Study to gauge risk of substance, prescription drug misuse in rural communities

University of Nebraska researchers are joining efforts to raise awareness among rural agricultural workers about substance and prescription drug use, particularly about opioids. By raising awareness, researchers hope to influence behavior change to improve the health and safety of agricultural workers.
 
Until recently, Nebraska was at the bottom of the list of states with opioid overdose deaths, but according to a U.S. Centers for Disease Control and Prevention report, drug overdose deaths in Nebraska are increasing, said Shinobu Watanabe-Galloway, Ph.D., co-principal investigator at the University of Nebraska Medical Center College of Public Health.
 
It’s estimated that 20 million people aged 12 or older had a substance use disorder related to alcohol or illicit drugs. In 2017, the U.S. Department of Agriculture reported rising death rates among working age rural adults due to prescription drug misuse and heroin abuse.
 
Researchers at UNMC, the University of Nebraska at Kearney and the University of Nebraska-Lincoln Extension will implement a $20,000 pilot study to try to determine the risk level of opioid and alcohol misuse among adults 19 years and older in rural Nebraska communities. They also will determine the feasibility of intervening using an anonymous, self-screening questionnaire.
 
The study team will use a voluntary, anonymous, self-screening questionnaire at 12 community events held over 18 months with the goal of completing more than 300 screenings. The tool, which is not a clinical diagnosis, takes five to 10 minutes to complete on paper or through a link access on a mobile phone
 
The research team includes: Christine Chasek, Ph.D., co- principal investigator, University of Nebraska Kearney Department of Counseling and School Psychology; Susan Harris-Broomfield, University of Nebraska Lincoln Extension; and Chandran Achutan, Ph.D., UNMC College of Public Health Department of Environmental, Agricultural & Occupational Health.
 
Dr. Watanabe-Galloway said she and her colleagues anecdotally hear about substance abuse issues in rural populations from rural health professionals, but researchers need to conduct a study to determine its actual prevalence.
 
“We are interested in creating awareness in communities about the risks as well as identifying the resources for those who need help,” Dr. Watanabe-Galloway said. “Not being aware of the risk of dependence on opioids is part of the problem, but a lot of people are not aware, especially in rural areas.”
 
Another goal of the study is to work with rural health and policy professionals to design evidenced-based interventions that prevent opioid addiction, treat those addicted and prevent death from overdose.
 
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Susan Harris-Broomfield, University of Nebraska-Lincoln Extension
“I have conducted informal surveys during casual conversations, asking people if they know what an opioid is. Many do not know and some don’t realize they have opioids in their medicine cabinets. In the long run, I look forward to using data from this project for educating rural Nebraskans about what behaviors to watch for and how to avoid succumbing to those addictions.”
 
Christine Chasek, Ph.D., co- principal investigator, University of Nebraska at Kearney Department of Counseling and School Psychology
“The USDA report about mortality rates rising among working age rural adults is in part due to the opioid crisis. This is a major concern for rural states like Nebraska, Iowa, and Kansas where prescription rates for opioids are high and binging drinking rates are high. This project proposes a new approach to addressing the opioid crisis and alcohol misuse by taking substance use screenings out of the clinic and into agricultural work settings using an extension model.”
 
Chandran Achutan, Ph.D., UNMC College of Public Health Department of Environmental, Agricultural & Occupational Health
“This study is important because substance abuse impacts individuals and families, especially in rural communities where access to help is limited. The number of opioids prescribed in Nebraska is higher than the national average, so we need to get a handle on this before it becomes a crisis. Because agriculture is the backbone of the Nebraska economy, it is imperative that farmers and others in the rural community are healthy.”
 
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