A peaceful place in the country with a white picket fence.
This is a dream for many people in America, but is it everything they’re imagining?
Over 97 percent of the land area in our country is rural and this rural land is home to 60 million people (nearly 20 percent of the population). Every coin has two sides, and there is a dark underbelly to this rural escape as well.
While the air is clear compared to the smog of the city, the cities are at an advantage when it comes to substance abuse recovery. They are areas where substance abuse is expected and planned-for. Medical professionals see overdoses on a regular basis and are familiar with the many ways to handle addictions. There are resources seemingly everywhere.
Drive through a rural Iowa town, even the mid-sized ones with college campuses, and you will notice there are decidedly fewer options for those people seeking treatment for substance abuse. There may be a clinic, or even a small hospital. There might even be a physical therapy office or counseling service. However, these are unfortunately few and far-between.
One selling point for a rural community is the smaller number of people. There is less traffic, smaller class sizes for the school children, and you are more likely to know your neighbors. You may even feel safer, removed from the threats of gangs and other violence.
These things can bring a false sense of security. In actuality, the dangers are often more of a concern to rural residents because of their small community size. Towns with smaller populations can’t financially support the resources to help residents struggling with addiction and mental illness. Many don’t even have a police force or EMS services beyond volunteer organizations.
Between a Rock and a Hard Place
Doctors practicing in rural locales have limited options for their patients in this respect as well. If someone comes in with an injury from work—as many rural areas are supported by labor jobs and farming—they have few resources to help ease the pain. Prescriptions such as opioids are a common answer.
This comes with its own set of challenges, as the opioids are addictive in long-term use and alternative options can be costly for the patient. Many laborers don’t have the flexibility in their schedule to utilize physical therapy and/or can’t afford to take time off work to properly heal. Some rural patients can be stubborn and resist “alternative” healing methods like chiropractic or therapy as well, thinking that there has to be a pill to fix what’s wrong.
There is always the financial aspect to throw into the mix too. Medicines, office visits, lab tests, x-rays, and therapy all can cost large sums even with insurance. Many patients will resist going to see the doctor, or will cheat on their medicines by finding an OTC alternative or borrowing from others who have a prescription if they can’t afford it themselves. This opens the door for possible illegal substance use as a way to self-medicate.
Opioids are also a danger for seniors, having some dangerous effects that can go unnoticed or misdiagnosed as general “old age” problems. Mixing opioids with alcohol or other prescriptions can cause respiratory distress, increased fall risks, and confusion.
Ignorance Isn’t Always Bliss
Many times, people in rural areas don’t think that substance abuse is a problem in their communities. The “rose-colored glasses” don’t allow them to see the potential for problems in their own homes, their neighborhoods, and even themselves. They run on the assumption that if a doctor prescribes a medication, it’s not something that can be abused.
Even the D.A.R.E. (Drug Abuse Resistance Education) program used by many schools in rural America didn’t adequately address the problems associated with prescription medication misuse until as recently as October 2018. Youth were taught the dangers of illegal substances, tobacco, and alcohol, but if the doctor prescribed something it wasn’t mentioned as being dangerous or addictive.
These youth grow into adults who remain unaware of the dangers surrounding opioid pain relievers and mood- or attention-focusing medications. They may think they are simply “following doctor’s orders” by taking a medication by its prescribed dosage or “helping a friend” who can’t afford a doctor’s bill or prescription of their own.
Limited Rehabilitation Options
To exacerbate the problem in rural areas, there are limited resources for rehabilitation. Once someone has come to the conclusion they or a loved one have a problem, it is often difficult— especially here in rural Iowa—to find the help they need.
Most rehab centers are located near or in larger, more urban areas. Even St. Gregory, while being in a smaller community itself, is considered to be in the Des Moines metro area due to its close proximity to the city.
This can be a deterrent to many, as they don’t want to be too far from home. If clients are seeking outpatient treatment, they may worry about the cost of commuting (or the cost of a hotel stay nearby). They may worry their insurance won’t cover expenses.
These are all questions to raise when talking to the admissions counselors. The staff at St. Gregory understand the challenges rural residents face and work closely with clients to provide access to a full continuum of care. From aiding loved ones in the intervention process to working with insurance coverage, our staff are committed to helping you reach the goal of successful recovery.