Not Just an Urban Problem

Jul 19 2017

Not Just an Urban Problem

It’s a long held tenet of substance abuse treatment that addiction affects everyone regardless of age, gender, class, or location. But recently treatment providers have noticed a shift in the overall addiction trends that require immediate attention.

Addiction to illicit drugs was long thought to affect primarily urban areas, and government agencies and other treatment providers subsequently directed funding and other resources into those areas. But with the recent heroin epidemic, researchers and providers are now seeing more issues in rural communities, and they’re trying to play catch up to allocate the resources necessary to address the problem.

According to the National Institute on Drug Abuse (NIDA), “Rural communities face special challenges in implementing services to prevent and control substance use and these related conditions. Low population densities and limited public transportation mean that access to public health services and treatment are limited.”

That simple lack of access to treatment can cause issues to snowball. The NIDA says public health agencies can have difficulty tracking infectious disease outbreaks in rural areas, which can cause higher rates of HIV and hepatitis B and C. Although the rates of addiction are similar between rural and urban areas, tackling those challenges requires a different approach

It’s because of these unique barriers to treatment that the federal government is putting a renewed focus on providing resources to rural areas. The NIDA recently announced they would be spending $6.5 million to improve community response efforts for disease outbreaks, particularly in hard to reach areas like rural Appalachia. The agency is also allocating $500,000 in funding for new research projects that will try to improve outcomes for substance users in rural areas throughout the country.

“This initiative will support comprehensive, integrated approaches to prevent opioid injection and its consequences, including substance use disorder, overdose, HIV and hepatitis C virus (HCV) infection, along with associated conditions, such as hepatitis B virus (HBV) infection and sexually transmitted diseases,” according to the NIDA

As researchers look for new ways to increase access to treatment in rural areas, others say the key to better outcomes lies in the kind of treatment being delivered. The FDA recently approved a long-term release version of an opioid blocker that can work for up to six months, helping users battle addiction without daily visits to a methadone clinic or other treatment facilities. Some researchers, like Dr. Stacey Sigmon (University of Vermont) and Dr. George Bigelow (Johns Hopkins University) who recently discussed the topic in the journal Addiction, say this could be a game changer for people in rural areas.

“The current system of daily or near-daily medication administration has presented challenges for the widespread delivery of effective treatment to opioid-dependent patients, particularly in many rural areas with limited providers,” the authors wrote. “Sustained-release formulations hold potential for surmounting these barriers.”

Although the authors note that providers will still need to evaluate if the treatment is appropriate for each individual client, they say simply decreasing the need for clients to stay in constant contact with providers could lead to better outcomes across rural America.