A person pours an open pill bottle into their hand.

Rural America was often thought to be safer, quieter, and free from the problems that plague cities, but that doesn’t seem to be the case anymore. Now, according to the CDC, opioid misuse and the consequences of it have found their way into rural American towns. Drug overdose deaths are rising in the rural U.S., with the drug overdose death rate in rural towns higher than that of both suburban and urban areas. 

The big question is: why?

The cause of the opioid crisis in rural America

The recession of 2008 is a contributing factor to the current opioid crisis in rural America, as many rural towns still have not sufficiently recovered from it. With the recession came unemployment, falling incomes, businesses closing down, and dwindling community resources. This makes it impossible to improve living conditions, which in turn leads to fear, stress, and emotional distress, all of which contribute to substance abuse. 

Many jobs in these areas are also labor-intensive and can lead to injuries or chronic pain. As a result, many are prescribed opioids. The resources to provide other treatments, such as occupational therapy or physical therapy, are limited. Sometimes what starts out as a legitimate reason for taking an opioid spirals into an addiction. Limited healthcare access is also considered a contributing factor to opioid addiction in rural America.

The impact of the opioid crisis in rural America

The opioid crisis in rural America has had a tremendously negative impact on the people who live there. Studies have found that opioid death rates in rural areas have quadrupled among 18- to 25-year-olds and tripled for females from 1999 to 2015. Meanwhile, in 2012, an estimated 21,372 babies were born with opioid withdrawal symptoms, known as Neonatal Abstinence Syndrome. The American Farm Bureau Federation and National Farmers Union conducted a survey of rural America and found that:

  • Seventy-four percent of farmers have been directly impacted by opioid abuse.
  • Three in four farmers and agriculture workers say it’s easy to obtain opioids or painkillers without a prescription. 
  • Seventy-five percent of adults recognize that opioid abuse can begin with the use of painkillers or opioids that have been prescribed to them and deemed safe.
  • Only 34% of adults say it’s easy to access treatment for addiction. 
  • Only 38% of adults are confident that they could find effective and affordable care to deal with addiction.

When it comes to feelings about solutions for the opioid crisis, the survey found that 68% of people believe in increasing public education, while 57% of people believe in reducing the shame and stigma around opioid addiction.

Litigation and resource groups aiming to solve the opioid crisis in rural America

There are many initiatives and legislation that aim to help solve the opioid crisis in rural America, including but not limited to:

  • The Federal Opioid Response Fairness Act of 2018: This legislation changes the governmental formula used for allocating opioid funding by reducing the emphasis on population.
  • Rural Opioid Federal Interagency Working Group (IWG): This group, established in 2018, addresses the opioid crisis in rural communities by improving coordination of and reducing potential overlap among federal responses. 
  • Rural Communities Opioid Response Program (RCORP): This multi-year initiative group aims to reduce the mortality of substance use disorders, including opioid use disorder, in high-risk rural communities. It includes funding for medication-assisted treatment, neonatal abstinence syndrome treatment, and technical assistance to support those who receive RCORP grants.
  • The Addiction Recovery for Rural Communities Act: This legislation sets aside 20% of the USDA’s Distance Learning and Telemedicine Program grant funding for substance abuse treatment. It prioritizes USDA Rural Health and Safety Education grant funding for those applicants who are seeking to improve education and outreach on substance abuse issues.

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