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Two Epidemics: Rural NC Fights Substance Abuse, COVID-19

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In September, the highest rates of emergency-room visits related to drug overdose occurred in North Carolina's most rural counties, including Caldwell, Richmond and Robeson. (Adobe Stock)
In September, the highest rates of emergency-room visits related to drug overdose occurred in North Carolina's most rural counties, including Caldwell, Richmond and Robeson. (Adobe Stock)
 By Nadia Ramlagan - Producer, Contact
December 9, 2020

MARION, N.C. -- Rural North Carolina is battling two health epidemics - substance abuse and COVID-19 - as treatment centers navigate shutdowns and internet-access challenges to address addiction and mental-health issues.

In McDowell County, Jacqueline Fox heads McDowell Impact, a peer-support specialist network. Her organization is working to place specialists with key agencies that work with people battling addiction and related challenges such as family separation, finding housing and infectious disease. She said building a strong network of resources and educating people is critical to reducing the long-term societal effects of COVID-19.

"In McDowell, we're kind of resource poor," she said. "We have one mental-health provider. And when you're working with people who struggle with substance misuse, you have a small timeframe when they're ready and seeking help. Transportation is always an issue. Medication was always an issue, the cost."

A new report from the North Carolina Division of Public Health found that emergency-room visits related to drug overdose have jumped by 22% compared with last year. The highest rates of overdose occurred in rural counties among the hardest-hit by COVID-19.

Fox added that prolonged social isolation and economic hardship will affect families differently, so treatment centers and social-service agencies will have to work to meet individual needs.

"When you isolate folks and you take away their connection to community, to churches, that's just going to have far-reaching effects," she said. "It's going to have a ripple effect on their life. Maybe they're not able to afford meds, or they are having to seek out those services for food, they become food insecure. So, I don't think there's really one thing that we can pinpoint to focus more on."

Anthony Tyre, a behavioral health counselor and founder of the Eastern Community Care Foundation, said the stigma surrounding mental health and substance use, combined with fear of COVID-19, deters people from seeking help. Also, many rural residents lack reliable home internet and can't have online appointments. So his organization checks on clients at home, in what he called COVID-safe "front-yard visits."

"We're kind of seeing a lot of the kids going through major depression," he said. "A lot of the folks who are living with substance-use disorder and trying to battle that, they're struggling because they're having difficulties getting in to their appointments."

This summer, the Centers for Disease Control and Prevention reported more Americans are experiencing worsening mental health linked to the pandemic, especially among younger adults, people of color, essential workers and unpaid family caregivers.

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