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SALT LAKE CITY — The stigma attached to opioid addiction, even if the addict is seeking help and treatment, can last a lifetime in rural communities, according to officials from the Utah Center for Rural Health at Southern Utah University.
“These towns are very close; they’re very intimate. Everybody kind of knows what’s going on, and that creates that stigma,” said Kasey Shakespear, the program manager at the center. “And that can be very damaging to their reputation, very damaging to future job opportunities, very damaging socially.”
Even if an individual does seek treatment, there is no guarantee that smaller rural communities, some of which don’t even have hospitals, will possess the resources necessary to provide help.
To combat these pressures and limitations, the center has a new program starting Tuesday that will allow specially selected people to receive expert treatment without even leaving their homes.
Funded through a $1 million Health Resources and Services Administration federal grant, the program represents the second phase of plans made two years ago. The first phase, which was implemented last year, focuses on community based efforts — including workforce development, community education and campaigns.
It works with Carbon, Emery, Grand, Beaver and Iron counties, according to Shakespear, and will run for a total of three years.
“Our first year has gone quite well,” he said. “Given the condition, especially, we’ve done very well at adjusting and continuing to have some impact on the communities.”
The program’s next step, phase two, will have much more of a clinical focus and will give people access to remote health care services. Participants for the program will be chosen from the Garfield, Kane, Piute and Wayne counties.
One of the program’s primary benefits is how little it disrupts a person’s life. In rural communities where specialized care may be limited or nonexistent, participants will no longer have to relocate when seeking help — a blessing especially relevant to Utahns.
“Utah has one of the highest, if not the highest percentage, of women with children in the household who are in addiction,” said Rita Osborn, the executive director of the center. “That’s pretty startling. And if you’re a mom with kids in your house, how are you going to leave your family to go to rehab?”
People living in rural areas are also, generally, poorer than those living in cities, and so the program will cover around 90% of the costs for participants, according to Shakespear.
Poorer communities often means fewer health care options as well.
“These rural, frontier communities do not have the health care infrastructure to offer this care,” Shakespear said. “It takes a lot of infrastructure to offer these treatment programs. They’re not situated in order to be able to deliver that additional care on top of everything else that’s expected from them.”
So the center pulled together a group of local, state and national entities to help realize the project’s vision, now called the Utah Rural Opioid Healthcare Consortium.
Aspire 365, a company based in Salt Lake City, will provide substance abuse, nutritional and behavioral health counseling remotely, according to the release. The telehealth services will run through Scriptyx, a California technology company.
“Aspire will take care of pretty much all of the clinical side of the treatment, and then any additional health-related issues that need to be dealt with to make sure the patient is healthy as a whole will be treated by the local providers,” Shakespear said.
“It’s a partnership,” Osborn added. “You can’t have one without the other.”
The local providers will also select the participants for the pilot program, as they are closest to the patients. According to Osborn, the program will accept a minimum of 18 participants. The goal is to combine local and statewide health care services to best help those people, in whatever capacity they need.
Utah has one of the highest, if not the highest percentage, of women with children in the household who are in addiction. That’s pretty startling. And if you’re a mom with kids in your house, how are you going to leave your family to go to rehab?
–Rita Osborn, executive director of the Utah Center for Rural Health
“As we’ve experienced increased numbers of patients presenting with opioid dependence into our ER, we know there’s a critical need for treatment, particularly inpatient rehabilitation,” said Sarah Boone, a social worker at Kane County Hospital, in the press release.
“Through this HRSA grant, some of our Kane County residents battling addiction may be able to receive vital support that they otherwise wouldn’t have had access to, and we’re grateful to SUU for including us in this important partnership,” she said.
Shakespear hopes the project’s initial participants will be the first of many Utahns living in rural areas to gain access to these types of services.
“The long-term goal is to demonstrate the efficiency of this program, demonstrate that it works in these communities in hopes of finding ways to get coverage in the future,” he said.
Another piece of the plan is training existing health care providers and working with them to get waivers so they can eventually perform medically assisted treatments for patients, according to Osborn.
“Part of the grant will be developing a sustainability plan so that patients do have access to this level of care going forward,” she said. “By helping our health care providers identify when a patient might have an addiction issue and to better treat that patient, not with just one thing, but to look at that patient very holistically and provide services, hopefully we can decrease this terrible issue in our community.”