Building a recovery oriented system of care: Effective approaches to prevention, early intervention and treatment of people with substance abuse problems in North Carolina

The adverse consequences of substance abuse and addiction are tremendous for the individuals themselves, their families and society at large. Yet, very little is done to prevent people from becoming addicted, nor are early intervention services offered or effective treatment services provided once a person has problems. In North Carolina, approximately 8.5% of the population 12 and older are addicted to alcohol or drugs, but the state substance abuse system serves less than 10% of those in need. At the request of the North Carolina General Assembly, the North Carolina Institute of Medicine convened a broadly diverse task force to improve the state's substance abuse system. The task force developed a plan to improve primary and secondary prevention, expand early intervention programs through primary care providers, and develop a recovery oriented system of treatment services and supports. Because of the broad-based participation in the development of the plan, the state has already begun to implement task force recommendations. In addition to the initial victories in the North Carolina General Assembly, including the first increase in the wine and beer taxes since 1979 and 1969 respectively, local foundations have placed particular interest on proposals consistent with the task force in their funding priorities. With relatively small investments, North Carolina has begun creating an effective system of care to help people reduce their reliance on tobacco, alcohol, and other drugs. The success of this process in North Carolina may be translated into approaches to help address problems in other substance abuse systems.