Indiana Regional Medical Center Indiana, Pennsylvania
Background and Hypothesis: Substance use disorder is expanding across the country, especially in rural areas. There is a severe shortage of healthcare professionals, a lack of access to treatment facilities, the pervasive effects of stigma and social isolation, financial and insurance restrictions, disparities in technology and telemedicine accessibility, complex interactions of co-occurring mental health disorders, and significant cultural and linguistic barriers in receiving care. This thorough investigation aims to provide a thorough grasp of the various obstacles that Americans with substance use disorders who live in rural areas must overcome.
Methods: We conducted a comprehensive search of Psych Info, Web of Science, PubMed literature sources from January 2005 until October 2023. The publications that meet the strict inclusion requirements, which cover rural populations, obstacles to drug treatment, and a geographic reach within the United States, were carefully chosen. Specific key topics were methodically identified that illuminate the vast array of treatment-related difficulties.
Results: Nine categories were assessed for critical evaluation. One major barrier for rural areas is lack of suitable treatment facilities for addressing drug use disorders and found rural areas had longer drive times of 16.1 to 48.4 minutes for opioid treatment programs compared to chain pharmacies of 4.4 minutes. Limited health insurance coverage was another barrier in rural areas identified. Substance use disorders are at risk of being untreated or underdiagnosed as insurance benefits are more generous for mental health service than for substance use treatment. Stigma was another category that stood out and was found that women were more likely than males to perceive stigma as a barrier to treatment, especially in rural areas. Another category identified was the healthcare workforce shortage of enrollment and retention of medical professionals in rural substance use disorder therapy. Technology and telemedicine play a role as well in that access to internet and mobile phones was associated with greater chances of obtaining outpatient substance use disorder therapy. It was also found that lack of understanding and awareness of substance use disorder in rural areas also hampered access to therapy, which included low levels of formal education and increased unemployment rates.
Conclusion: There are numerous obstacles to treating substance use disorder in rural parts of the USA. Several factors affect people's ability to access treatment, from a lack of treatment options and limited funding to stigma, a shortage of healthcare workers, disparities in technology, co-occurring mental health conditions, and inadequate SUD education and awareness. These findings highlight the obstacles in rural regions that must be addressed with a comprehensive strategy. In osteopathic medicine, the body is capable of self-healing, self-regulation, and health maintenance and structure and function are interrelated. Treating substance use disorder effectively for the patients in rural areas will allow the body to self-heal over time.
Acknowledgement of Research Study Sponsors and IRB: The study was exempt from Institution Review Board. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
