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Arizona rural areas have been disproportionately affected by the opioid epidemic. There was a 45.4% increase in total opioid deaths in Arizona from December 2019 to December 20201, with a noticeable increase occurring in rural counties.2 Learning materials on this page are focused on addressing the opioid epidemic in rural communities. Providers will find resources and actionable plans to implement in their own practice and communities to ensure that rural patients can gain and maintain equitable access to rural-centric medication for opioid use disorder and safe opioid prescriptions.
Arizona rural areas have been disproportionately affected by the opioid epidemic. There was a 45.4% increase in total opioid deaths in Arizona from December 2019 to December 20201, with a noticeable increase occurring in rural counties.2 Learning materials on this page are focused on addressing the opioid epidemic in rural communities. Providers will find resources and actionable plans to implement in their own practice and communities to ensure that rural patients can gain and maintain equitable access to rural-centric medication for opioid use disorder and safe opioid prescriptions.
Rural Health and Rural Providers
Rural Health and Rural Providers
Rural Health Disparities
Rural Health Disparities
Data and Strategies to Address the Rural Opioid Crisis
Data and Strategies to Address the Rural Opioid Crisis
Resources for Rural Substance Use Prevention and Treatment
Resources for Rural Substance Use Prevention and Treatment
Related Demographic Information
Related Demographic Information
Naloxone
Naloxone
How to use Naloxone
How to use Naloxone
AZDHS Naloxone Demonstration
AZDHS Naloxone Demonstration
Reference List
Reference List
Calculated from: Vital Statistics Rapid Release - Provisional Drug Overdose Data. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm. Published July 13, 2022. Accessed July 15, 2022.
Sjolander S. An ADHS Update on Opioid Overdose Data Trends . azdhs.gov. https://www.azdhs.gov/opioid/documents/opioid-overdose-data-trends.pdf. Published 2021. Accessed July 15, 2022.
Dahlhamer J, Lucas J, Zelaya, C, Nahin R, Mackey S, DeBar L, et al. Prevalence of chronic pain and high-impact chronic pain among adults — United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67:1001–1006. http://dx.doi.org/10.15585/mmwr.mm6736a2
Sachs-Ericsson NJ, Sheffler JL, Stanley IH, et al. When emotional pain becomes physical: Adverse childhood experiences, pain, and the role of mood and anxiety disorders. J. Clin. Psychol. 2017; 73: 1403-1428. 10.1002/jclp.22444
Derefinko KJ, Salgado García FI, Talley KM, Bursac Z, Johnson KC, Murphy JG et al. Adverse childhood experiences predict opioid relapse during treatment among rural adults. Addictive Behaviors. 2019; 96: 171-174. https://doi.org/10.1016/j.addbeh.2019.05.008
Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci USA. 2016; 113(16): 4296-4301. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/
Ramachandran V. Rapid decline in rural health – what's in a zip code? . YouTube. https://www.youtube.com/watch?v=0NkE1kYFuHI. Published May 15, 2020. Accessed July 15, 2022.
Piercy J. What rural medicine teaches us about a doctor's role in the community . YouTube. https://www.youtube.com/watch?v=zHKK_KXzxr4. Published August 25, 2019. Accessed July 15, 2022.
Rural Health Challenges. YouTube. https://www.youtube.com/watch?v=aRYcqtFNfYE. Published June 29, 2018. Accessed July 15, 2022.
Understanding the opioid crisis in the United States. Drug Overdose Deaths in the United States. https://opioidmisusetool.norc.org/. Accessed August 5, 2022.
Statz M, Evers K. Spatial barriers as moral failings: What rural distance can teach us about women's health and medical mistrust. Health Place. 2020;64:102396. doi:10.1016/j.healthplace.2020.102396
Gildersleeve R, Brady B, Koch B, Campos-Outcalt D, Derksen D. Rurality is associated with increased drive times to opioid treatment programs in Arizona. crh.arizona.edu. https://crh.arizona.edu/sites/default/files/2022-03/20210609_Rural%20Access%20to%20OTPs%20and%20FQHCs%20Poster.pdf. Published 2021. Accessed July 15, 2022.
Amiri S, McDonell MG, Denney JT, Buchwald D, Amram O. Disparities in access to opioid treatment programs and office-based buprenorphine treatment across the rural-urban and area deprivation continua: A US nationwide small area analysis. Value Health. 2021;24(2):188-195. doi:10.1016/j.jval.2020.08.2098
Brady BR, Gildersleeve R, Koch BD, Campos-Outcalt DE, Derksen DJ. Federally Qualified Health Centers Can Expand Rural Access to Buprenorphine for Opioid Use Disorder in Arizona. Health Serv Insights. January 2021. doi:10.1177/11786329211037502
Rural Community Action Guide - USDA. USDA.gov. https://www.usda.gov/sites/default/files/documents/rural-community-action-guide.pdf. Published 2018. Accessed July 1, 2022
Harder VS, Villanti AC, Heil SH, et al. Opioid use disorder treatment in rural settings: The Primary Care Perspective. Prev Med. 2021;152:106765. doi:10.1016/j.ypmed.2021.106765
Rural prevention and treatment of substance use disorder toolkit - rhihub. Rural Prevention and Treatment of Substance Use Disorder Toolkit - RHIhub. https://www.ruralhealthinfo.org/toolkits/substance-abuse. Accessed July 1, 2022.
Rural medication for opioid use disorder (MOUD) toolkit - rhihub. Rural Medication for Opioid Use Disorder (MOUD) Toolkit - RHIhub. https://www.ruralhealthinfo.org/toolkits/moud. Accessed July 1, 2022.
Rural Opioid Educational Resources. share.nned.net. https://share.nned.net/2018/07/rural-opioid-educational-resources/. Published July 3, 2018. Accessed August 15, 2022.
Arizona Center for Rural Health Home. Arizona Center For Rural Health. https://crh.arizona.edu/. Published August 11, 2022. Accessed August 15, 2022.
Brunner M. Barriers to screening for substance use in rural primary care. Addiction Technology Transfer Center (ATTC) Network. https://attcnetwork.org/asme/barriers-screening-substance-use-rural-primary-care-1. Published September 6, 2019. Accessed August 29, 2022.
Brunner M. Prevalence and treatment of opioid use disorder among primary care patients. Addiction Technology Transfer Center (ATTC) Network. https://attcnetwork.org/asme/prevalence-and-treatment-opioid-use-disorder-among-primary-care-patients. Published January 8, 2020. Accessed August 29, 2022.
Arizona Custom State Reports. KFF.org. https://www.kff.org/statedata/custom-state-report/?i=189592~189595~189598~189707~189703~189705~32128~32479~32135~477897~179704~388199~388193&g=az&view=3. Published April 5, 2018. Accessed August 15, 2022.
USDA ERS Atlas of Rural and Small-Town America. ers.usda.gov. https://www.ers.usda.gov/data-products/atlas-of-rural-and-small-town-america/go-to-the-atlas/. Published 2019. Accessed August 15, 2022.
Arizona State Data. ers.usda.gov. https://data.ers.usda.gov/reports.aspx?StateFIPS=04&StateName=Arizona&ID=17854. Published June 3, 2022. Accessed August 15, 2022.
American Medical Association. How to use Naloxone. Youtube. https://www.youtube.com/watch?v=-xTKsHFBXlIch%3Fv. Published February 23, 2018. Accessed August 15, 2022.
Naloxone demo. YouTube. https://www.youtube.com/watch?v=gi42gS9EfkA. Published August 1, 2018. Accessed August 15, 2022.
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