The opioid addiction crisis is having a devastating impact on rural communities, where older people are especially vulnerable to becoming "collateral damage," a report from Grantmakers In Aging finds.
The report, Heartache, Pain, and Hope: Rural Communities, Older People, and the Opioid Crisis: An Introduction for Funders (24 pages, PDF), found that the epidemic of addiction has affected entire rural communities, many of which lack substance-abuse infrastructure and resources. Rural populations also are older and poorer on average than non-rural populations, and rural America in general tends to be overlooked in national policy making discussions. In 2015, rural Appalachia, New England, and the Midwest had the highest drug overdose rates, with people in rural counties, according to the CDC, nearly twice as likely to overdose on prescription painkillers as people in cities.
"Opioid misuse by older adults is very common in this region, largely due to poor health literacy and misunderstanding of the medication itself rather than a blatant desire to abuse," a healthcare worker in rural Ironton, Missouri, says in the report. "They also have very little understanding of serious side effects like respiratory depression and potential signs of an overdose."
The study also found that the repercussions of addiction extend far beyond the addicted individuals, affecting child welfare, public safety, criminal justice, the economy, caregiving, and housing. And as more adult children with addiction problems move back in with their parents, older people can become easy targets for financial, physical, and emotional abuse; reports of elder abuse cases in Massachusetts, for instance, have increased 37 percent over the past five years.
At the same time, the report finds that rural communities have a number of assets they can deploy to combat the epidemic, including cohesive, supportive kinship and community networks and flexible, innovative local institutions. Indeed, by understanding both the needs and the potential of rural communities, funders can achieve greater impact in addressing the crisis. Funded by Tivity Health and the Empire Health Foundation, the report highlights proven programs, partnerships, policy recommendations, and scientific and medical responses that governments, communities, nonprofits, and philanthropies can support and scale.
"Some older people do suffer from opioid misuse and addiction problems, but the fallout reaches well beyond the addicted individuals," said John Feather, CEO of Grantmakers In Aging, "and the response from foundations and service providers must be broader as well, to address that wider set of needs."