Researchers at the University of Rochester Medical Center have received a $6.7 million federal grant to study how to reduce the toll of the opioid epidemic in rural Appalachian counties.
“It’s not as far away from us in Rochester as it sounds,” said Michele Lawrence, one of the principal investigators on the research team. “Many people don’t realize that Appalachia extends to New York’s Southern Tier.”
Lawrence said some people seeking treatment for opioid use disorder in Allegany and Steuben counties find themselves driving four hours each day to get the medications they need to stave off cravings.
Across a four-state swath of Appalachia where the team from URMC's newly established Rural Center of Excellence on Substance Use Disorder will carry out its research, Lawrence said barriers to care are common. Rural communities often lack the resources to effectively address a crisis that killed more than 11,000 people in those states in 2017, the most recent year for which data is available from the federal Centers for Disease Control.
“Because of that, drug dealers often target rural communities,” Lawrence said.
In some spots in rural Appalachia, 80% of the patients who needed treatment for substance use disorder were unable to access it, she said.
But despite a rising death toll and wrenching economic impacts, Lawrence said the opioid epidemic still does not get the same treatment as other diseases.
“The people of this country would be up in arms if 80% of the cancer patients could not access the treatment they needed,” she said.
So under the grant from the federal Health Resources and Services Administration, the URMC researchers will work to figure out what combination of treatment programs works best to connect opioid-dependent patients to long-term recovery. Lawrence called it an “ecosystem of recovery.”
“You can’t do it piecemeal,” she said. “When a person has an overdose, and they get stabilized, you can’t say, ‘OK, now drive an hour to your counseling appointment next week.’ People drop off the map.”
But the precise combination of programs that will work best is still somewhat of a mystery to researchers, and even more to policymakers.
“We need to understand how to build a system of support for people, and we need to understand where the funding is to make it last,” Lawrence said.