Ending the Chase: Experiences of Rural Individuals with Opioid Use Disorder

Abstract

Background

The US remains in the midst of an opioid overdose epidemic. Given that rural populations have higher rates of opioid-related morbidity and mortality, it is important to understand the factors that perpetuate opioid use and facilitate recovery in rural communities. Purpose: To explore experiences of individuals living with opioid use disorder (OUD) and to analyze these experiences within a broader sociocultural context. Methods: Using a descriptive, qualitative design, we interviewed twenty purposefully sampled participants. We used thematic content analysis to identify themes and patterns. Results: As participants became dependent, the chase for opioids was to avoid the pain of withdrawal. Waking up sick became an everyday experience, leading to a lifestyle of hustling. The pursuit of opioids resulted in physical, social, emotional, and legal consequences that fed a cycle of stigmatization. In recovery, participants learned to embrace a new way of thinking, allowing them to make new choices. The strong influence of family and community in their lives was a key factor in their resiliency and opioid use experiences. Conclusions: Individuals with OUD are impacted by intersecting social, physical, economic and policy factors that reinforce the expansion of the opioid epidemic rurally. This study provided a voice to rural individuals with opioid use disorder, a group often underrepresented in the literature, providing an understanding of their struggles and the unique sociocultural dynamics that exist in rural northern New Mexico. The complex sociocultural relationships to family and community represent important adaptive factors that could support individual healing and community transformation.

Keywords:

• Substance abuse
• opioid use disorder
• mental health
• rural health
• health care disparities

Acknowledgements

The authors acknowledge the insightful intellectual contributions of Van Roper, PhD, RN, FNPBC, Sharon Ruyak, PhD, RN, CNM and Lawrence Leeman, MD, MPH. Scholarship support was provided to K.L.S. from the Hearst Foundations, the Sharon Lee Smoker Scholarship, and the Rufus Carter Scholarship.

Declaration of interest

The authors declare that they have no conflict of interest.

Additional information

Funding

This research was funded by a grant from the American Psychiatric Nurses Association (K.L.S.). The funding agency had no role in study design, data collection, analysis of data, writing or review of the manuscript or decision to submit the manuscript for publication.