The abuse of prescription painkillers and illicit opioids has become a public health concern in the United States of America. The Centers for Disease Control and Prevention (CDC) reports that more than 1,000 Americans are given treatment in emergency departments every day for misusing prescription opioids.

1. www.prescriptiondrugabusehelpline.com
Opioid Epidemic in Rural America
The abuse of prescription painkillers and illicit opioids has become a public health concern in
the United States of America. The Centers for Disease Control and Prevention (CDC) reports
that more than 1,000 Americans are given treatment in emergency departments every day
for misusing prescription opioids. Moreover, nearly 40 percent of overdose deaths in the
country are due to a prescription opioid.
The upsurge in the use of opioids is attributed to a growing number of doctors prescribing
painkillers, long-term prescription of opioids even for mild to moderate pain, unmonitored
prescription database system, aggressive marketing by the pharmaceutical companies, social
acceptance of prescription medications and easy availability of drugs. The epidemic has not
even spared the rural areas of the country.
As per the National
Advisory Committee
on Rural Health and
Human Services
Policy Brief 2016,
rural areas have a
higher rate of
overdose deaths
from prescription
opioids. Overall,
drug-related deaths
are 45 percent higher
and use of naloxone
is 22 percent higher.
The situation is
worsened by lack of
insurance, limited
access to care and fewer health care providers. Some of the badly affected states include
Alaska, Oklahoma, West Virginia and Kentucky due to lower response time of the emergency
medical service (EMS), mountainous terrains and higher transit times required for the EMS to
reach these regions.
Limited access to MAT
Even though medication-assisted treatment (MAT) is one of the most effective ways of
combatting the opioid epidemic, its success in the rural areas is limited. It not just reduces the
use of drugs but also the rate of accidental overdose. However, MAT can be used by only
those physicians who receive a special waiver to prescribe medications like buprenorphine.

2. www.prescriptiondrugabusehelpline.com
The doctors receiving such waivers are mostly clustered in the urban geographies with only
2.2 percent of the practicing physicians having the authority.
Many providers think of MAT as another form of an addiction, so they favor an abstinence
model. Rural providers who are able to prescribe buprenorphine report an extremely large
demand, which is way beyond they can handle. Waiting time is prolonged and the resources
are limited. Some of the other barriers are workforce shortage, transportation issues, longer
distances, and stigma associated with addiction and mental health disorders.
Benefits of OTOPs in serving rural community
Given the limited resources disproportionately divided between rural and urban areas, some
of the common methodologies for the treatment of opioid use disorder are:
1. Opioid Treatment Programs (OTPs)
2. Office-Based Opiate Treatment Programs (OBOTs) and
3. Abstinence-based models
The abstinence-based approach includes some inpatient models that are less popular than
the OTPs and OBOTs. The latter replace illicit opioids with safer and long-acting opioids like
methadone that help to reduce the risk of relapse, incarceration, personal and family
disruption as well as death.
In OTPs, patients need to visit the treatment facilities almost daily. This can cost a significant
burden on them due to long hours of travelling and waiting lists. Besides, many patients on
these lists are at high risk for mortality. Moreover, the transportation requirements prevent
many patients from working full time.
On the other hand, OBOTs is a more successful model for less-populated areas. The patients
are not required to visit the treatment facility on an everyday basis. It’s an outpatient model
where a licensed physician can prescribe buprenorphine for weeks or months, which can be
retrieved by the patient through a nearby pharmacy. They are also encouraged to seek
counselling along with their regular course of medication. A successful program integrates
OTPs with OBOTs.
Measures to combat opioid epidemic
In order to combat the burgeoning opioid epidemic in the rural regions, the National Rural
Health Association supports several policies. Some of these are:
 Removing barriers to MAT and making it accessible in all the rural communities.
 Improving the availability of outpatient mental health services, recovery and peer-
recovery services.
 Making Naloxone available to people struggling with opioid use disorder, their loved
ones, family members and even the bystanders who are trained in its use.
 Providing adequate financial support to research on opioid use related issues.

3. www.prescriptiondrugabusehelpline.com
Timely treatment key to early recovery
If someone has been prescribed any prescription opioid for pain management, he/she should
be careful about the dosage and duration of use. Long-term use of any drug can have adverse
effects on mental and physical health.
If you or your loved one is addicted to prescription drugs, contact the Prescription Drug Abuse
Helpline to find the best treatment facilities in your area. You can call our 24/7 helpline 866-
450-1557 to get connected to some of the reputed prescription drug abuse treatment
centers.