Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural community

Abstract Background Rural areas in the United States (US) are ravaged by the opioid overdose epidemic. Oconee County, an entirely rural county in northwest South Carolina, is likewise severely affected. Lack of harm reduction and recovery resources (e.g., social capital) that could mitigate the wors...

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Main Authors: Moonseong Heo, Taylor Beachler, Laksika B. Sivaraj, Hui-Lin Tsai, Ashlyn Chea, Avish Patel, Alain H. Litwin, T. Aaron Zeller
Format: Article
Language:English
Published: BMC 2023-04-01
Series:Substance Abuse Treatment, Prevention, and Policy
Subjects:
Online Access:https://doi.org/10.1186/s13011-023-00532-3
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author Moonseong Heo
Taylor Beachler
Laksika B. Sivaraj
Hui-Lin Tsai
Ashlyn Chea
Avish Patel
Alain H. Litwin
T. Aaron Zeller
author_facet Moonseong Heo
Taylor Beachler
Laksika B. Sivaraj
Hui-Lin Tsai
Ashlyn Chea
Avish Patel
Alain H. Litwin
T. Aaron Zeller
author_sort Moonseong Heo
collection DOAJ
description Abstract Background Rural areas in the United States (US) are ravaged by the opioid overdose epidemic. Oconee County, an entirely rural county in northwest South Carolina, is likewise severely affected. Lack of harm reduction and recovery resources (e.g., social capital) that could mitigate the worst outcomes may be exacerbating the problem. We aimed to identify demographic and other factors associated with support for harm reduction and recovery services in the community. Methods The Oconee County Opioid Response Taskforce conducted a 46-item survey targeting a general population between May and June in 2022, which was mainly distributed through social media networks. The survey included demographic factors and assessed attitudes and beliefs toward individuals with opioid use disorder (OUD) and medications for OUD, and support for harm reduction and recovery services, such as syringe services programs and safe consumption sites. We developed a Harm Reduction and Recovery Support Score (HRRSS), a composite score of nine items ranging from 0 to 9 to measure level of support for placement of naloxone in public places and harm reduction and recovery service sites. Primary statistical analysis using general linear regression models tested significance of differences in HRRSS between groups defined by item responses adjusting for demographic factors. Results There were 338 survey responses: 67.5% were females, 52.1% were 55 years old or older, 87.3% were Whites, 83.1% were non-Hispanic, 53.0% were employed, and 53.8% had household income greater than US$50,000. The overall HRRSS was relatively low at a mean of 4.1 (SD = 2.3). Younger and employed respondents had significantly greater HRRSS. Among nine significant factors associated with HRRSS after adjusting for demographic factors, agreement that OUD is a disease had the greatest adjusted mean difference in HRSSS (adjusted diff = 1.22, 95% CI=(0.64, 1.80), p < 0.001), followed by effectiveness of medications for OUD (adjusted diff = 1.11, 95%CI=(0.50, 1.71), p < 0.001). Conclusions Low HRRSS indicates low levels of acceptance of harm reduction potentially impacting both intangible and tangible social capital as it relates to mitigation of the opioid overdose epidemic. Increasing community awareness of the disease model of OUD and the effectiveness of medications for OUD, especially among older and unemployed populations, could be a step toward improving community uptake of the harm reduction and recovery service resources critical to individual recovery efforts.
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spelling doaj.art-45f9121a89744318ad04e2221092853c2023-04-23T11:09:46ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2023-04-011811910.1186/s13011-023-00532-3Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural communityMoonseong Heo0Taylor Beachler1Laksika B. Sivaraj2Hui-Lin Tsai3Ashlyn Chea4Avish Patel5Alain H. Litwin6T. Aaron Zeller7Department of Public Health Sciences, Clemson UniversityPrisma Health Addiction Medicine CenterDepartment of Public Health Sciences, Clemson UniversityDepartment of Public Health Sciences, Clemson UniversityUniversity of South Carolina School of Medicine—GreenvilleUniversity of South Carolina School of Medicine—ColumbiaPrisma Health Addiction Medicine CenterUniversity of South Carolina School of Medicine—GreenvilleAbstract Background Rural areas in the United States (US) are ravaged by the opioid overdose epidemic. Oconee County, an entirely rural county in northwest South Carolina, is likewise severely affected. Lack of harm reduction and recovery resources (e.g., social capital) that could mitigate the worst outcomes may be exacerbating the problem. We aimed to identify demographic and other factors associated with support for harm reduction and recovery services in the community. Methods The Oconee County Opioid Response Taskforce conducted a 46-item survey targeting a general population between May and June in 2022, which was mainly distributed through social media networks. The survey included demographic factors and assessed attitudes and beliefs toward individuals with opioid use disorder (OUD) and medications for OUD, and support for harm reduction and recovery services, such as syringe services programs and safe consumption sites. We developed a Harm Reduction and Recovery Support Score (HRRSS), a composite score of nine items ranging from 0 to 9 to measure level of support for placement of naloxone in public places and harm reduction and recovery service sites. Primary statistical analysis using general linear regression models tested significance of differences in HRRSS between groups defined by item responses adjusting for demographic factors. Results There were 338 survey responses: 67.5% were females, 52.1% were 55 years old or older, 87.3% were Whites, 83.1% were non-Hispanic, 53.0% were employed, and 53.8% had household income greater than US$50,000. The overall HRRSS was relatively low at a mean of 4.1 (SD = 2.3). Younger and employed respondents had significantly greater HRRSS. Among nine significant factors associated with HRRSS after adjusting for demographic factors, agreement that OUD is a disease had the greatest adjusted mean difference in HRSSS (adjusted diff = 1.22, 95% CI=(0.64, 1.80), p < 0.001), followed by effectiveness of medications for OUD (adjusted diff = 1.11, 95%CI=(0.50, 1.71), p < 0.001). Conclusions Low HRRSS indicates low levels of acceptance of harm reduction potentially impacting both intangible and tangible social capital as it relates to mitigation of the opioid overdose epidemic. Increasing community awareness of the disease model of OUD and the effectiveness of medications for OUD, especially among older and unemployed populations, could be a step toward improving community uptake of the harm reduction and recovery service resources critical to individual recovery efforts.https://doi.org/10.1186/s13011-023-00532-3Social capitalRuralOverdoseOpioid use disorderRecoveryHarm reduction
spellingShingle Moonseong Heo
Taylor Beachler
Laksika B. Sivaraj
Hui-Lin Tsai
Ashlyn Chea
Avish Patel
Alain H. Litwin
T. Aaron Zeller
Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural community
Substance Abuse Treatment, Prevention, and Policy
Social capital
Rural
Overdose
Opioid use disorder
Recovery
Harm reduction
title Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural community
title_full Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural community
title_fullStr Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural community
title_full_unstemmed Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural community
title_short Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural community
title_sort harm reduction and recovery services support hrrss to mitigate the opioid overdose epidemic in a rural community
topic Social capital
Rural
Overdose
Opioid use disorder
Recovery
Harm reduction
url https://doi.org/10.1186/s13011-023-00532-3
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