MSU Extension Michigan Substance Use, Prevention, Education and Recovery (MiSUPER)

Opioids in Rural Farming Communities

The opioid crisis is having an impact on rural communities.

While opioid medications can be safety used to treat pain, there are risks for misuse, addiction and overdose; each are serious public health issues. While all areas of the country have been affected by these crises, rates of drug-related deaths in rural areas have surpassed those in urban areas (Centers for Disease Control and Prevention [CDC], 2017 https://www.cdc.gov/opioids/basics/prescribed.html.

• 136 Americans die every day from an opioid overdose (CDC, 2021).
• Opioid misuse can begin accidentally with safe use of prescription pain medication.
• Rural areas have higher rates of opioid prescriptions (Guy et al., 2017).
  
  

How does the opioid crisis impact rural farming communities?

Agriculture can be a stressful occupation. Farmers often have financial pressure, as well as, unpredictable issues involving property, weather, prices, animals and crops. Farming can also be dangerous work, with high risk for fatal and nonfatal injuries.

Every day in this nation, approximately 100 agricultural workers suffer an injury leading to lost work time (CDC,2018a). In recent years, the highest number of injuries was among aging farmers age 50-59 years (CDC, 2018b). 

In addition to acute injuries, and the effects of aging, chronic pain is also prevalent among farm workers due to common repetitive motions, kneeling, and carrying heavy loads (XIao et al.,2013).

• 74% of farmers or farm workers are or have been impacted by opioid misuse.
• 26% of farmers and farm workers have abused, been addicted or have taken an opioid without a prescription.
• 77% of farmers or farm workers believe it would be easy to access opioid painkillers without a prescription.  (Morning Consult, 2017).

What drugs are opioids?

Opioid drugs block pain signals in the body and are usually used to treat moderate to severe pain. Some examples of opioids that can be prescribed by a doctor include oxycodone (OxyContin, Percocet), hydrocodone (Vicodin, Lortab, Lorcet, Norco), hydromorphone (Dilaudid), meperidine (Demerol), oxymorphone (Opana), fentanyl, morphine, codeine, tramadol and others. 

What is opioid misuse?

• Taking an opioid medication prescribed by your doctor but in higher quantities or frequencies.
• Taking an opioid medication prescribed by your doctor for a time period longer than indicated.
• Taking an opioid medication prescribed by someone else’s doctor.
• Using an opioid to feel a high.
  
  

What are signs and symptoms of opioid misuse?

• Slurred speech
• Constricted pupils
• Runny nose or nose sores
• Sweaty, clammy skin
• Moving slower than usual
• Unable to move in a coordinated way
• Lack of awareness or inattention to people and/or things around them
• Being sedated or acting drowsy
• Feeling unusually happy, excited or “high”
• Problems with attention and memory
• Feeling sad or losing interest in activities one normally enjoys
• Less sensitive to pain
• Feeling hopeless
• Confusion
• Constipation

What can I do to help my community?

• If you or someone you know needs help, talk with a healthcare provider or seek support through SAMHSA’s Behavioral Health Treatment Services Locator. https://findtreatment.samhsa.gov
• Learn how to use Naloxone (Narcan) in case you encounter an individual experiencing an overdose.
• Store medications for you, your family and your farm animals safely by locking them up.
• Do not share prescription medications.
• Take unused medications to prescription drop-off points.
• Learn to recognize signs and symptoms of opioid misuse.
• Educate others in your community about the impact of opioids.
  
  

What support and resources are available for someone who may need help addressing opioid misuse or an opioid use disorder?

• Behavioral therapy & counseling
• Medications for opioid use disorder
• Non-opioid treatments available for pain
• Recovery support resources such as relapse prevention groups, recovery coaches, employment support, and other community services
  
  

Learn more about preventing opioid misuse in your community through Michigan State University Extension’s Michigan Substance Use, Prevention, Education, and Recovery (MiSUPER) initiative. canr.msu.edu/misuper

Acknowledgments

Authors: Cheryl Eschbach, Abigail Cudney, Lauryn Lin, and Liz Josaitis Previous contributions by Courtney Cuthbertson, University of Illinois

Resources

• Centers for Disease Control & Prevention 
• Health and Human Services website on the opioid epidemic
• National Institute on Drug Abuse about opioid crisis 
• Michigan Department of Health and Human Services Opioid Resources
• American Farm Bureau’s Farm Town Strong website 
• Michigan State University Extension Managing Farm Stress website 

References

Centers for Disease Control and Prevention. (2021). Understanding the epidemic. Atlanta, GA: U.S. Department of Health and Human Sciences. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html.

Centers for Disease Control and Prevention. (2017a). CDC reports rising rates of drug overdose deaths in rural areas. CDC Newsroom. Atlanta, GA: U.S. Department of Health and Human Services.

Centers for Disease Control and Prevention. (2017b). National Vital Statistics System, mortality. CDC Wonder. Atlanta, GA: U.S. Department of Health and Human Services.

Centers for Disease Control and Prevention. (2018a). Agricultural safety. National Institute for Occupational Safety and Health. Atlanta, GA: CDC. https://www.cdc.gov/niosh/topics/aginjury/default.html

Centers for Disease Control and Prevention. (2018b). Table AI-4. National estimates of agricultural work-related injuries to adults (20 years and older) on US farms by age group: Occupational Injury Surveillance of Production Agriculture (OISPA) Survey. Atlanta, GA: CDC. https://www.cdc.gov/niosh/topics/aginjury/oispa/pdfs/AI-4-508.pdf

Guy, G. P., Zhang, K., Bohm, M. K., Losby, J., Lewis, B., Young, R., Murphy, L. B., & Dowell, D. (2017). Vital signs: Changes in opioid prescribing in the United States, 2006-2015. Morbidity and Mortality Weekly Report 66(26): 697-704.

Morning Consult. (2017). American Farm Bureau Federation: Polling presentation. October 31, 2017. Retrieved from https://1vix7b4f3jvk2x4eqy1byl1n-wpengine.netdna-ssl.com/wp-content/uploads/sites/13/2017/12/171015-AFB-Opioids-LE.pdf

Understanding the epidemic: Opioid overdose. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. https://www.cdc.gov/drugoverdose/epidemic/index.html.

Xiao, H., McCurdy, S. A., Stoecklin-Marois, M. T., Li, C. S., & Schenker, M. B. (2013). Agricultural work and chronic
musculoskeletal pain among Latino farm workers: the MICASA study. American journal of industrial medicine, 56(2), 216–225. https://doi.org/10.1002/ajim.22118