Rural Substance Abuse
It is common to think of substance use disorders as synonymous with inner-city and metropolitan lifestyles, fuelled by hedonistic behaviour and the busy hustle and bustle of the city. However the rates of substance abuse within rural towns and villages have been increasing over the years, and as a result, there has been an explosion in rural crime rates as well as alcohol and drug-related deaths.
Which factors contribute to rural substance abuse?
While anyone can develop a substance use disorder, there are certain factors that may increase the chances of an individual developing an addiction to drugs or alcohol. Many aspects of rural living do not lend themselves to substance abuse, but there are a handful of elements that can raise the risk in these more isolated areas and communities.
Of course, it must be stated that the below factors do not apply to all individuals living in rural areas and many of these factors can also be related to suburban and inner-city areas.
1. Higher rates of poverty
A number of studies has found links between poverty and addiction, with the likelihood of developing a substance use disorder, increased when the individual is residing in a deprived or poverty-stricken area. [1] Some people in this situation may turn to deal drug in an attempt to earn extra money, while others may resort to drinking alcohol and ingesting illicit drugs as a temporary means of escape.
2. Increased unemployment rates
In general, individuals who are unemployed are more likely to smoke, consume alcohol at high levels, take illicit drugs and struggle with addiction according to numerous studies. [2] This may be due to the fact that other factors such as poverty and a lack of education are also associated with being unemployed, and these individuals may also have less access to services and treatment programmes that can provide help and support with these issues.
3. Lack of education
While many individuals who have not achieved higher levels of education do not abuse alcohol or drugs, it can be a factor in developing a substance use disorder. Higher education levels are generally linked to a greater knowledge of health and the dangers of risk-taking, and individuals who have graduated from university or college are thought to have more access to resources and preventative materials that may dissuade them from dabbling in illicit substances.
4. Being isolated
Living far from basic amenities and social events can take its toll on some people, and they may turn to substances such as drugs and alcohol as a replacement for human contact or to stave off feelings of loneliness and isolation. If left unchecked, this coping mechanism can quickly spiral into a substance use disorder.
How does rural substance abuse differ from non-rural substance abuse?
While the nature of addiction does not differ across cities, towns, villages or extremely isolated rural communities, the quality and convenience of treatment within each of these areas can present as an entirely different experience depending on where you are located.
The majority of rural areas are confronted with a number of unique challenges when it comes to treating and dealing with the effects of substance abuse, with the most prevalent factors detailed below.
1. Limited treatment services available
As anyone who has travelled to a rural area from a larger town knows, there are far fewer resources and services available in smaller communities. Larger corporations typically do not expand to areas in which there are few potential customers, and this can extend to medical treatment services.
As a result, people who are living in rural areas and require substance abuse treatment may find that there are little to no local detoxification or counselling services available.
2. Longer distances to get help and support
Following on from the above point, many people living in rural communities may find it difficult to receive help and support from services that are local to them. This includes support groups, counselling, rehabilitation centres and treatment plans, all of which are essential to a healthy long-term recovery from addiction.
They may have to travel long distances to reach these services, which may prevent many people from seeking help and support.
3. Less experience with overdoses
While hospitals and emergency rooms located in rural areas are equally as capable and professional as those in non-rural areas at dealing with illness and accidents, workers may have limited experience with treating drug overdoses and may potentially need to rely on other hospitals and services in these situations.
This may result in a higher risk of death or serious injury due to the length of time between the overdose and treatment, making it potentially more dangerous to overdose in a rural community as opposed to a larger city or town.
4. Privacy issues
Rural communities tend to be smaller and more personal, and as a result, many people living in small rural areas tend to know each other and have semi-regular communication with the majority of other residents. This can lead to some individuals feeling hesitant to seek help for their substance use disorder, as they are concerned that their private business could become the subject of local gossip.
Which substances are commonly involved in rural substance abuse?
In general substances such as alcohol, nicotine, cannabis and opioids are more commonly abused in rural areas, as they are relatively easy to obtain or even potentially make at home.
However, while certain substances may be more difficult to obtain while living in a more isolated area there are no limits to the types of substances that are commonly involved in rural substance abuse particularly as the internet and social media have made it easier than ever to purchase illicit drugs and have them delivered to your door.
Common substances involved in rural substance abuse include:
- Alcohol
- Nicotine
- Cannabis
- Opioids
- Cocaine
- Inhalants
- LSD
- Hallucinogens
- Ketamine
- Ecstacy
- Spice
- Methamphetamine
- Prescription medication
Each of the above substances is highly addictive and can have severe and detrimental effects on your physical, psychological and emotional health. If you live in a rural area and are concerned that you or someone you know is suffering from a substance abuse disorder, there is always a way to get help.
How can rural communities help to prevent substance abuse?
There are a number of strategies that can be put into place within rural areas in order to combat the rise in substance abuse disorders in these communities and identify those who are most vulnerable. It’s also important to ensure that more emphasis is placed on providing local support and guidance to those who require these services.
1. Increased focus and training on substance abuse within rural police forces and hospitals
In order to assist the local police force and hospital workers in identifying at-risk individuals as well as those who are actively struggling with substance use disorders, more training must be provided to those servicing rural and isolated locations.
2. Regular community meetings in order to raise awareness
Addiction is often a hidden and secretive disease, and making the effort to bring this difficult subject out into the open during regular community meetings can help to ensure that all residents are educated on the dangers of substance abuse.
3. Development of community-based support groups and programmes
While online support groups can be extremely effective, in-person meetings with other local residents who share similar experiences with substance abuse can foster communication and a sense of belonging. This could further help to increase the chances of long-term recovery from addiction. [3]
4. Working with community hubs such as churches and schools
Utilising popular and influential spaces such as churches, larger employers and schools in order to provide awareness and support to those at risk of developing a substance use disorder can be a highly effective method in which to educate and guide community residents in rural areas.
5. Where can individuals dealing with substance abuse disorders in rural areas access treatment services?
Many support groups such as Alcoholics Anonymous are dotted around the country and can often be found in even the most isolated of places. However, if you are located too far away to be able to regularly attend any support groups, you may benefit from the online experience instead.
Most support groups can be found online, and meet regularly via Skype or Zoom in order to provide help and guidance to people who are unable to attend in-person meetings.
Helpful resources for people living in rural areas
Alcoholics Anonymous online meetings
https://www.alcoholics-anonymous.org.uk/AA-Meetings/Find-a-Meeting/online
Narcotics Anonymous online meetings
Cocaine Anonymous online meetings
https://meetings.cocaineanonymous.org.uk/meetings/?tsml-type=ONL
If you are living in a rural area and are having thoughts of self-harm or suicide, there is immediate help available to you no matter where you are. Call the Samaritans on 116 123 to speak to a friendly and non-judgemental worker who will listen to your thoughts and help you sort through your worries and emotions.
References
[1] https://pubmed.ncbi.nlm.nih.gov/21466502/
[2] https://www.sdf.org.uk/wp-content/uploads/2017/03/Drugs__Poverty_Literature_Review_2007.pdf
