Michael Leach

Drug busts seem more common in rural America now than before, and the growing presence of drugs is not exclusive to one county; it is a nationwide problem.

The problem is slowly destroying both small and large communities, affecting people of all demographics, backgrounds and social classes. Some rural neighborhoods see police cruisers pass through streets at least two to three times per day. One of the most serious drug problems affecting rural America is opioid addiction.

Between 2017 and 2019, a total of 771 Mainers died from drug overdoses. In 2018, opioids were responsible for 80% of those deaths. However, drug overdose deaths are declining, yet more people are suffering from substance abuse disorders. For example, Aroostook County had the highest rate of drug trafficking or manufacturing arrests made by the Maine Drug Enforcement Agency. The majority of these arrests were associated with methamphetamine-related offenses.

York County had the third-highest rate of drug/medication overdose responses among public health districts. The number of overdose responses related to drug/medication overdose has increased and remained above the statewide average. In 2017, York County recorded the highest rate of naloxone administration. Many of the issues connected to drug use begin with accessibility. In 2017, one in five York parents felt that, at home, their child would be able to access prescription medication that was not prescribed to them.

Opioid or other drug addiction or abuse has emerged as a similar problem with economic concerns in rural United States. Between 2018 and 2019, 25% of adults in rural communities list opioid or other drug addiction as the most serious problem facing their community. In addition, 21% said economic concerns, including job availability, poverty, business closing, cost of living, and low wages, were the top issue — according to a study published in JAMA Network Open.

Additionally, adults in rural Appalachia were significantly more likely to say drugs were the biggest problem in their community. The Appalachian counties make up 25.5 million people living in 420 counties across 13 states. More than two-thirds of these are small counties consisting of 11.8 million within the civilian labor force population. In 2017, the opioid overdose death rate in Appalachian counties was 72% higher than in counties elsewhere in the United States.

Rural Americans view drug addiction as equal to current economic conditions, especially after the COVID-19 pandemic and government restriction. Since the late 1990s, there have been countless deaths connected to prescription medication, heroin, and fentanyl. Painkillers flooded small communities, especially within the Appalachian counties. Per the JAMA survey, 49% of respondents said they know someone addicted to opioids.

The COVID-19 pandemic has significantly impacted rural communities across the United States. Drug abuse was once viewed as the number one health problem within many communities. However, the pandemic overshadowed this, and due to widespread shutdowns and social distancing measures, COVID-19 is a grave risk to the millions of Americans with opioid use disorders. Those who are vulnerable and marginalized are heavily dependent on face-to-face health care delivery.

Although rural communities have traditionally been self-reliant, more of them are opening up to outside help to solve some of these serious problems. About one-quarter of adults living in these communities struggle to pay for or gain access to health care services. In addition, one in three rural adults still have problems paying their medical bills, despite the Patient Protection and Affordable Care Act, per the survey results.

The problems associated with drug abuse continue and were made worse due to the pandemic. The solution remains to be access to treatment and support services in rural communities and increasing the number of resources for prevention, treatment, and recovery.

Michael Leach of Atco, New Jersey, has spent most of his career as a health care professional specializing in Substance Use Disorder and addiction recovery. He is a regular contributor to the healthcare website Addicted.org and a Certified Clinical Medical Assistant.


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