J.D. Vance, a Yale-educated lawyer with roots deep in the addiction riddled Appalachian region, penned Hillbilly Elegy, shedding light upon addiction in one of America’s poorest areas. Addiction is often synonymous with areas like the one Vance eventually escaped from and with urban areas. However, the National Rural Health Association recently reported that 2.5 million Americans are addicted to opioids with an additional 467,000 addicted to heroin. According to the same report, the largest jump in opioid deaths are occurring in rural states, a particular challenge considering the limitations of health care availability in these same areas.

National Public Radio reported on Colorado’s rural opioid crisis early in 2017. Sterling, Colo., located in the northeast corner of the state, was center stage as Melissa Morris, who has now been clean for two years, recounted not only her opioid addiction and the ease of which she fueled her addiction in the small town, but also the two-hour drives to Denver to seek treatment.

Logan County, the county in which Sterling is located, has seen a doubling in the number of opioid overdoses since 2002. According to NPR, a recent University of Michigan study found rates of babies born with opioid withdrawal symptoms rising much faster in rural areas than urban ones. This raises concern as rural areas also often face more limited health care resources.

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Sen. Cory Gardner, R-Colo., applauded the 2016 passage of the Drug Addiction Treatment and Prevention legislation, providing drug prevention and education programs and increased treatment and recovery efforts to address drug addiction. Gardner said in a statement that he has heard about the “devastating impact heroin and opioid addiction has on families and communities across” the state. Of the counties in Colorado, only Mineral County hasn’t experienced an increase in accidental drug overdose deaths, according to the Denver Post.

According to the Centers for Disease Control and Prevention’s 2014 report, the numbers of deaths due to drug overdoses in the rural, northeastern counties of Sedgwick, Phillips, and Logan counties rival those reported in El Paso County, Colo. The reported overdose deaths in rural, southern counties is equal to those deaths reported in Adams and Denver counties. The number of intentional and unintentional drug overdose deaths in the state numbered 899. The rates of overdose deaths are among the highest in the nation with 12 Colorado counties reporting more than 20 per 100,000 residents. Seven of the 12 counties — Baca, Bent, Conejos, Rio Grande, Las Animas, Costilla and Huerfano — are rural, southern Colorado counties with the other three — Adams, Denver, and Pueblo — being metropolitan counties. The remaining two counties are western Colorado’s Delta County and northern Colorado’s Jackson County.

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ON THE FARM

American Farm Bureau Federation and National Farmers Union recently initiated dialogue about the opioid crisis after a poll by Morning Consult revealed that while half of rural Americans say they have been directly impacted by opioid addiction, 74 percent of farmers and farm workers say they have been affected.

Zippy Duvall, AFBF president, urged members to talk to those around them who may be struggling with addiction, which Duvall points out is a disease requiring treatment.

“The opioid crisis is not just some talking point or abstract issue — it is an enormous challenge for both rural and urban America, and we as a country need to come to grips with it,” said NFU President Roger Johnson. “These responses demonstrate the reach of the unrelenting and deadly crisis that is gripping farm families across the country. Farm and rural communities currently face major challenges in the fight against addiction, like access to services, treatment and support. Time and time again, farmers and ranchers have come together to help their families and their neighbors through challenging situations. That same resolve and compassion will help us break the grips of opioid addiction in rural America.”

The poll also indicated that nearly 80 percent of those who work in agriculture believe large amounts of prescription opioids without a prescription are easily procured in rural communities. While one in three rural adults believe access to treatment in their community is available, less than half were confident that the treatment would be effective, covered by insurance, convenient or affordable.

NPR cited the use of opioids in rural communities for pain management being popular, in part, due to the limited availability to alternatives like physical therapy. Additionally, as economic stresses prevail in rural areas, as well as the popularity of jobs like manufacturing, farming, and mining that carry higher rates of injury, self-medication with opioids is prevalent.

Jack Westfall is a family physician and a researcher with the University of Colorado who works with the High Plains Research Network. The network, works closely with rural clinics and hospitals in the state and many eastern Colorado doctors report feeling frantic.

“We don’t know what to do with this wave of people who are using opioids,” he said. “They’re in the clinic, they’re in the ER, they’re in the hospital. They’re in the morgue, because they overdosed.” ❖

— Spencer Gabel is a freelance writer from Wiggins, Colo., where she and her family raise cattle and show goats. She can be reached at rachelspencermedia@gmail.com or on Facebook at Rachel Spencer Media.