Preventing opioid misuse in the rural America

Nearly 2,500 adolescents and adults in rural communities across South Dakota are better prepared to prevent opioid misuse, thanks to free educational seminars provided through SDSU Extension’s Strengthening the Heartland Program.

“The goal is prevention,” said SDSU Extension 4-H Youth Development Specialist Amber Letcher, an associate professor in the South Dakota State University Department of Counseling and Human Development.

“We are strengthening the heartland against opioid misuse,” said assistant professor Kristine Ramsay-Seaner, clinical experiences coordinator for counseling and human development.

They are coordinating the program in South Dakota, which is made possible with more than  $300,000 in funding from U.S. Department of Agriculture National Institute of Food and Agriculture and $500,000 from the Substance Abuse and Mental Health Services Administration.

Since winter 2018, the teen/youth programming, “This is (Not) About Drugs,” has reached nearly 2,000 students in 20 schools in eastern South Dakota. To do this, faculty are working with NDSU Extension. Adjunct assistant professor of pharmacy Chamika Hawkins-Taylor, now at Xavier University of Louisiana, and two graduate students also work on the project.

The presentation emphasizes ways of dealing with stress, other than drugs, Letcher said. “It focuses on making good choices.” In January, the programming was presented in Philip, Bison and Murdo.

In addition, 460 parents, teachers, employees, employers and service providers in 28 communities gained knowledge about opioids through the adult programming.

“This is a one-touch program that takes roughly an hour to present, which has allowed us to reach a lot of communities,” Ramsay-Seaner said. “Our goal is to provide as much free knowledge and resources as possible.”

The faculty have trained 10 professionals, many of whom have prevention backgrounds, to present the free seminars and are looking for more presenters, particularly West River and in Pierre and Aberdeen. Presenters receive $100 plus mileage for each session through grant funding.

“We would not be where we are if we did not have such motivated presenters who say, ‘yes, I am willing to be there,’” Ramsay-Seaner said.

Lack of statistics due to community size

In the last five years, the Centers for Disease Control and Prevention has not reported statistical data for the majority of South Dakota counties. “When you try to get national data, South Dakota and North Dakota are gray boxes,” Letcher said.

“Our rural communities are so small that a reported overdose can become identifiable data, so the CDC will not collect it,” Ramsay-Seaner said. However, Letcher pointed out, “We know the problem exists, anecdotally.”

As part of the project, the team mailed surveys to 1,000 rural households in each state to get a sense of their attitudes toward prescription opioids. Some of the 350 South Dakotans who replied told “deeply moving stories” about how opioids had affected them or their families, Letcher said. “People were filling the back pages (of the survey).”

“One thing that became clear is there are both a lot of fear and questions about opioid prescriptions,” Ramsay-Seaner said. “One person shared a story about someone who had been given opioids after an injury/surgery and refused to take them. That set back recovery and resulted in the loss of a job. Our message is about helping people understand the safe use of opioids.”

Helping families find services

Responding to the opioid crisis is particularly challenging in the Dakotas, where 90% of counties are classified as mental health shortage areas, Letcher noted.

Families assume they can simply take their family member to a treatment center and get the help they need, but that may not be the case, because there is not a one-size-fits-all treatment approach, Ramsay-Seaner said. First, the person must be assessed. Some facilities are at capacity so have waiting lists. Other times, the treatment that a family member needs is not available at a nearby facility. To assist individuals in understanding the system, an upcoming webinar will focus on navigating the useful tools created by the State Opioid Response team.

“These families are at a crisis point when they need this information,” Letcher said. The Strengthening the Heartland website (https://www.sdstate.edu/strengthening-heartland) provides a wealth of information for families and professionals. This includes webinars on subjects such as recognizing addiction and the history of opioids that are available on YouTube.

“We are trying to bridge the gap between what professionals in the field know and the services and information that people who are actually dealing with addiction need,” Ramsay-Seaner said.

Though the researchers feel that the educational programming is making a difference, they also agree that there is a lot of work yet to do. Recently, they received contract funding from the S.D. Department of Social Services to offer programming in urban areas, such as Sioux Falls and Rapid City.

“Our hope is to continue providing programing and resources under the umbrella of rural health and wellness,” Letcher said. “It’s all about rural empowerment—the strength of the state and the people who love living here,” Ramsay-Seaner said.

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