Rural Substance Abuse

Substance Abuse In Rural Communities And Small Towns

Substance abuse in rural communities is on the rise. According to reports from the Centers for Disease Control and Prevention (CDC), drug overdose death rates in America are now the highest in rural areas, compared to urban areas.

The US Census Bureau defines rural areas as sparsely populated, having low housing density, and far from urban centers. About 1 in 5 Americans (60 million people) live in these rural areas. An increase in substance use disorders (SUDs) can have devastating effects on these communities, as they can lead to poor physical and mental health, employment problems, broken relationships, and higher overdose rates.

Risk Factors And Causes Of Substance Abuse In Rural Communities

The more risk factors a person has, the more likely it is they will experience substance abuse problems. The most common risk factors for substance abuse among residents in rural communities include the following.

Poverty

People with lower incomes have higher rates of drug and alcohol misuse. A study published in Addiction Health shows that someone living at the poverty level is more likely to develop an addiction, with 25% of participants who reported illicit drug use also claiming to have a family income of less than $20,000 annually.

Unemployment

According to the US Department of Agriculture, unemployment rates in rural areas are often caused by the lack of population growth and lower demand for local goods and services. Unfortunately, a study in the journal Healthcare found that unemployed residents have much higher rates of substance abuse, especially with alcohol, tobacco, and illicit drugs. Despite unemployment rates in rural areas declining, many people continue to struggle with addiction.

Low Educational Attainment

Adults who have not finished high school are at higher risk of substance abuse since lower educational attainment is associated with higher drug and alcohol misuse. When someone starts misusing substances at an early age, they may develop an addiction that takes priority over obtaining education. Some reasons for not completing education include academic failure, disciplinary actions, and family responsibilities.

Stigma

While stigma is not a risk factor for substance abuse, it is a risk factor for not seeking addiction treatment. An Indiana University study found the stigma surrounding addiction is much higher in rural communities than in urban areas. People living in rural America may view addiction and attending addiction treatment as a sign of weakness. They may have negative views on seeking professional help or fear a lack of confidentiality as the community is small.

Additional factors that lead to addiction may include:

• Having a close family member with a SUD
• Having past traumatic experiences
• Living in a home environment that supports drug or alcohol abuse
• Experiencing substance misuse from an early age
• Peer pressure to use substances
• Lack of treatment services available

These risk factors are not all-encompassing or limited to rural areas; substance abuse can affect anyone. If you are struggling with substance abuse, start your recovery journey today by reaching out to a treatment provider. All calls are free and confidential.

Challenges Of Rural Substance Abuse

Rural communities often lack the resources found in urban areas. Small towns may have limited treatment professionals or cannot offer salaries comparable to those of larger cities.  Many other barriers create challenges with rural substance abuse, such as:

Limited Health Insurance Options

Although health insurance is now available through the Healthcare Marketplace, many rural residents still lack appropriate coverage. A study of 28 million people involved with community health centers found 23% were uninsured. Reasons for being uninsured in rural America included not wanting insurance and finding the process of getting insurance too difficult. Researchers found that poverty and low socio-economic status are common factors contributing to a lack of insurance. Another factor is a person’s belief that they cannot afford health insurance. Although laws have been passed to help everyone access health insurance, rural Americans claim insurance carriers, even Medicaid and Medicare, limit coverage, services, and location of services.

Limited Access To Treatment Centers

Lack of reliable transportation can often be a roadblock to seeking treatment in rural communities. Buses, trains, and public transportation systems are generally sparse in rural areas, which poses a challenge in setting appointments for treatment. Ride-share programs or taxis are also limited, making it especially tough to reach a treatment center miles away.

A lack of comprehensive and varied addiction treatment is another barrier among rural Americans. Since appropriate treatment is based on the level of care that a person needs, it may be difficult to find specialized treatment options, such as inpatient detox services or partial hospitalization programs.

Likewise, medication-assisted treatment (MAT) programs are also difficult to find, as rural areas may lack MAT-trained doctors, therapists, and staff.

Social Stigmas And Other Misperceptions

Fear of discrimination within the community and among family members and friends often poses a challenge to those living in a rural area who are seeking treatment.

The limitations of rural life also bring a lack of awareness regarding addiction and treatment, with many often assuming that treatment costs are high, which further limits their options. Some presume that professionals working in rural areas lack the skills and qualifications necessary to treat their addiction effectively. Due to a lack of aftercare services, they may observe others go to treatment and relapse. Even though this is a common occurrence in recovery, it could be easy for someone to assume that the same thing will happen to them.

A review of multiple studies regarding social stigma and misperceptions among rural Americans revealed the following:

• The availability of medications was thought to be lower in rural areas.
• Rural residents were more likely to receive brief interventions due to a lack of specialty treatment services, like intensive outpatient programs.
• Rural residents may view stopping substance misuse as a matter of willpower or help from a higher power.
• Services are not available for all age groups.
• People feared being perceived as weak.
• People are worried that the treatment staff will not be trustworthy, will lack training, or will be judgmental.

With addiction treatment centers and support less plentiful, people with a substance use disorder may have a harder time finding the help they need.

Statistics On Substance Use In Rural Communities

The National Survey on Drug Use and Health shows how substance abuse affects rural communities. Some of the most worrisome data include the following:

• Prescription painkiller misuse in rural areas is at the highest it has ever been.
• Alcohol, tobacco, and methamphetamine use is higher in rural areas.
• Forty-three percent of deaths caused by an impaired driver occurred in rural areas.
• Thirty percent of all rural traffic fatalities involved alcohol.
• Opioid overdose rates are 45% higher per capita in rural areas.
• Only 14% of all behavioral health treatment centers are in rural communities, and less than half of those focus on treating substance abuse.

Recovery is possible for those struggling with substance use disorders, and there are actions communities can take to help prevent and treat addiction.

How Can Rural Communities Combat Substance Abuse?

Rural communities can begin improving substance abuse treatment services with the help of primary care providers, many of whom can get approval to participate in medication-assistance treatment programs. If rural residents can go to their primary care doctor for medication to help them avoid relapsing on alcohol and opioids, that is an excellent step in the right direction.

Primary care providers also need to continue their training in addiction so they can appropriately refer someone to treatment. Other ways rural communities can combat substance abuse include:

• Connecting people to local resources that help them succeed, including help with transportation, childcare, housing, and continuing education.
• Improving screening tools at medical centers, physicians, dentists, and schools.
• Supporting law enforcement efforts to reduce drug use in the community.
• Prioritizing community support groups like Narcotics Anonymous (NA) and Alcoholics Anonymous (AA).
• Having mental health treatment professionals that offer dual diagnosis services.
• Developing transportation programs that take residents to and from treatment.
• Offering programs that address the stigma of seeking addiction treatment.
• Reducing costs for treatment or offering scholarships for services.
• Offering supplemental addiction treatment services until a person can get to a more intense program, like intensive outpatient programs and 12-step programs.
• Increasing employment opportunities for those in recovery.
• Implementing prevention programs.

For those working to quit using substances, treatment programs can help.

Finding Treatment In Rural Communities

While the ability to find treatment in rural communities is improving, general availability and access are still quite limited. Luckily, flexible treatment options can bypass many of the barriers small communities face.

Telehealth

Online therapy options can bring licensed addiction therapists and counselors to even the most remote parts of the country. These services are confidential, flexible, and covered by many insurance providers.

Telehealth is convenient and effective, reducing costs for everyone involved, including patients and providers. Other benefits include:

• Increased retention and program adherence
• Increased patient satisfaction
• Eliminated travel time and costs

In areas where rehab programs are less plentiful, telehealth can be a beneficial option.

Traveling For Rehab

Those living in a rural community may need to consider traveling for rehab, which has many benefits. Seeking treatment far from home — away from friends, family, and influences that trigger use or make substances readily available — often helps in recovery. The temptation to leave treatment early decreases because finding transportation may be difficult.

Traveling for rehab means starting fresh without the stressors and distractions from home. You not only get a break from the demands of home, but you also get a treatment plan that is specific to your needs. You can feel confident in staff qualifications, confidentiality, and program effectiveness. Most importantly, you can fully commit to your recovery in a safe environment.

Start Your Recovery Journey, No Matter Where You Live

While drug and alcohol misuse is prevalent in rural communities and treatment services are limited, there are treatment options available to you.

Explore our online therapy directory or contact a treatment provider today to discuss your treatment options.