The stereotype of who can develop a substance disorder has changed.

“Drug addiction can now come in the form of a bottle with a prescription label, not just a baggie off the street,” says Jackie Preston, community prevention educator with Pathways Behavioral Services, an organization that provides substance abuse prevention training to residents and community leaders in six counties in northeast Iowa. “Previous estimates from pharmaceutical companies suggested around 3% of persons taking a prescription opioid may become addicted. We now know that nearly 30% misuse them, and about 80% of people who use heroin first misused prescription opioids.”

SHE SAID IT: “Nearly 30% of persons taking a prescription opioid today will misuse them and become addicted.”—Jackie Preston, Pathways Behavioral Services.

The opioid crisis has hit rural America especially hard where workers tend to have higher injury rates with many jobs requiring physical labor and involving more risk. A December survey by the National Farmers Union and the American Farm Bureau Federation found that as many as 74% of farmers have been directly impacted by the opioid crisis.

Rural Development offers help
“USDA Rural Development is committed to partnering with rural communities to address substance misuse disorders at the local level through program investment, strategic partnerships and best-practice implementation,” says Timothy Helmbrecht, USDA Rural Development acting state director in Iowa. “Looking for innovative ways to collaborate is an important step in addressing this problem that is impacting rural prosperity.”

According to the Iowa Department of Public Health, opioids were a contributing factor to 59 deaths in Iowa in 2005 and 608 admissions for opioid treatment across the state. In 2016, the figures jumped to 180 opioid-related deaths and 2,274 treatment admissions.

The ongoing work of USDA and IDPH in collaboration with other local, state and federal entities, and public and private stakeholders will help protect and improve the health of Iowans who are struggling with overusing opioid pain killers, such as hydrocodone, oxycodone, oxycontin and vicodin.

“While the United States has less than 5% of the world’s population, Americans consume around 75% of all prescription medication in the world, including 81% of the oxycodone and 99% of the hydrocodone,” Preston adds. “From July 2016 through September 2017, the Midwest region saw opioid overdoses increase 70%.”

Drug prevention, treatment
Rural Development loan and grant funding can be used in drug prevention, treatment and recovery capacity level through several core programs.

Each year police and fire departments and first responders across rural Iowa tap into USDA’s community facilities loan and grant program to purchase needed equipment, vehicles and trucks, or to build new facilities.

In 2017, the city of Albia used the program to buy a new police car replacing a 10-year-old vehicle that had become unreliable. The new vehicle was also equipped to safely transport the department’s K-9 officer when assisting with drug-related emergency calls.

Around $80 million in USDA Rural Development community facilities loans were awarded last year to support a variety of health care improvement projects in rural Iowa. A groundbreaking ceremony was held in early April to kick off a renovation and expansion at Humboldt County Memorial Hospital, including replacing the existing medical clinic in Humboldt.

Other health care facilities receiving USDA funding recently include Waverly Health Clinic, Merrill Pioneer Community Hospital in Rock Rapids and Community Hospital Inc. in Hamburg.

USDA’s distance learning and telemedicine grant program can be used to purchase and install equipment that uses broadband to help rural communities remotely connect to educational and health care services. Telemedicine can help rural health care facilities access and provide specialized treatment for patients in need.

Prescription drug monitoring
Steps are in place in Iowa to help reduce opioid addiction by improving the statewide prescription drug monitoring program and increasing the number of health care providers who specialize in Medication Assisted Treatment (MAT).

State leaders have also issued a statewide standing order to allow dispensing the medication Narcan to help reverse the effects of an opioid overdose. This medication can be administered by anyone with proper training, including first responders, as well as any family member or friend who finds themselves in a position to assist someone who is overdosing.

“Some states are now renting cold storage facilities because there are so many deaths and the morgues are full,” Preston notes. “We do not want to end up like that in Iowa. That is why awareness and collaboration to develop planning strategies and identifying stakeholders and resources are so important.”

Iowa, along with the neighboring states of Nebraska, South Dakota and Minnesota, currently have some of the lowest rural-area drug mortality rates in the country.

Communities, agencies must work together
An example of a key partnership serving northeast Iowa is a collation called Community Resources United to Stop Heroin (CRUSH). This group, which consists of representatives from law enforcement, education, substance abuse prevention and treatment, health care, mental health providers, correctional services, human services, government, faith communities, and family members of persons affected by opioid use disorders, hold regular meetings and special events.

An event earlier this year at Hawkeye Community College in Waterloo was attended by 100 people, with 56 receiving training on Narcan administration, and more than 80 Narcan kits were distributed.

For more information about USDA resources available for rural communities facing opioid misuse, visit usda.gov/topics/opioids. Additional resources and information about individual assistance are found at yourlifeiowa.org or by calling the Iowa Department of Public Health’s help line at 855-581-8111.

Leach is public information coordinator with USDA Rural Development in Iowa.

Priority funding for opioid-related projects

USDA Rural Development is reserving $5 million in its community facilities grant program and is giving priority to distance learning and telemedicine grant program applications proposing innovative projects to address the opioid epidemic in rural communities.

With the community facilities program, rural communities, nonprofit organizations and federally recognized tribes can apply for grants up to $150,000, which may be used to fund up to 75% of an eligible project.

Applicants for USDA’s distance learning and telemedicine grant program will have priority for telemedicine projects, with the primary purpose of providing opioid prevention, treatment or recovery services. Eligible proposals can receive 10 priority points on their applications.

Applications for these special community facilities and distance learning and telemedicine program grant funds are due June 4. Contact USDA Rural Development at 515-284-4663 or visit rd.usda.gov/ia for more information.