Prescription drug abuse is a powerful addiction, and addiction rates are steadily increasing across the country. People are losing the battle—and their lives—daily. And these people are not just faceless strangers. They are our friends and our neighbors. They are the people we love.

As a professional counselor who has worked in the field of addiction for many years, I find it heartbreaking to watch this epidemic unfold. I’ve always taken immense pride in my work with individuals struggling with addiction. I have always assumed a degree of ownership over their struggles, along with a dedication to passionately assist them on their road to recovery. I like to think many of those I’ve treated are now living healthy and productive lives, lives free from the pain they once endured when they came to me for help. Now I’m not so sure.

Today, U.S. opioid addiction continues to increase at an alarming rate, and research conducted by the U.S. Department of Health & Human Services indicates that deaths from prescription opioids have more than quadrupled since 1999.

Drug manufacturers and distributors carry a large part of the burden for this public health crisis. Beginning in the 1980’s, opioid derivative drugs were advertised and marketed as safe and non-habit forming. Doctors believed what they were being told, and patients thought they were being prescribed a miracle drug that alleviates pain without consequences.

Opioids are widely popular due to their effect on the brain. The chemical composition of the drug attaches itself to nerve receptors that control pain reduction and increase feelings of euphoria. Once a person becomes physically and psychologically addicted, the brain becomes consumed with the drug, leaving a person struggling with intense urges to repeat. Withdrawal symptoms are also extremely difficult to cope with, leading to a vicious cycle.
Specific examples of prescription opioid drugs include hydrocodone, oxycodone, morphine, fentanyl, and codeine. They are all extremely addicting; fentanyl, however, is by far the most dangerous of the group. Fentanyl was originally intended to treat the pain of cancer patients, but it has been frequently misused and prescribed for conditions not originally intended. According to the National Institute on Drug Abuse, fentanyl is 50 to 100 times more potent than morphine. It is widely abused illicitly, and it is responsible for countless overdose deaths.

America’s rural communities have been among the most affected by opioid abuse and overdose deaths. By way of explanation, researchers cite lengthy distances to urban resources, high rural unemployment and poverty rates, and high rates of chronic illness. Rural populations are older, an older populations are at particularly high risk. Chronic health problems and years of access to prescription opioids have done untold harm to America’s older rural population. Fortunately, experts around the country are now focused on highlighting the vulnerability of our rural regions to drug abuse and overprescription.
A study published recently by the CDC explores the ramifications of prescribing practices. Findings suggest that long term chronic abuse correlates highest with longer days of access to the prescription drug. The length of time a person is exposed to the drug following an acute injury or illness contributes to an increased possibility of dependence over time.
Distance to adequate care facilities further aggravates the problem. When people are in a life and death situation, they need assistance quickly, but lack of transportation continues to be a serious issue. Treatment centers are also scarce and costly, leaving this valuable resource out of reach for many.

In short, obtaining drugs—prescription or illicit— is often easier for rural folks than obtaining other kinds of professional help when they need it.

In a combined effort to combat these problems, federal and state agencies have begun to focus on preventative and harm reduction strategies. Physicians and medical professionals are becoming more aware of the alarming rates of addiction, and numerous states are using database systems known as PDMPs (Prescription Drug Monitoring Programs). PDMPs monitor patients’ access to certain scheduled drugs and allow physicians to track the prescribing history of patients. The information provided can highlight high-risk patients which can turn into a recommendation for drug treatment programs before a patient’s drug use escalates.

Telemedicine services are also becoming more readily available in rural areas. Technology that provides remote access to medical professionals is bridging a gap that allows treatment for medical and psychiatric conditions. Improved overall health leads to less pain and addiction, in addition to increased hope.

A more recent strategy is to allow pharmacies to provide access to a schedule III drug called Naloxone without a prescription from a physician. Naloxone is a fast acting antidote for an opioid overdose.

Swift action is vital for a person who is in a medical emergency from the dangerous effects of a drug overdose, and rural citizens are in more danger without access to this life saving medication.

Additional Medication Assisted Treatment options include access to treatment programs that provide Methadone and Buprenorphine to patients. These two drugs are used to assist a patient in managing the symptoms of withdrawal from the drug they are addicted to, thus reducing the urges and craving to get high. According to SAMHSA, a combined approach to treatment that includes medication assistance, counseling and behavioral therapies are optimal to the recovery of opiate drug addiction. Sadly, these costly programs are scarce.

Legislation enacted in other states includes the 911 Good Samaritan Law. The intent of this law is to de-criminalize the act of addiction and provide immunity for illegally obtaining drugs. It does not provide immunity for other illegal drug related activities, such as distribution of illegal substances. Many states are going in this direction in hopes of allowing people to feel more comfortable asking for help.

Addiction has undoubtedly touched the lives of most Americans. Directly or indirectly, we are all affected. I’m grateful to all my clients who have taught me so much. I’ve always said, “Teach me. I’m here to listen.” So they did, and I continue to hope and pray for their wellbeing.

Strategies for battling the addiction epidemic need to include increased community involvement and connectedness. We must work together to create programs designed to combat drug addiction and to provide drug-related education that can empower people to ask for help. We motivate others to invest in their own recovery by teaching them that we are listening and invested in their needs.

People need people. We don’t strive in solitude. At least, not for long.

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Shawn Marie Parrott
Shawn Marie Parrott is a Licensed Professional Counselor at the F. Marie Hall Institute for Rural and Community Health at the Texas Tech University Health Sciences Center in Lubboc , TX.