Substance Abuse in Rural Nebraska Focus of Upcoming Study


February 21st, 2019

OMAHA, Neb. – Research has shown that rural communities are particularly susceptible to drug and alcohol abuse. According to a CDC study from 2017, drug overdose deaths in non-metro areas are increasing at a much higher rate than in urban areas.

And while Nebraska still has one of the lowest rates of opioid overdose deaths in the country, that number has increased over the past year. As for alcohol, CDC data found that the prevalence of binge drinking among Nebraska residents aged 18 and older was just over 20 percent.

A new study by University of Nebraska researchers aims to gather more data on substance abuse in rural Nebraska, particularly among agricultural workers. Dr. Shinobu Watanabe-Galloway of the University of Nebraska Medical Center explains why these workers are particularly at risk:

Watanabe-Galloway: “The farming community is still very physical, labor intensive occupation, which means they’re prone to injuries and other physical problems so using pain medication is not uncommon.”

As well as physical issues, Dr. Chandran Achutan—also from UNMC—suggests mental health stressors, particularly related to the economy, could also be factors in potential abuse.

Achutan: “Research has shown that when there is an economic downturn, there’s going to be a lot more stress and mental health issues among ag workers. Worldwide, there’s a lot of suicides among farmers, especially when there’s an economic downturn, so when you have all this stress, it becomes even harder for people to heal.”

Field work for the study launches in a couple months with self-screening questionnaires at 12 community events over 18 months, with a goal of collecting more than 300 screenings. The study team includes researchers from UNMC as well as the University of Nebraska at Kearney and the extension of the University of Nebraska at Lincoln.

These questionnaires, both voluntary and anonymous, could help people talk about their struggles with drugs and alcohol, especially if they’re not willing to discuss them with a primary care provider. Anecdotal evidence suggests a problem with substance abuse in Nebraska’s rural communities, but Watanabe-Galloway says more data must be gathered to determine the actual prevalence of the issue.

Watanabe-Galloway: “If the patients are not willing to talk about problem once they have access to providers for primary care, it’s not going to start. So we decided to take a kind of portion of the evidence-based practice into the community to do awareness building.”

She adds that providers must also be further educated about appropriate prescription and dosage of medication.

Watanabe-Galloway: “We really need to educate providers about the prescription behavior—who should be taking it, what dosage—and really what else we can do instead of prescribing pain medication.”

The opioid crisis is garnering national headlines, but Watanabe-Galloway warns that alcohol abuse is a serious concern in Nebraska and must be addressed, too.

Watanabe-Galloway: “Opioid problem is not there yet, hopefully we can really contain the problem in the state. But we do have a problem with alcohol misuse, binge drinking in particular, so we do have a huge issue in Nebraska as far as alcohol goes, so I think we have a long way to go.”

By collecting this data and raising awareness of substance abuse, Achutan thinks that the study can make a positive impact on Nebraska’s rural communities.

Achutan: “We have together a pretty diverse expertise on this project. We should all be talking, whether it’s mental health or substance abuse, and get people to all get healthy by being more open about this topic.”

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