Thursday, August 23, 2018

Opioid deaths spike but treatment gaps remain

The opioid epidemic continues to ravage rural America. According to recently released data from the Center for Disease Control, drug overdose deaths reached a record high of 72,000 in 2017. The increase is largely driven by the increased use of synthetic opioids, such as fentanyl, which are frequently mixed with other drugs, sometimes without the knowledge of the consumer. In 2016, more than half of the opioid overdoses in ten states involved fentanyl and in some states, such as New Hampshire, that number was as high as two-thirds. Similar data is not yet available for 2017 but based on the preliminary data, it appears that this trend may continue. So far this year, the North Carolina Harm Reduction Coalition has distributed 1,296 fentanyl test strips in order to assist users with detecting fentanyl in their drug mix and so far 82% of the strips have tested positive. The danger presented by fentanyl and similar drugs is very real and will only continue to ravage our communities unless we can come up with ways to control the opioid epidemic.

According to the Center for Disease Control, the drug use rate is higher in urban areas while fatal drug overdoses are more prevalent in rural areas. Why is that? To explore this gap, we need to ask ourselves what happens when a rural person becomes addicted to opioids. In some cases, you could seek out treatment. For a lot of people however, that is sadly not an option. According to the National Academy for State Health Policy, 91.1% of drug treatment facilities are located in metro or metro adjacent counties. People in rural spaces also struggle to find transportation and are often unable to consistently make appointments. For people who are able to access treatment however, they may have to work through models that are not designed for members of their community. According to Joy Buck, a nursing professor at West Virginia University, many of our drug abuse response models are modeled on urban areas and do not reflect the realities of rural communities.

There are however a couple of promising steps to finding solutions to the issues above. In New Hampshire, newly released federal funding is being used to create nine regional hubs around the state that will act as "one-stop shops for those seeking help. Individuals entering the system through those hubs will be evaluated for their medical and social service needs, and then connected to relevant resources. That may include not just coordinated addiction treatment or counseling, but also broader social supports like job training and housing assistance that can help maintain a stable recovery." These hubs will collect information for patients over a period of time so officials can improve treatment delivery models. In West Virginia, WVU has been issued a grant to specifically study the issue of rural drug overdoses, work with community leaders and members, and assess outcomes in order to develop a coordinated response to the opioid crisis.

Rural America is struggling with an epidemic that it is ill-equipped to handle. The opioid epidemic, fueled by various causes, is continuing to ravage rural communities. As the usage of more potent, synthetic opioids become more prevalent, the need to respond to this epidemic becomes even greater. While hopefully renewed attention to this issue results increased options for rural residents, we cannot ignore that this is yet another example of the disastrous and often fatal impact of the resource gap that continues to persist.

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