Substance abuse is often thought of as a problem affecting residents of large cities, but addiction doesn’t discriminate. A significant number of rural residents are struggling with substance abuse and facing difficulty accessing the treatment they need for a sustained recovery.
How Substance Abuse Is Influenced by Location
The 2016 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) looked at substance abuse rates in people ages 12 and up. They found that substance abuse patterns vary depending upon where individuals live. Findings of note include:
- Rural residents are more likely to abuse alcohol, with 37.8 percent of non-metro residents and 34.4 percent of large metro residents engaging in this behavior.
- Rural residents are significantly more likely to abuse tobacco, with 28.5 percent of non-metro and 20.5 percent of metro residents engaging in this behavior.
- Rural residents are less likely to use illicit drugs, with 14.2 percent of non-metro residents and 19.4 percent of large metro residents engaging in this behavior.
Marijuana was the illicit drug most likely to be abused by both non-metro and large-metro residents.
Substance abuse in rural areas is often thought to be linked to a broader mental health crisis, with the changing economy placing the wellbeing of rural residents at risk. Deaths of despair, defined as those linked to suicide, alcohol, or drug use, rose 51 percent from 2005 to 2016 according to The Commonwealth Fund. Rural areas, including states in the Northeast and Appalachian communities, drove much of the increase.
Factors Affecting Addiction and Recovery in Rural Communities
Recovery is never easy, but rural residents who struggle with addiction can face specific challenges related to their location. Staying sober is difficult for rural residents due to several interconnected factors. For example:
- Job opportunities can be scarce in rural communities, with many available positions paying less than a living wage. Some people may turn to selling drugs as a source of income.
- Good paying jobs are often physically demanding, which creates a high risk of injury. Residents who suffer on-the-job injuries leading to chronic pain may try to self-medicate with drugs and alcohol.
- There are few recreational activities in rural areas, which leaves people with too much free time.
- Substance abuse provides an escape from the stress of everyday life.
- Rural people are less likely to have post-secondary education, which can increase the number of people who believe in addiction stigma. This leads to reduced support for recovery efforts.
- Seeking treatment may require a rural resident to travel far from home, which can be difficult without access to reliable transportation.
- Local treatment resources may not have the funding necessary to serve everyone who needs help.
Identifying and Treating People in Need
Promoting addiction-related education among primary care physicians, who are typically the most accessible healthcare providers in rural communities, can help identify individuals who are in need of substance abuse treatment. Identifying at-risk patients before they experience an overdose or other crisis event makes a substance use disorder easier to treat.
Primary care physicians can also be trained to prescribe buprenorphine, a medication that helps with the treatment of opioid addiction. Medication-assisted treatment shows great promise for treating opioid addiction, but prescriptions can be difficult to obtain in rural communities. A 2016 study in American Family Physician found that only 5.5 percent of psychiatrists and 15.4 percent of primary care physicians trained to prescribe buprenorphine practice in rural areas.
Expanding the use of telemedicine may be a way to offer additional healthcare services in rural areas. Psychiatric services are considered a vital part of the recovery process, since therapy helps people develop the coping skills necessary for long-term sobriety. Delivering these services remotely helps keep costs down and removes transportation barriers.
Strengthening Local Support Systems
Residents of rural areas often take great pride in the close-knit nature of their community. Often, it’s not uncommon for several generations of one family to live within a few miles of each other and for neighbors to be close personal friends.
This community pride can be a tremendous asset in the recovery process, if everyone understands the disease nature of addiction and how a holistic approach to recovery promotes a wellness-focused lifestyle. Community-based education programs, offered through schools or churches, can alert members to the dangers of substance abuse, the signs of addiction, and available treatment options. Community groups can also work together to provide sober entertainment options, such as outdoor concerts, fairs, guest speakers, and family game nights, to address the role that boredom plays in relapse.
It’s often said that the opposite of addiction is connection. The disease of addiction can affect the entire family, but treatment that promotes a stronger connection with loved ones can help heal these wounds. Family programs offered through facilities such as Mountain Laurel Recovery Center can help participants learn healthy communication skills and ways to promote a happier, healthier future for everyone.
