INDIANAPOLIS, Ind. — U.S. Sen. Joe Donnelly (D-Ind.), along with Senate Agriculture Committee Chair Pat Roberts (R-Kan.) and Sen. Luther Strange (R-Ala.), announced a bipartisan package of legislation aimed at combating substance abuse in rural communities.

 

The bill would help rural communities combat these disorders through treatment centers and increased availability of telemedicine. “This bipartisan package would help us fi ght back against the opioid epidemic that has harmed rural communities in Indiana and across the country,” Donnelly said of it.

The package of bills includes The Community Facilities Direct Loans and Grant bill and the Distance Learning and Telemedicine bill. Both efforts are operated by the USDA.

The Community Facilities Direct Loans and Grants bill provides funding to develop essential community facilities in rural areas. These are facilities that provide essential infrastructure, such as health care facilities, police stations and courthouses. The Donnelly-Roberts bill would give priority for applicants to the program who want to develop facilities to provide substance abuse prevention, treatment and/or recovery services.

The Distance Learning and Telemedicine bill would offer grants to rural communities to help address education or medical provider shortages, by linking them directly with teachers and medical service providers. The Donnelly-Strange bill would set aside 20 percent of the funding for the program for grant applicants who can use the funds for substance abuse treatment services.

Donnelly’s introduction of these bills are a follow-up of his most recent effort to address the opioid epidemic.

 

Last month he introduced the bipartisan Strengthening the Addiction Treatment Workforce Act, which would help address the shortage of providers who treat people battling substance abuse, by making addiction treatment facilities eligible for the National Health Service Corps student loan repayment and forgiveness program.

“We know that it will take all of us, regardless of party or geography, to confront this public health crisis,” he said.

According to the American Society of Addiction Medicine (ASAM), opioids are a class of drugs that include the illicit drug heroin as well as prescription pain relievers oxycodone, hydrocodone, codeine, morphine, fentanyl and others.

The ASAM points out that of the 20.5 million Americans age 12 or older who have had a substance abuse disorder in 2016, 2 million had a disorder involving prescription pain relievers and 591,000 had one involving heroin.

In its 2016 end-of-year executive summary of drug issues in the U.S., the ASAM blamed the 2008 recession, saying rural areas consistently lagged behind urban areas in the recovery, losing jobs and population. Magdalena Cerda, epidemiologist at the University of California-Davis, said rural areas “may be particularly fertile ground to the growing opioid problem.

“Larger economic, environmental and social factors leave rural Americans at risk,” she said. “In the rural community you have a situation where people might be particularly vulnerable to perhaps using prescription opioids to self-medicate a lot of symptoms of distress related to sources of chronic economic stress.”

According to Alexis Nager, research associate at The National Center on Addiction and Substance Abuse, statistics show a greater increase in the proportion of babies born addicted to opioids in rural communities than in urban areas.

“Rural communities have been especially affected in the past few years by rising rates of poverty and unemployment – two key community-level risk factors for addiction,” she said.

“Getting treatment for addiction in rural communities is also much harder than in urban areas. There is limited access to medications that help treat addiction in rural areas because of stigma, misunderstanding and a lack of accessibility communities face relative to those in urban areas.

“It’s not difficult to imagine the hardships presented in rural communities.

Your friend or family member struggles with an addiction and wants help, but the nearest treatment facility is over an hour away. Or, your neighbor is addicted to heroin and can’t get the medication he wants because there is no methadone clinic in the country or no doctor nearby to prescribe buprenorphine. These are barriers people in rural (areas) face continuously,” said Nager.

Cerda said that specific types of rural jobs, such as mining and farming, tend to have higher injury rates, resulting in the need for more painkillers.

“Roughly one in five Americans live in a rural setting, defined as a community with fewer than 2,500 people,” she explained. “Although substance use rates in rural areas have kept pace with those in urban areas, rural communities seem to have been hit harder.”

Other research points to the unique social structures in rural America as a potential cause. “In some ways, rural regions are built to spread illicit drugs,” said Kirk Dombrowski, a sociologist at the University of Nebraska-Lincoln. 

“People who live in rural areas tend to have sprawling social networks.

“In some cases, rural residents know and interact with about double the number of people an average urban resident does, giving rural people more opportunities to know where to access drugs.”