There are many reasons why some people have certain accessing substance abuse treatment in various parts of the US. From obtaining funds to support therapy, through cultural context and stigma, all the way to geographical location – all of these factors combined shape the individual’s decision concerning substance abuse rehab. Today, we’ll focus on that last element – geographical location. We’ll lecture on the regional disparities in substance abuse treatment access in the US. Of course, location isn’t just the location. Many other things are associated with where people live: the abovementioned cultural context, urban vs. rural community differences, and so on. Stay tuned!
Overlooked barriers on the path to recovery
Instead of blaming individuals for not having the strength to undergo substance abuse treatment (which is something many people so easily see as an appropriate way to tackle the topic), one should focus on statistics. Did you know that:
- Most substance abuse treatment centers are located in metropolitan areas, while alcohol dependence and dependence on drugs, as nationwide issues, affect both urban and rural communities.
- Homeless people (usually urban dwellers themselves) have next to no chance of getting the treatment they deserve.
- People who don’t have good health insurance have a pretty hard time obtaining the financial support for going into rehab.
Now that you know these facts, it’s quite easy to see that certain structural issues (cost, transportation, access to good health insurance, not to mention ethnic or racial discrimination issues outlined in the Journal of Behavioral Health Services & Research, and so on) might pose a great challenge for some individuals. And while the personal motivation behind the intent to go into rehab is not to be underestimated, the blame can’t be solely on the individual.
Even though urban areas have greater quantities of treatment centers, many people can’t use them.
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Regional disparities in substance abuse treatment access in America (rural vs. urban areas)
As was emphasized in the introduction, today we’ll focus our attention on the geographical limitations in the context of substance abuse treatment access in the US.
Rural communities lack treatment facilities
Most facilities where people check into substance abuse rehab are located in urban areas. Take this as an example: California has over two thousand treatment centers, with the We Level Up California rehabilitation center being a benchmark for world-class detox and rehabilitation as part of a state-wide network of specialized, licensed facilities.
At the same time, Vermont, a US state known for its rural image, has about sixty. While this might seem like a shock at first, it’s good to know that over ninety percent of the people who have a substance use disorder live in bigger cities. Therefore, one might say that being from Vermont doesn’t put them in an inferior position as opposed to those in California in the context of substance abuse treatment access.
Be careful with conclusions
While Vermont might be a positive example, take the US state of Montana as its negative counterpart. Montana is a state larger (both in size and population) and more rural than Vermont. At the same time, it’s not like it has plenty more treatment centers than its East Coast little cousin. That makes it harder for Montana residents in need of treatment since they have to go back and forth constantly, and that’s especially true for those living far away from bigger settlements.
Also, it’s not just that rural communities in states like Montana or Vermont have less access to treatment centers. It’s that many of these areas lack substance use professionals who can issue medicine prescriptions, and so on. Here’s an example:
About ninety percent of all doctors who are in the position to issue a buprenorphine prescription, a medicament that’s often used in the treatment of opioid addiction and its consequences, practice their craft in urban areas. On the other hand, more than half of rural counties across the US don’t have a single professional to prescribe the medication in question.
It’s not just about prescriptions
More than sixty percent of rural communities around the US don’t have a single practicing psychiatrist, and about fifteen percent don’t have behavioral health providers.
Lastly, let’s comment on transportation. You might have to travel a good distance to get a bed in a rural treatment center (because some of them have fewer beds). Rural communities also lack the means of public transport, which clearly doesn’t help.
Many rural areas in the US don’t have doctors who can prescribe medications for treatment.
What about insurance?
Health insurance is another big factor one should be watching out for in terms of treatment access. Here’s the thing: many national instance statistics usually show little to no difference between rural and urban states/areas in the percentage of people with health insurance. However, things change once you focus on people under sixty-five. In that demographic group, rural residents are less likely to have insurance. To conclude, younger people in rural communities tend to be uninsured, which also limits their access to substance abuse treatment in the US.
Rural community culture and stigma
People who have a substance use disorder and live in rural areas and communities are also at a bigger risk of being judged by their peers for going into rehab. Also, there’s sufficient self-stigmatization present. Self-stigmatization isn’t something extraordinary, however: many people with an addiction internalize the negative feelings and shame their communities place on their backs. That, of course, causes them to avoid reaching out for help. Many people are worried about what others might think of them if they were to seek professional help. Also, many of them wrongly think that treatment wouldn’t help their unique case or that they might not have an addiction problem at all.
The geographical location impacts treatment access in major ways
It’s evident that there’s a solid regional, rural, vs. urban disparity in substance abuse treatment access across the United States. While the biggest city centers are more likely to have a solid population of people suffering from substance abuse, some of them are not in a position to get professional help because of, say, poverty and homelessness. Rural communities are also not so good at tackling addiction issues: even when homelessness isn’t an issue, there are infrastructural problems that limit access to treatment centers and rehab programs, making it logistically difficult to get the necessary help.
