Policy Brief – Overdose Prevention in the Rural Areas of Arizona

State the Issue

Overdose prevention in the rural areas of Arizona is a social welfare policy that requires a solution. It is well known that overdose has been on the rise each year, and though the state has taken decisive steps to combat this opioid crisis, it seems as though the rural areas in the state are being missed. Rural towns in Arizona are already limited to clinics, sober living homes, and licensed counselors, so when faced with overdoses, we are limited to the resources and education when trying to assist with this specific issue. For example, rural towns in La Paz County do not currently have an opioid surveillance system to track reported overdoses. Very few clinics are educated on administering naloxone if there is an overdose. This issue is important because I am a resident of Parker, Arizona, where we are on both tribal land and state land. There is an opioid epidemic that is not being addressed due to a lack of education and resources. La Paz County is being overlooked in this area, which shows the existing power imbalance in implementing policies.

Background Data

• Social inequalities (urban vs. rural population) increase the stigmatization of vulnerable populations, including people who use drugs (Constance-Huggins, 2012).
• It is critical to have a nonjudgmental inquiry in addressing the problem of overdose prevention in rural areas (Moya-Salas, Sen, & Segal, 2010).
• Reports show that there were 36,450 unintentional drug overdose deaths in the US in 2008, increasing annually (Wheeler, Davidson, Jones, & Irwin, 2012).
• The first program to prevent overdose started in 1996. During the first year, the number of overdose reversals was 10.171 from 53.032 participants (Wheeler, Davidson, Jones, & Irwin, 2012).
• 34.6% percent of drug users report unintentional overdose (Wheeler, Davidson, Jones, & Irwin, 2012).
• Rural areas have limited access to naloxone, widely considered the best counter to opioid overdoses. Rural areas have fewer hospitals and large providers spread at greater distances, while a pharmacy may be more accessible in underserved regions (Bachyrycz, Shrestha, Bleske, Tinker, & Bakhireva, 2016).
• Policy and practice gaps include limited access to supervised services, unavailability of safe opioid or naloxone supply, fewer opioid agonist therapy programs, and significantly lesser social support in terms of housing and healthcare access (Bardwell & Lappalainen, 2021).
• A supervised site may be safer in rural areas than one’s home or otherwise due to scarce medical resources (Kennedy & Kerr, 2017).
• The primary finding by the MMWR commission to the CDC was that distribution and training in the use of naloxone could have prevented more opioid overdose deaths (Wheeler, Davidson, Jones, & Irwin, 2012) significantly.

Question to be Debated

Should the American government introduce overdose prevention programs in the rural areas of Arizona as a part of social welfare policy?

Pros

• Educating people on administering naloxone in the case of an overdose requires a political decision to introduce licensed courses that can guarantee qualification.
• Establishing an opioid surveillance system to track reported overdoses requires governmental supervision and accreditation.
• Rural communities should have equal access to naloxone for overdose prevention.
• Introducing a policy that includes equal access to healthcare, education of healthcare personnel in the use of naloxone, and establishing social support systems in overdose centers might help solve this problem.

Cons

• The use of naloxone does not solve the problem of drug abuse. Instead of it, people develop a careless attitude to addiction.
• People who use drugs are stigmatized more in rural communities, and they are less likely to receive a compassionate attitude from society, which aggravates the problem of overdose.

Recommendations

The research shows that the problem is complex, making the local administration’s holistic approach necessary. Organization of education, licensing of professionals, introducing the surveillance system of overdoses, the stable supply of naloxone, and ensuring adequate access to healthcare in rural areas require much financing. The political decision of the state government, supervision of the state authorities, and stable funding might help improve this situation. Moreover, it is vital to work with activists on the local level, educating them about overdose prevention and eliminating the stigmatization of people who use drugs.

References

Bachyrycz, A., Shrestha, S., Bleske, B. E., Tinker, D., & Bakhireva, L. N. (2016). Opioid overdose prevention through pharmacy-based naloxone prescription program: Innovations in health care delivery. Substance Abuse, 38(1), 55–60. Web.

Bardwell, G., & Lappalainen, L. (2021). The need to prioritize research, policy, and practice to address the overdose epidemic in smaller settings in Canada. Canadian Journal of Public Health, 112, 733-736. Web.

Constance-Huggins, M. (2012). Critical race theory in social work education: a framework for addressing racial disparities. Critical Social Work,13(2), 1-37. Web.

Kennedy, M. C., & Kerr, T. (2017). Overdose prevention in the United States: A call for supervised injection sites. American Journal of Public Health, 107(1), 42–43. Web.

Moya-Salas, L. M., Sen, S., & Segal, E. A. (2010). Critical theory: pathway from dichotomous to integrated social work practice. Families in Society: The Journal of Contemporary Social Services, 91(1), 1-6. Web.

Wheeler, E., Davidson, P.J., Jones. S.T., & Irwin, K.S. (2012). Community-based opioid overdose prevention programs providing naloxone — United States, 2010. Morbidity and Mortality Weekly Report (MMWR), 61(6), 101-105. Web.