A Qualitative Study of Community Priorities, Attitudes, and Beliefs Regarding Opioid Misuse in Rural Georgia
DOI:
https://doi.org/10.14738/assrj.115.17052Keywords:
substance misuse, opioids, rural, community preventionAbstract
Increasing mortality rates resulting from opioid use are reported in rural areas. This study aims to better understand the realities rural communities face related to opioid misuse. The objectives are 1) to examine what attitudes surround opioid use; 2) to describe existing prevention efforts currently available in the community, particularly those targeting youth; 3) to describe what substance use disorder treatment options are currently available locally; and 4) to discover what barriers keep people from accessing treatment. Researchers held community focus groups in four counties in rural Georgia, asking participants to describe local attitudes surrounding opioids, existing prevention and intervention efforts in their community, and barriers to accessing treatment. Qualitative analyses revealed eight overarching themes among the groups: 1) access/availability 2) physician prescribing behavior; 3) methamphetamine use as a substitute for opioids; 4) education; 5) environment; 6) restricted access; 7) intervention; and 8) awareness of the problem. Results suggest that prevention and intervention initiatives should be increased and should include focus on patterns of substance use (including substitution of one substance for another difficult-to-access one), education, and the environment. Environmental factors are critical—safe housing, communities of support, and peer coaches can provide the substance-free environment, socialization, and encouragement required for a former user to remain in recovery.
References
Keyes, K. M., Cerdá, M., Brady, J. E., Havens, J. R., & Galea, S. Understanding the rural-urban differences in nonmedical prescription opioid use and abuse in the United States. American Journal of Public Health, 2014. 104(2), p. e52-e59. doi:10.2105/AJPH.2013.301709
Young AM, Havens JR, Leukefeld CG. A comparison of rural and urban Nonmedical prescription opioid users' lifetime and recent drug use. The American Journal of Drug and Alcohol Abuse, 2012. 38(3): p. 220–227.
Centers for Disease Control and Prevention. Increase in fatal drug overdoses across United States driven by synthetic opioids before and during the COVID-19 pandemic. CDC Health Alert Network, issued December 17, 2020. Accessed August 31, 2022.
Georgia Department of Public Health. Opioid overdose surveillance 2018 preliminary report; 2017 overdose data. 2019. file:///C:/Users/amscheye/Downloads/2019_georgia_opioid_overdose_prelim_report_.pdf
Pew Charitable Trust. Opioid Use Disorder: Challenges and Opportunities in Rural Communities. 2019. Retrieved from https://www.pewtrusts.org/-/media/assets/2019/02/opioiduseruralcommunities_final.pdf 381
Andrilla, C.H.A., Coulthard, C., & Larson, E.H. Barriers rural physicians face prescribing buprenorphine for opioid use disorder. Annals of Family Medicine, 2017. 15(4): p. 359-362. doi: 10.1370/afm.2099.
Skinner, L., Staiger, D., Auerbach, D. I., & Buerhaus, P.I. Implications of an aging rural physician workforce. New England Journal of Medicine, 2019. 381(4); p. 299-301. DOI: 10.1056/NEJMp1900808
Miller, A. Fighting the doctor shortage in rural Georgia. Georgia Health News, December 2, 2019. https://www.georgiahealthnews.com/2019/12/fighting-doctor-shortage-rural-georgia/
Meit, M., Knudson, A., Gilbert, T., Yu, A., Tanenbaum, E., Ormson, E., TenBroeck, S., Bayne, A., & Popat, S. The 2014 update of the rural-urban chartbook. Rural Health Reform Policy Research Center, 2014. P. 153.
Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S. Exposing some important barriers to health care access in the rural USA. Public Health, 2015. 129(6): p. 611-620. https://doi.org/10.1016/j.puhe.2015.04.001
Substance Abuse Research Alliance. (2017). Prescription opioids and heroin epidemic in Georgia, white paper, Georgia prevention project. 2017. https://static1.squarespace.com/static/5a57a723bce1767362f84141/t/5b6b0e02758d46fd95897194/1533742624569/SARA_WP_Complete_v3_revEM.pdf
United States Department of Health and Human Services. Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health. 2016. https://addiction.surgeongeneral.gov/sites/default/files/surgeon-generals-report.pdf
American Public Health Association. Prevention and intervention strategies to decrease misuse of prescription pain medication. 2015. https://www.apha.org/policies-and-advocacy/public-health-policystatements/policy-database/2015/12/08/15/11/prevention-and-intervention-strategies-to-decreasemisuse-of-prescription-pain-medication
Browne, T., Priester, M. A., Clone, S., Iachini, A., DeHart, D., & Hock, R. Barriers and facilitators to substance use treatment in the rural south: a qualitative study. The Journal of Rural Health, 2016. 32(1): p. 92-101. doi:10.1111/jrh.12129
Brignone, E., George, D.R., Sinoway, L., et al. Trends in the diagnosis of diseases of despair in the United States, 2009–2018: a retrospective cohort study. BMJ Open, 2020. 10 p. e037679. doi: 10.1136/bmjopen-2020-037679
Dasgupta, N., Beletsky, L., & Ciccarone, D. Opioid crisis: No easy fix to its social and economic determinants. American Journal of Public Health, 2018. 108(2): p. 182-186. doi:10.2105/ajph.2017.304187
United States Department of Agriculture. Rural-Urban Continuum Codes. 2020. https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/
Hunt, M.R. Strengths and challenges in the use of interpretive description: Reflections arising from a study of the moral experience of health professionals in humanitarian work. Qualitative Health Research, 2009. 19(9): p. 1284-1292. doi:10.1177/1049732309344612
Thorne, S., Reimer, K.S., & MacDonald-Emes, J. Interpretive description: A non-categorical qualitative alternative for developing nursing knowledge. Research in Nursing and Health, 1997. 2: p. 169-177. https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1098-240X(199704)20:2%3C169::AID-NUR9%3E3.0.CO;2-I
Morse, J.M. & Chung, S.E. Toward holism: the significance of methodological pluralism. International Journal of Qualitative Methods, 2003. P. 13-20. https://doi.org/10.1177/160940690300200302
Bao, Y., Wen, K., Johnson, P., Jeng, P.J., Meisel, Z.F., Schackman, B.R. Assessing the impact of state policies for prescription drug monitoring programs on high-risk opioid prescriptions. Health Aff (Millwood). 2018. Oct; 37(10): p. 1596–604.
Perry, B.L., Pescosolido, B.A., & Krendl, A.C. The unique nature of public stigma toward non-medical prescription opioid use and dependence: A national study. Addiction, 2020. 115(12): p. 2317-2326.
Korthuis, P.T., Cook, R.R., Foot, C.A., et al. Association of methamphetamine and opioid use with nonfatal overdose in rural communities. JAMA Netw Open. 2022. 5(8): p. e2226544. doi:10.1001/jamanetworkopen.2022.26544
Chandler, R.K., Fletcher, B.W., & Volkow, N.D. Treating drug abuse and addiction in the criminal justice system: improving public health and safety. Journal of American Medical Association, 2009. 301(2): p. 183-90. doi: 10.1001/jama.2008.976. Erratum in: JAMA. 2009 Mar 11;301(10):1024. PMID: 19141766; PMCID: PMC2681083.
Emigh, M. Are drug courts effective? Drug court success rate statistics. Evidence-Based Community Society Blog. 2017. https://www.ebpsociety.org/blog/education/271-efficacy-drug-courts
Havens, J.R., Oser, C.B., Leukefeld, C.G., Webster, J.M., Martin, S.S., O'Connell, D.J., Inciardi, J.A. Differences in prevalence of prescription opiate misuse among rural and urban probationers. The American Journal of Drug and Alcohol Abuse. 2007. 33(2): p. 309–317.
Ahmad, F.B., Cisewski, J.A., Rossen, L.M., & Sutton, P. Provisional drug overdose death counts. 2022. National Center for Health Statistics. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.html
American Addiction Centers. Guide to drugs on social media. 2022. https://americanaddictioncenters.org/drugs-on-social-media
Jason, L., Salomon-Amend, M., Guerrero, M., Bobak, T., O'Brien, J., & Soto-Nevarez, A. The emergence, role, and impact of recovery support services. Alcohol Research, 2021. 41(1): p. 04. doi: 10.35946/arcr.v41.1.04.
Volkow, N.D., & Blanco, C. Research on substance use disorders during the COVID-19 pandemic Journal of Substance Abuse Treatment, 2021. 129: p. 108385. doi: 10.1016/j.jsat.2021.108385
Czeisler, M.E., Lane, R.I., Petrosky, E., Wiley, J.F., Christensen, A., Njai, R., Weaver, M.D., Robbins, R., Facer-Childs, E.R., Barger, L.K., Czeisler, C.A., Howard, M.E., & Rajaratnam, S.M.W. Mental health, substance use, and suicidal ideation during the Covid-19 pandemic — United States, June 24–30, 2020. MMWR Morbidity and Mortality Weekly Report, 2020. 69(32): p. 1049-1057. doi:10.15585/mmwr.mm6932a1
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