The Rise of Opioid Abuse in Rural Communities and Promising Practices
Jennifer D. Lenardson, MHS, Research Associate, MHS in Health Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD & John A. Gale, MS, Research Associate MS in Health Policy and Management, University of Southern Maine, Portland, ME

Opioid abuse is the fastest growing substance abuse problem in the nation and the primary cause of unintentional drug overdose deaths. Multiple studies document higher non-medical pain reliever use among rural populations, particularly youth, pregnant women, women experiencing partner violence, and persons with co-occurring disorders. Heroin use has also grown in recent years, particularly among those reporting prior use of pain relievers. This workshop will present findings from one project using both quantitative and qualitative methods. With data from the 2008-13 National Survey of Drug Use and Health, we examined the rural-urban prevalence of non-medical use of pain relievers and heroin and user characteristics. We also conducted interviews with state-level key informants in North Carolina, Indiana, Vermont, and Washington to understand the challenges and promising practices in monitoring opioid prescribing and diversion, developing prevention interventions, and developing an opioid prevention and treatment infrastructure in rural communities.

Learning Objectives

1.  Compare national prevalence estimates of past-year heroin and non-medical pain reliever use in rural and urban communities and the socio-economic vulnerabilities that might contribute to adverse outcomes.
2.  Identify promising practices that are being implemented by states to address prevention and improve access to treatment for opiate addiction for rural residents.

Jennifer D. Lenardson received her M.H.S. in Health Policy from the Johns Hopkins Bloomberg School of Public Health.  She is a Research Associate at the Maine Rural Health Research Center at the University of Southern Maine, conducting quantitative research across a range of rural health policy topics. Ms. Lenardson’s research interests include access to care, substance abuse and mental health prevalence and treatment, health insurance, and affordability of care.  She is currently working on an analysis of mortality differences between rural and urban residents and examining rural residents’ early experience with the Affordable Care Act and the Health Insurance Marketplaces. Other recent projects include an analysis of rural-urban prevalence of non-medical use of pain relievers and heroin and the socio-economic characteristics associated with their use and an examination of differences in access and affordability among low-income rural children with public and private insurance. She received her M.H.S. in Health Policy from the Johns Hopkins Bloomberg School of Public Health.  

John A. Gale received his MS in Health Policy from the University of Southern Maine. He is a Research Associate with the Maine Rural Health Research Center at the University of Maine. His research focuses on rural health care delivery systems, mental health and substance use services, safety net programs, and behavioral health/primary care integration. He is a senior member of the research team and Project Director for Maine’s Flex Monitoring Team activities.  Recent studies include state and community strategies to address opioid misuse, charity care activities of Critical Access Hospitals, rural substance use, and Rural Health Clinic performance measurement.  Mr. Gale has published and presented widely on the results of his work.  He serves on the Boards of Trustees for the National Rural Health Association and New England Rural Health Roundtable.  He is also a Senior Fellow of the Health Research and Educational Trust of the American Hospital Association and teaches in the University of New England’s School of Public Health.