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The table below from the CDC illustrates what we hear all the time on the news and in our communities: drug overdose deaths are on the rise. It’s both heartbreaking and shocking! Since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids. Escape from chronic pain, caused by a myriad of physical ailments, often initiates the journey to overuse and addiction.

Rather than focusing on the enormous and incredibly complicated routes to opioid addiction, this newsletter will take this opportunity to shine a light on some of the people, communities and projects that are working to make a difference. Once again, our mantra at the Foundation, “it’s a whole-person, whole-community thing,” holds true. Solving this issue is not possible by a single person or a single agency/institution; it’s about how we all can work together.

Rural communities are particularly vulnerable to this issue for a variety of reasons. Access to care, access to pain management, and the number of heavy labor occupations inherent in the economy of these communities have all been linked as reasons for increased opioid use. Research has also shown that prescription drug use in some rural areas is an embedded part of the culture, as they are often prescribed them to maintain a steady workflow in heavy labor occupations.

The Foundation houses The NC Rural Health Leadership Alliance, a group that works closely with the National Rural Health Association (NRHA) on a variety of issues. In February, NRHA provided testimony to the United States Senate Committee on the Judiciary regarding mental health and substance abuse issues in rural America. The following is a summary of the comments and recommendations from NRHA:

Rural Americans in need of substance abuse treatment services and behavioral health care will find that access to care can be limited.
Even with rural telemedicine services improving access to mental health care, 60 percent of rural Americans live in a mental health professional shortage area.
Rural Americans are forced to travel significant distances for care, especially specialty services such as mental health services and pain management.
With rural hospital closures, rural Americans are farther away from emergency care, as well as options for the ongoing treatment that is essential for successfully treating substance abuse.
The differences between rural and urban settings, culture and resource availability means the solution for rural America must be uniquely tailored to this population.
Treatment programs must be available locally and should be tailored to the unique needs and characteristics of rural Americans. Treatment programs must be able to leverage the health care providers in the community while using tele-health and other resources to bring new providers into the community.
The implementation of models to engage rural communities in addressing opioid issues must be supported. Broad community coalitions, including schools, law enforcement and medical providers need to be a part of the rural solution.
Evidence-based prevention programs tailored to the needs of rural communities must be identified and developed.
Implementation of harm reduction strategies must increase. Harm reduction is an essential part of dealing with the existing problem and will require training of both law enforcement and first responders. It will also require administering interventions known to reduce the harm of drug use including needle exchange and naloxone.
Use of evidence-based prescribing guidelines need to be promoted. Pain management is an important component of health care. However, measurement of hospital and physician quality must balance the need to address patient’s legitimate pain with the need to avoid misuse and diversion of pain medications.
State prescription drug monitoring programs (PDMPs) must be strengthened.
Use of substance abuse treatment as an alternative to incarceration for opioid users must expand. Those facing substance abuse or mental health crisis may wait years before seeking treatment from a professional, especially in rural America where the stigma discourages people from seeking treatment and views addiction as moral failure.

For the complete testimony from NRHA to the U.S. Senate Committee on the Judiciary, visit: http://connect.nrharural.org/blogs/erin-mahn/2016/02/22/nrha-submits-testimony-on

An enormous thank you to all the people engaged in this work every day. At the end of the day, success comes from the work done by communities, their citizens and the people who need their help.

-Maggie Sauer

CEO & President

Through a series of regional briefings held this month, the NC Rural Economic Development Center (Rural Center), a partner of the Foundation, released its rural advocacy agenda titled “Rural Counts: 10 Strategies for Rural North Carolina’s Future”.

The agenda promotes “stabilizing and transforming rural health” as an essential strategy for providing rural communities with a foundation for success. Regarding this strategy, the Rural Center specifically advocates to “strengthen local, state, and federal efforts to reduce opioid and methamphetamine drug addiction” recognizing addiction and substance abuse as a national crisis and supporting programs from various sectors and government levels designed to address this issue.

Learn more about the Rural Center’s recommendations regarding rural health and its comprehensive strategies for realizing the “economic potential for our rural communities and citizens” from the #RuralCounts download center on the Rural Center’s homepage: http://www.ncruralcenter.org/

The date is set! Please reserve October 6, 2016 from 6:00-9:00pm for the 11th Annual Jim Bernstein Health Leadership Fund Dinner supporting the Jim Bernstein Health Leadership Fellows Program. This premier event convenes health professionals and stakeholders from across North Carolina to network and learn from one another and to celebrate and honor past, present, and future contributions in our state’s health sector.

On April 15th, Marley Braun joined the staff of NC Foundation for Advanced Health Programs as the Administrative Manager for Rural Forward NC. We were able to sit down with Marley for a few minutes to learn more about her background and goals for this position:

Q: Where were you before coming to work with Rural Forward NC?

A: I’ve been a stay-at-home mom for the last 13 years, and I have two children, ages 15 and 18. I’m originally from Upper Marlboro, MD and went to Elon, I spent summers working in DC and hated the traffic, and I fell in love with North Carolina. My degree is in communications, and I’ve worked for an NBC affiliate and corporate communications role in The DC area, and then moved into a marketing role when I moved down to North Carolina. I worked at FGI communications in marketing and then at Duke for 10 years, ultimately doing marketing for the Duke Health System.

Q: What drew you to Rural Forward NC?

A: After 13 years as a stay-at-home mom I knew it was time to work again. I started volunteering and decided I wanted to do something that made a difference in people’s lives. I’ve known Calvin for many years, and always found the work he does interesting, and very important. When he moved to this job he seemed to be so busy, and I volunteered to help out any way I could. I was looking for somewhere I could really make a difference. Once I started working here, I saw that this was a place I could have an impact. I’ve always been interested in nutrition and health and those interests fit nicely into this role.

Q: How have your first few weeks been?

A: I feel like I’ve learned a lot in my time at home as a mom, and I’m able to contribute some of what I’ve learned from that perspective of being around kids and families in this role as I support Rural Forward. I’ve been a volunteer at the school and for the PTA for years, and can contribute knowledge I’ve picked up in those settings and apply them to projects here, for instance looking at an early intervention for kids in need. Now I can make a difference for many children, even indirectly.

Q: What do you like most about working with Rural Forward NC?

A: I’ve already in a short amount of time learned a lot about our state. And a lot about how, especially in Wake county, we have so many services; my kids have had so much more offered to them than most kids in these rural counties that are underserviced. It’s really not fair.

Q: What are you excited for in this position?

A: Last week the team went to a meeting in Rockingham County. Based on the 10-year plan, just in Rockingham County, it looks like Rural Forward might be able to bring the kinds of services Wake County kids already have to kids in Rockingham County, even within the next 10 years. They’re working really hard to get everybody in the community working together to offer these kids what they should be offered. Some examples of these services are parks and recreation programs, programs to teach healthy eating, after-school activities and even programs within schools.

Q: What do you do when you’re not working with Rural Forward?

A: I love yoga, I like to bike ride, and I love to travel. My favorite places are Italy and Peru, and right now I really want to go to Croatia – I’ve heard it’s so beautiful, and I want to do the Game of Thrones tour.

It’s STILL About Whole-Person, Whole-Community… Opioid Abuse and Addiction