perceptions about local health issues. Communities are strongly encouraged to collect their own, local-level data to inform local planning and evaluation activities.
What’s Helping?
- Awareness/Education
- Policies/Programs
- Increased outreach opportunities
- Community Partnerships
- Problem Recognition
What’s Hurting?
- Mental Health
- Lack of resources
- Funding
- Denial/Stigma
- Poverty
What we are hearing:
“Many groups are working on a common goal of reducing youth substance use, adult substance misuse, food insecurity and issues related to poverty.”
“Increased community partnerships to handle the pandemic, racism, housing, opiate use crisis.”
“Collaborations are going on through coalitions to address health issues like substance use and behavioral health.”
“Growing number of organizations adopting tobacco-free policies, school-system which is actively working to prevent tobacco use in school-aged children.”
How is the region prioritizing this issue?
The western North Carolina region includes 17 communities: 16 counties and Eastern Band of Cherokee Indians (EBCI)
