primary prevention

Evaluate and Compare Youth Social Capital to Risky and Protective Factors

Children who have a network and a supportive community that provides awareness, education and skill building  are less likely to use drugs and alcohol. Programs, policies, and services have been put into place within our communities to support youth thriving.

  • Strategy 1: Build Social Capital in our youth to reduce and prevent risky behaviors including substance abuse.

  • Strategy 2: Create a toolkit of resources, build awareness, and teach families about prevention.

Increase Public Awareness

The Community readiness to address alcohol and drug use prevention is important to program success. There is substantial evidence that delaying substance use until adulthood protects against addiction. The community needs heightened awareness of this evidence in order to fully embrace effective prevention strategies.

  • Strategy: Plan 1-year and 5-year term strategies to increase public awareness in collaboration with work happening at both the state and national level.

Secondary Prevention

Reduce Prescription Drug Misuse

The four main contributors to prescription drug misuse and abuse are:

  1. Accessibility of prescription drugs in our homes

  2. Over-prescribing

  3. Lack of consumer awareness

  4. Using multiple providers to obtain large amounts of pills.

The community has already begun to  address these issues through drug “take back” programs, prescription-monitoring databases (PDMP), and consumer education. Health systems are adopting CDC prescribing recommendations. Expanding these strategies and broadening both consumer and provider education is needed.

  • Strategy: Expand drug "take back" programs and ensure compliance with Prescription Drug Monitoring Program. Partner with healthcare providers on their programs for prescribing drugs. Broaden consumer education regarding the risks of opioid painkillers and alternatives.

Worksite/Employee Wellness

Most adults and many teens work in the  community. Businesses are impacted by the  addiction epidemic through lost work time,  reduced productivity, absenteeism and increasing insurance premiums. Providing employers with effective addiction prevention resources and education will enhance their employee wellness programs and see that a broad audience receives and understands  addiction. 

Blue Ribbon has a worksite wellness group led by Face It Together. The group will collaborate with the Worksite Wellness Program at ND Blue Cross and P5 Performance, DMF’s worksite wellness program.

  • Strategy 1: Proactively provide effective addiction prevention resources and education to employers. The education will ensure awareness, early detection, and early intervention. Partnering with other worksite initiatives also ensures activities that support primary prevention.

  • Strategy 2: Research, expand, and implement evidence-based addiction prevention programs in the workplace. Educate the workforce on strategies to prevent addiction and support recovery. Promote worksite wellness.




Many service providers in our community work within the addiction continuum. The system is complex, fragmented and very difficult to  navigate. FirstLink hosts our 211 system for suicide response, disaster, volunteers and other call assistance. Broadening their resources and adding education on addiction would ensure they can provide help for all those addiction-related calls, from a parent’s first questions to the  person ready to seek treatment.

This will ensure the community always knows where to go for help for addiction. Assistance will be timely and  efficient to get connections among the community, treatment providers, first responders, and health care professionals.

  • Strategy: Enhance 211 to establish and market a highly intuitive and usable Clearinghouse for addiction services by Fall 2018. A full time addiction navigator will be available via the 211 phone line.


A critical component to success in early  intervention is access and an ongoing barrier  is difficulty finding or affording reliable  transportation to and from services.
Expanding and subsidizing transportation would ensure people can get where they need to be and return home again. Helping people get to activities and events that promote wellness and social  connections is also critical.

  • Strategy: Enhance the transportation system to better help people access needed services and supporting activities.

Minimize Opioid Use During Pregnancy/Pregnancy During Opioid Use

Minimizing the number of babies born with effects from addiction is another priority for early  intervention. A small group including Cass and Clay social services, treatment providers, Sanford, Essentia, Family Healthcare and others will meet to create a strategy from current work and  potential collaborations.

  • Strategy: Align work to increase engagement and connect women to services to support recovery.

Early Intervention

treatment & recovery

Medical Detox/Withdrawal Management

The community currently has medical detox  management at the Clay County Medical Detox Unit and social withdrawal management at Fargo Cass  Public Health. Transportation from the area medical centers to the Clay County detox center has been a barrier in the past. Law enforcement officers are not able to cross state line and can transport within their state and  community, but do not cross the Red River. The  demand for transport has increased to the level that law enforcement can no longer fill this role. The current option is to use ambulance transport.

  • Strategy: Fargo Cass County Public Health received funding for a withdrawal management transport van from the ND Department of Human Services. This program runs 7 day a week, 8-hours a day staffing with two people for this van. This staffing level allows transportation from hospitals, shelters, police or others to the level of withdrawal management (Cass or Clay) that is required.

Medication Assisted Treatment (MAT)

There are many scenarios where medical detox or withdrawal management can be achieved at home. A sub-group of the Treatment Expert Panel has  developed information for primary care providers about services to help with withdrawal management. It includes medication protocols so they can prescribe meds and be assured monitoring is assumed by local treatment facilities. The education is being tailored for presentations to all providers working with such patients.

  • Strategy: Ensure options for MAT to support those seeking recovery.

Transitional Housing

Transitional drug and alcohol-free housing and support services are a best practice for sustained recovery. Sober housing coupled with other support is necessary for many to sustain recovery after inpatient treatment, during outpatient treatment, and for those leaving correctional facilities.

  • Strategy: Increase access to transitional drug and alcohol free housing through a sober support model for housing and schools.