In Virginia, the opioid crisis predominantly affects rural areas. This is largely due to low literacy level populations, shortage of pain management specialists, inadequate resources for the primary care physicians to manage these patients, and lack of awareness among doctors on effectiveness of these drugs in a poor condition. In America, 15% of people live in a rural area. Death rates for unintentional injuries like drug overdoses, falls, and motor vehicle crashes are approx. 50% higher in rural verses urban areas. In general, people who live in rural areas of the United States tend to be older, poorer, and sicker than those living in urban areas. Differences in socio-economic factors, health behaviors, and access to health care services contribute to these differences. From 1999 to 2015, the opioid death rates in rural areas quadrupled among those 18-25 years old and tripled for females. 

 

The rate of drug overdose deaths in rural areas has now surpassed rates in urban areas, creating a huge public health concern. Understanding how rural areas are different when it comes to drug use/drug overdose deaths, including opioids, can help public health professionals identify, monitor, and prioritize their response to this epidemic.

 

Overdose deaths can be prevented through improved public health programs. We can start addressing the opioid overdose epidemic and save lives by:  Understanding the differences in burden and context of drug use, drug use disorders, fatal overdoses, and identifying how to tailor prevention efforts to local situations between rural and urban areas. Teaching healthcare providers about safer opioid prescribing practices and how to treat patients with opioid use disorder (addiction) in one of the keys to prevention.  Considering non-opioid pain treatment options, like exercise and physical therapy, cognitive behavioral therapy, or more effective pain medicines (like acetaminophen, ibuprofen, and naproxen) also has treatment potential. Some of these options may actually work better and have fewer risks and side effects than opioids, according to some.  Supporting training and access to naloxone, a medication that can abruptly stop an opioid overdose, for high-risk individuals, families, emergency responders, and law enforcement is another key to helping those at risk.  Increased access to treatment for opioid use disorder (addiction) through medication-assisted treatment or comprehensive services to reduce infections from injection drug use, like HIV or Hepatitis C will only help in recovery.  Finally, working with public safety to share data, scale up evidence-based strategies, and decrease the illicit drug supply is the beginning of preventions for those in need.