Perceptions of Prescription Opioid use among Rural Farming and Ranching Communities: Preliminary Implications for Outreach and Treatment

Abstract

Background: In 2017, 45% of rural adults reported being directly impacted by the opioid epidemic. While research on the experiences of those using prescription opioids in rural communities is increasing, less is known about a unique sub-population who may have high rates of exposure: rural agricultural workers. The purpose of this study was to explore the prevalence and perceptions related to prescription opioids among rural producers and farmworkers. Methods: A questionnaire was mailed in spring 2019 and spring 2020 to rural residents living in one of two agricultural-based states in the Upper Midwest. Individuals were eligible to participate if any member of their family was involved in the agricultural industry. A total of 1116 questionnaires were returned for a 27.9% response rate. Results: Participants were 68.1 years old on average. The majority identified as white, male, and married. Prescription opioid use was found in 8.2% of households currently, and 15.7% in the past year. There were no gender differences in prevalence of use, but women and older individuals reported significantly more perceived risk than men and younger individuals. Nearly half used alternative pain management, and received most information about prescription opioids from the radio (65.5%) and newsletters (13.5%). Conclusions. Despite their elevated age and working in an occupation at high risk of injury and chronic pain, study participants reported few opioid prescriptions and moderate use of alternative pain management. Perceived risk of prescription opioids may explain low prevalence. Outreach efforts that increase access to healthcare services and alternative pain management treatments for agricultural workers may mitigate the experience of chronic pain that can interfere with their overall quality of life.

Opioid use, prescribing and fatal overdose patterns among racial/ethnic minorities in the United States: A scoping review and conceptual risk environment model

“…Similarly, rural Latinos, namely those living in migrant/farmworker communities, and Indigenous peoples, many of whom live on rural reservations, may experience elevated opioid use-related risks corresponding to the heightened social stressors and limited resources typifying their environments. Emergent evidence suggests that rural Latinos' physically intensive labour on farms and in other forms of seasonal work may spur usage-and eventual misuse-of prescription opioids and fuel illicit opioid use [119,157,158]. Likewise, communal-living Indigenous peoples' comparatively high levels of social isolation, limited economic opportunity and exposure to poor and inadequate housing (when living on reservations) may propel their nonmedical usage of opioids [159,160].…”