This portfolio explores substance use in Pender County, NC. Recent data from the community health opinion survey indicates that substance use in Pender County is the number one community issue (Pender County Health Department, 2018). From 2012 through 2016, the number of Pender County resident babies hospitalized with drug withdrawal syndrome per 1,000 was 20. To contrast, as a whole, the state of North Carolina recorded 9 per 1,000 (Pender County Health Department, 2018). To date, the local management entity (LME) in Pender County responsible for managing state and federally funded services, including substance use disorders, is Trillium Health Resources. Trillium provides prevention plans based on care team evaluations and crisis or emergency intervention (Trillium Health Resources, 2020). In conjunction with LME services, substance use resources are limited to the Pender County Alcoholics Anonymous Intergroup, one medication disposal site, Pender County webpages, and the Pender County crisis unit. Evidence suggests that Pender County lacks an inclusive plan for substance use prevention.