The prevalence of synthetic drugs is undercutting a previously effective and widely embraced opioid use disorder treatment tactic. Now, the model pioneered in Vermont a decade ago and adopted at sites nationwide, especially in hard-to-reach rural areas, is being forced to evolve.
No local hospital and anemic ambulance services mean residents in rural Pickens County, Alabama, are thrown into perilous situations when they have medical emergencies. It’s a kind of medical care roulette that has become a fact of life for rural Americans who live in ambulance deserts.
As evidence supporting medication treatment for opioid addiction mounts, judges, district attorneys, and law enforcement officials in rural America are increasingly open to it after years of insisting on abstinence only.
Since 2005, central Appalachia has recorded a tenfold increase in cases of severe black lung disease among long-term coal miners. Now, federal regulators are expected to propose a new rule to protect against silica dust, which causes the most severe form of black lung, progressive massive fibrosis.
Research shows offering clean syringes to people who misuse IV drugs is effective in combating the spread of HIV. But an epidemiologist and advocates say state and local officials in West Virginia, home to one of the worst HIV outbreaks in recent years, have taken measures that render syringe exchange less accessible.
Some churches and other faith-based organizations are offering clean syringes to IV drug users, while still others are voicing their support for comprehensive treatment, testing and education programs that also help stem transmission of diseases like HIV and hepatitis C.
Advocates emphasize peer support and community reintegration for people with behavioral health problems.
Prison helped Richie Tannerhill overcome substance abuse, but that was just the beginning of rebuilding his life.