The opioid crisis is hitting rural areas especially hard. Recently, Montana State University received a pair of grants totaling more than $1.3 million for projects aimed at addressing prescription opioid misuse in the state, with an emphasis on rural areas.

The grants will fund work by MSU professors, Extension agents and other partners to offer education, training and technical assistance to community leaders and interested citizens throughout the state. Sandy Bailey, an MSU professor and Extension specialist, will serve as principal investigator on both grants.

The first grant, for $310,000, comes from USDA’s Rural Health and Safety Education Competitive Grants Program. A second grant for $1.09 million comes from the Substance Abuse and Mental Health Services Administration (SAMHSA), which is part of the U.S. Department of Health and Human Services.

A key for both grants is to better understand, and reduce misuse, of legal prescription drugs including codeine, morphine, hydrocodone and fentanyl. Michelle Grocke, assistant professor in the MSU Department of Health and Human Development and an Extension specialist working on both grant teams, notes that prescription opioid misuse is “a growing, yet understudied crisis here in Montana — particularly among aging adults living in our very rural communities.”

The Rural Health and Safety Education grant will target community awareness, education and prevention efforts related to prescription opioid misuse, particularly among older adults. Prevention strategies will include safe household storage and safe disposal of prescription opioids.

To better understand current conceptions of this class of drugs and their use — and misuse — in the state, researchers are gathering data through a statewide survey and community forums. Three open forums for community leaders and citizens in five counties — Powder River, Petroleum, Fergus, Rosebud and Treasure — have already been held. Sheriffs, county commissioners, school counselors, nurses and others attended the forums.

Grocke notes that “through stories told by individuals around the state, we are learning that not only are individuals keeping their prescription opioids much longer than they need the medication, but we are gaining insight into why this is happening. Better understanding the reasoning behind this is helping us identify how the process of misuse often begins.”

Materials in process

The next step for the program will be to create educational materials for MSU Extension agents to distribute. They’ll also provide more safe disposal options, including disposal bags and prescription take-back boxes in locations throughout the state. Some communities already have takeback boxes at pharmacies, police stations or other sites, but others do not, Grocke says.

Grocke notes that the premise of the grant is that “through dissemination of educational materials, Extension agents can really take an active role in the prevention of opioid misuse.”

The SAMHSA grant will allow researchers to expand the education and community awareness part of the Rural Health and Safety Education grant and provide other educational resources related to opioid use and misuse. The team will expand work to three rural communities; work with tribal opioid response grantees and the Montana Department of Public Health and Human Services; and develop public videos related to opioids in Montana.

The final piece of the SAMHSA grant funding is to develop an online cognitive behavior therapy program using education and coping tools for both substance abuse and mental health for adolescents, which is modeled after a program called Thrive.

Thrive is a computerized program using video to deliver confidential, evidence-based care to anyone with web access. The program can be tailored to the needs of the user, and program responses are based on participants’ answers to a series of questions. The program becomes more personalized in response to evaluations as participants continue using the program.

Delivery over the web means Thrive can reach individuals throughout Montana. The costs of computerized treatment are less than traditional person-to-person care.

You can learn more about the projects by visiting MSU Extension's opioid misuse webpage.

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