Quiet crisis hurting farm families

‘I’m going to be fine’

High rate of opioid abuse in agriculture impacts farm families

BY NICOLE ZEMA

Aquiet crisis shrouded in shame is hurting American farm families.

Stereotypes ascribed to addiction have resulted in a stigma that exacerbates the suffering of those affected by opioid abuse.

A 2017 Morning Consult poll indicated the opioid crisis has struck farm families harder than the rest of rural America. Morning Consult is a data intelligence company that conducts global research.

The survey found 74% of farmers and farmworkers say they have been directly impacted by opioid abuse. For survey purposes, directly impacted means participants know someone who is or has been addicted; have addiction in the home; have used opioids not prescribed to them; or are personally addicted.

The Morning Consult poll, sponsored by the American Farm Bureau Federation and National Farmers Union, has prompted a larger conversation about decreasing the stigma around opioid addiction in farming communities, and increasing awareness about available resources. Researchers and service providers across Virginia are initiating that conversation.

“There is implicit and open bias against people who have substanceuse disorders,” said Dr. Kathy Hosig, associate professor and director of Virginia Tech’s Center for Public Health Practice and Research. “Even those suffering often believe they are undeserving of help. People might not understand that addiction is a physical brain disease, which is where a lot of stigma arises.”

Stereotypes compound damage

Stereotypes of addiction can be socially and physically damaging to individuals and communities, said Dr. Kim Niewolny of Virginia Cooperative Extension’s Farm Safety, Health, and Wellness Initiative that supports mental health, grief and farm stress education for farmers and service providers.

“Addressing mental health, stress and trauma is essential as we talk about substance-use disorders,” she said. “For example, historical trauma can be transferred from generation to generation, acting as a possible factor for the way someone might respond to stressors and grief. We wrote case studies to show how farm stress can be manifested in people’s bodies.”

Market volatility, unpredictable weather and financial loss can amplify personal stress for farm families, and heighten the risk of substance-use disorder. Empathy is key to abolishing stigma, Niewolny said.

Access to resources lacking in rural areas

“That is challenging in agriculture because we often talk about rugged individualism, the ‘pull yourself up by the bootstraps’ attitude,” she said. “We need to do more to shift away from that kind of thinking.”

Hosig added that those suffering, especially in rural Southwest Virginia, don’t always have choices.

“What if you don’t have any bootstraps?” she asked. “If you can’t get resources you need to make choices, you don’t have agency.”

Team formed to address services

With the goals of reducing stigma and addressing access to services, a team of health experts is building relationships with Virginians recovering from substance abuse.

“Virginia Cooperative Extension became involved in the prevention side, and we started seeing there needs to be technical support for recovery services,” Hosig said. The Virginia Higher Education Opioid Consortium began providing technical assistance to Virginia Department of Behavioral Health and Development Services’ Community Service Boards. CSB peer-support specialists, who are in stable recovery and trained to provide support, can help Virginians navigate services.

Susan Dalrymple, Extension’s rural opioid coordinator, said since the pandemic began in March, rural Southwest Virginia counties have seen a significant increase in suicides and overdoses.

“Although one very positive point from the pandemic is that counseling services are held online,” she said. “You do not have to leave your home, which for farmers is their workplace.”

With increasing awareness of farm stress and the mental health crisis in agriculture, other risk factors for substanceuse disorder should be considered. The social isolation of rural regions can intensify substance-use disorders, and rural areas may have limited access to services, treatment and support. The physicality of farm operations means farmers are susceptible to injury, and at the average age of 58, most farmers fall into the demographic likely to obtain opioid prescriptions.

“Farming doesn’t mean you have to use your body to the point of not coming back from that,” Niewolny said. “A farmer might say, ‘I’m going to be fine,’ but it’s not OK to suffer.”

Common signs of opioid addiction

• Inability to control opioid use • Mood changes • Drowsiness • Changes in sleep habits • Weight loss • Frequent flu-like symptoms • Decreased libido • Lack of hygiene or dental care • Isolation from family or friends • Stealing from family, friends or businesses • New financial difficulties

source: Johns Hopkins Medicine

Local resources and methods of treatment

Behavioral health treatments can help those with substance-use disorders seek to change behaviors, thoughts, emotions and understanding of personal situations through counseling and specialized psychotherapies.

Virginia’s Community Services Boards are the primary point of entry into the state’s public behavioral health services system at dbhds.virginia.gov.

The U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration also lists local providers at findtreatment.samhsa.gov, or the national helpline at 800-662-HELP.

Medication-assisted treatments combine behavioral therapy and medications to treat substance-use disorders. These MATs are safe to use for months, years or even a lifetime under a doctor’s supervision. For more information, visit samhsa.gov/medication-assisted-treatment.