How do we fix the opioid crisis in rural communities?
By Jamey Lister, Ph.D., M.S.W.
The opioid crisis has devastated rural communities across the country. The number of families losing loved ones to prescription opioid, heroin, and Fentanyl overdoses has skyrocketed. Rural Americans are four times more likely to die from opioids compared to 1999. But we can stop this nightmare. Primarily, we need to help family and friends gain better access opioid abuse treatments.
The ideal scenario to help people recover is to start medication-assisted treatment. This treatment combines medications with counseling or peer support groups like Narcotics Anonymous. These medications – Suboxone, methadone, or Vivitrol – can drastically help people control cravings and stop abusing opioids. As people find sobriety, they can begin the process of rebuilding their lives.
The nearest clinic that provides this type of treatment is in Jackson. Getting there is challenging, though, considering the time and costs of travel, and the shame many people feel about being in treatment. The upside is medication-assisted treatment has already saved, and will continue to save countless lives.
Despite opioid abuse being a disease in need of treatment, few people in rural areas ever receive professional help due to feelings of embarrassment and shame about their addiction. Friends and neighbors often are confused about the causes of addiction, which can lead to people talking about addiction as simply the result of bad choices.
While it is true opioid abuse leads to consequences, it is helpful to remember many use as a way to self-treat other issues. People who have experienced emotional, physical, or sexual abuse, and those with health problems or depression may use to cope with pain. Some may use to numb traumatic memories from time spent in the military. Many witnessed addiction in their families.
Having grown up in Stockbridge with much of my childhood spent with extended family in other rural areas of Michigan, I witnessed the toll that addiction can take when left untreated. There is a deep anguish in watching people you love unable to stop using. There is a strain on relationships, and feelings of hopelessness and worry for everyone in the family.
The epidemic upon us is not going anywhere. We must respond. But, rural communities face a dilemma. On one hand, the science is clear: On average, professional help offers the most reliable road to recovery. However, many rural residents trust more in the support of people they know or in being self-reliant in their recovery.
My research on rural opioid abuse treatment focuses on this dilemma. How can we combine these ways of trying to fix the problem? How can clinics and communities work together to reduce the hassles and feelings of shame connected to treatment? Can we combine medication-assisted treatment as is in better harmony with the ideals of rural communities and get better results?
To answer these questions, I started a study with colleagues from Wayne State and University of Michigan called “A Project on Rural Opioid Use Disorder” or the PROUD Research Study, the name chosen because towns like ours take pride in fighting back to challenges.
Our study will try to combat the opioid crisis by getting input from those with opioid abuse and Jackson area clinics that provide treatment. If you or someone you know wants to participate, they may be eligible to take part in confidential phone surveys ($20 gift card) or focus groups ($40 gift card). We can be reached privately at 313-577-4408 or proud.wsu@gmail.com.
My hope is the PROUD findings will help us design better treatments using wisdom from rural communities. But, there are a few solutions we can start on today. It is important we continue talking openly about addiction so people feel less shame. Township leaders might consider providing transportation assistance or stipends to those traveling to treatment. We also need to advocate for medication-assisted treatment and counseling services in clinics closer to Stockbridge.
Many of these solutions require leadership from passionate members of our community. We have those people, so I am hopeful for our town. We can’t cure the crisis, but we can fight back.
About Jamey Lister
by Roberta Ludtke
Lister, now a Ph.D. and tenure-track professor at Wayne State University, is currently leading two grant-funded research studies that may someday lessen the hold that opioids have on his home town of Stockbridge and on similar communities.
Stockbridge born and raised Jamey Lister always had a mind for math and numbers. Classmates assumed he would pursue a career as a sportscaster or sports statistician, but he opted for social work. Lister, now a Ph.D. and tenure-track professor at Wayne State University, is currently leading two grant-funded research studies that may someday lessen the hold that opioids have on his home town and on other communities like ours.
According to WSU’s website, “Dr. Lister’s interdisciplinary research focuses on improving access to high-quality treatments for people with opioid use disorder. His projects examine psychosocial and clinical factors that influence OUD treatment across socio-economically disadvantaged rural and urban communities.”
Lister is looking to telemedicine to help make quality OUD care more accessible. In a Jan. 30 interview with Michigan Radio–NPR, he spoke of the potential for videoconferencing.“You might use Skype or different web-based platforms,” he said, “so that a physician or other healthcare providers can connect with a patient that might live in rural or remote areas away from the clinic or hospital setting.”
Lister suggested a patient could use telemedicine, from connecting with a remote psychiatristgist to undergoing a psychological consult. “They’ll call it telepsych,” he said. “There really isn’t any condition that you couldn’t potentially apply it to.”
The son of Jim and Anita Lister, both retired Stockbridge School District teachers and coaches, Jamey Lister completed a master’s degree in social work at the University of Michigan and his doctorate degree in social work at Rutgers University.
Anita Lister said she was not surprised with her son’s career choice, as he always had compassion for people. When he wrote his grant application, she said, it was very important to him to serve the people in Stockbridge. She said she is equally proud of daughter, Jessica, who has a master’s in social work from the University of Michigan and works with families of dialysis patients.
Lister’s research has been supported by the U.S. Fulbright Program, Wayne State University Office of Provost, School of Social Work, and WSU Robust Initiative. He also is part of the State of Michigan Targeted Response to the Opioid Crisis Grant, funded by the Substance Abuse and Mental Health Services Administration.
Lister says he hopes his research will lead to better treatment for those most in need.
Hyperlinks for more information:
Michigan Radio interview on opioid crisis in rural communities of Michigan
The Conversation article on opioid crisis and telehealth for rural America (Creative Commons)
Jamey Lister Wayne State University faculty profile
https://socialwork.wayne.edu/profile/fp7790
Patrice Johnson
Editor in Chief of Stockbridge Community News. Author of national award winning, "The Fall and Rise of Tyler Johnson"