Addiction has been a problem in America for quite some time now. Between the Opioid Epidemic and COVID-19, the situation is more grim than ever; overdose deaths, rates of alcoholism, people struggling with mental health (namely depression and anxiety), and overall addiction statistics are staggeringly high. While making treatment readily available to those in need is of utmost importance, it’s worth pointing out the nuances that exist throughout our country: what is currently flooding the streets in New Hampshire may be quite different from what’s being used in the midwest, which may be different from what’s popular in Appalachia, and so on. Though the risks any addictive substance pose is dangerous across the board, knowing the substances that are being used is important to address.
Lately there has been a great deal of new coverage on rampant addiction and overdose deaths in what’s called ‘rural America.’ Due to a confluence of social and economic factors, small-town substance abuse in this part of the country is a growing problem. In some regions, the number of rural addiction cases has surpassed that of metropolitan communities. Most alarmingly, the number of drug- and alcohol-related fatalities is skyrocketing outside of large cities.
Why is rural drug and alcohol abuse increasing to epidemic levels? What obstacles make stemming the addiction tide more difficult in small towns? Who can rural residents rely on when looking for treatment for substance abuse? Let’s dive in.
The Rural Substance Abuse Landscape
A whopping 97% of land in the United States is considered country or rural, but only 19.3% of Americans live in these areas. To put it another way, only one in six Americans lives outside of urban and suburban neighborhoods. When it comes to drug and alcohol use, trends differ in rural and urban enclaves.
For example, residents of smaller towns tend to use tobacco, alcohol, and meth, whereas city dwellers are more prone to use cocaine and hallucinogens. Moreover, the expansive nature of most rural communities creates unique challenges in the fight against widespread addiction.
Why Is Alcohol Abuse More Prevalent in Rural Communities?
According to reports, two out of five youths in rural communities say they engage in underage drinking, and over the years, researchers have uncovered the societal structures underpinning the phenomenon.
For starters, researchers have found that parents in rural areas aren’t as concerned about underage alcohol use as their metropolitan counterparts. Additionally, it’s easier for teenagers in the country to get their hands on alcohol. At the end of the day, there’s simply less to do in small towns, so drinking is more normalized across the board.
Why Has Rural Drug Abuse Increased?
For decades, people in rural areas have used more tobacco and methamphetamines than those living in metro and suburban bubbles. In recent years, though, the use of alcohol and opioids among country dwellers has shot through the statistical roof. Shockingly, overdose death rates are 10% higher than in urban settings.
Why is addiction running rampant in the countryside? Several factors have contributed to America’s rural substance abuse problem, including increased prescription drug use, the decline of stateside manufacturing and the rise of automation.
Increased Prescription Drug Use
In 1996, authorities green-lit Purdue Pharma’s two new prescription pain-killing drugs, Roxicodone and Oxycontin. Purdue aggressively marketed the drugs, and between the late ’90s and 2000, sales soared from $48 million to $1.1 billion. By 2004, Oxycontin became the most abused drug in the United States. Moreover, people who’d been prescribed the pills moved onto illicit opioids.
Demand for Roxicodone and Oxycontin wasn’t a huge surprise to people who understood their pharmacological makeup: Essentially, both were heroin in pill form. However, many Americans weren’t aware of how addictive the drugs could be, so they trusted their doctors and ended up dependent on them. This resulted in millions of people becoming addicted to pain medications after surgeries and other important procedures even though they had no intention of doing so.
Decline of Stateside Manufacturing
Traditionally, manufacturing plants went a long way in sustaining small-town America. However, since the 1980s and the advent of the aggressive free market, corporations that once helped build the nation shifted gears, prioritized the desires of stockholders instead of workers and moved manufacturing services offshore. According to some advocates, the shift ripped the soul out of rural America, and self-medicating substances have filled the gaping hole caused by unemployment and financial hardship.
Rise of Automation
In some ways, technological advancements have improved people’s lives. In other ways, they’ve badly frayed the country’s foundational fabric. Take, for example, the rise of automation. What once took 10 workers to do can now be completed by a single robot or machine. Because of this, blue-collar worker displacement has climbed since the 1980s and has continued to rise. This economic shift has affected small towns across the nation and led to an increase in rural substance abuse. After all, when people are desperate and losing resources, escapism is a natural instinct.
In addition to the three main factors above, some studies show that a propensity for higher risk behavior among rural residents also contributes to the problem.
Community Complications Caused by Rural Drug Abuse
Not only has drug and alcohol addiction in rural regions led to more deaths, but it’s also had a profoundly negative impact in other ways. The rise of substance abuse has led to
- An uptick in illegal activities
- An overall decrease in academic performance
- Poor health grades
- Higher death rates
Since rural areas are more likely to be economically depressed and less populated, negative influences can have a seismic impact.
Differences Between Rural and Urban Substance Abuse
An oft-cited study of 212 drug users from Kentucky highlights the differences between substance abuse trends in rural and urban communities. About half the respondents lived in the country with the other half in the city.
The rural respondents reported earlier oxycodone use and tended to have more experience with meth and benzos. Urban participants, on the other hand, reported doing more crack and cocaine. Plus, on average, they tended to start experimenting with drugs and alcohol at a slightly older age. These findings mirror other substance abuse studies and anecdotal evidence.
Obstacles to Substance Abuse Treatment in Rural Areas
Several factors contribute to increased substance abuse in small-town America:
- Lower educational attainment
- Generational poverty
- Unemployment and decreased job opportunities
- Lack of mental health care
- Isolation
It’s not true that highly educated people don’t do drugs. They do, and addiction affects everyone equally. However, studies indicate that people who don’t finish high school or complete some college are more prone to substance misuse. This trend may be because their job opportunities are less fulfilling or nonexistent.
Generational Poverty
When people have less money in general, fewer funds are available for health-related matters. As such, self-medicating becomes more prevalent, which can lead to substance addiction.
Things Are Farther Apart
Logistical obstacles also make things more difficult in the rural fight against substance abuse. Since emergency responders must drive farther distances to reach people in need, drug users experiencing an overdose are more likely to pass away before help arrives or before they make it to the hospital.
Additionally, many rural regions have fewer resources. As such, if multiple people in a given town need emergency care at the same time, ambulances may not even be available to help overdose victims.
Increased Rate of Drunk Driving
Not only do rural patients need to drive farther to reach a destination, but they’re also more likely to drive long distances while impaired, which leads to more drug- and alcohol-related fatalities.
Why are people in the country more likely to drive impaired? Again, rural sprawl has a lot to do with it. Plus, public transportation is not as readily available, nor does it run as frequently.
Fear of Shame in Tight-Knit Communities
Researchers are also discovering that small-town culture can impede recovery efforts. Stigma can carry a lot more weight in smaller towns, and as such, people may be less willing to admit that they have a problem and seek help when struggling with substance use.
Declining Economies
Since rural areas are experiencing economic declines, lack of money is another big problem. Many people don’t have the funds to secure rehab services. If someone can afford a program, transportation costs needed to participate can prove debilitating.
Health Care Deficiencies
Finally, a lack of health care facilities in rural areas makes the situation that much more difficult. Metropolitan and suburban neighborhoods typically have several hospitals and clinics within a few miles. People who find themselves in trouble can get help quickly. That’s not the case for rural communities. The closest hospital may be an hour away, and many ambulances aren’t outfitted with the medicines and equipment to save an overdose patient.
Four Eye-Opening Statistics About Rural Alcohol and Drug Abuse
- In 2006, the rate of fatal drug overdoses in rural communities surpassed that of urban areas.
- Young adults in rural regions are six times more likely to abuse methamphetamines than their city-dwelling counterparts.
- About 82% of rural residents don’t have access to a nearby detox center.
- Over 60% of rural counties don’t have a physician who can prescribe buprenorphine, also known as Suboxone, for opioid addiction treatment.
Rural Alcohol and Drug Abuse in New Hampshire
The opioid epidemic has severely affected rural areas of New Hampshire. Heroin, fentanyl and prescription pills flooded into the state starting in the 2000s. Over the years, the number of drug-related deaths has significantly increased.
The crisis has reached all corners of the state and crossed socio-economic lines. The lives of both rural and urban residents have been affected.
In 2010, New Hampshire suffered approximately 13 drug-related deaths per 100,000 people. By 2017, that figure had jumped to 36. Strafford and Hillsborough counties led the state in per-capita drug deaths. Currently, fentanyl is the state’s number one overdose killer.
Overcoming Substance Abuse in New Hampshire
Addiction is difficult, but overcoming it is possible. Millions of people have turned their lives around after short- and long-term misuse of alcohol and drugs. An earnest and authentic desire to get help is the first step. Once that exists, change is possible, and people turn over new leaves all the time.
Granite Recovery Centers
Granite Recovery Centers is an alcohol and drug rehabilitation group that works with residents in New Hampshire and around New England. At our leading detox and recovery center, we have helped countless people turn their lives around for the better.
As a full-service drug rehabilitation service, Granite Recovery Centers marries the 12-step curriculum with evidence-based clinical psychotherapies. Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention, are not a danger to themselves, and are capable of self-evacuation in the event of an emergency. We also offer medication-assisted recovery treatment, residential programs, sober living support, and intensive outpatient counseling. Whether you are trying to overcome a dependency on prescription medication, alcohol or other drugs, we want to help you deeply understand the root cause of your addiction and make strides in overcoming it.
We understand the extra hurdles that rural residents may face. As a solution, we regularly devise programs that cater to our clients’ individual needs and locations.
If you or a loved one in New Hampshire is struggling with substance abuse of any kind, contact Granite Recovery Centers. We have facilities across the state, in both city and rural settings, and our recovery team has the tools to help people like you get on the road to sobriety.
It’s never too late to turn around and start fresh. Get in touch today if you crave a bright tomorrow.
