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The opioid crisis is a story of many types of pain, and how individuals, families, and entire communities – particularly small and rural ones – are becoming collateral damage.

A new paper by Grantmakers in Aging – Heartache, Pain, and Hope: Rural Communities, Older People, and the Opioid Crisis: An Introduction for Funders – looks at the problem with a fresh perspective, focusing overdue attention on the damage to rural communities, particularly the lives of older people, and describing proven programs, innovative partnerships, policy recommendations, and scientific and medical responses that governments, communities, nonprofits, and philanthropies can support and expand. (You can download the full paper here.)

Rural communities tend to be tight-knit and self-reliant, but their infrastructure and resources are often limited, their populations are older than the rest of the country, and they are frequently overlooked in national policy-making.

This has been a dangerous mix when it comes to opioids.

According to the CDC, for example, people in rural counties are nearly twice as likely to overdose on prescription painkillers as people in cities, and the wider impact is enormous as well. 

“This crisis has caused community-wide aftershocks – in child welfare, elder abuse, public safety, criminal justice, the workforce, the economy, caregiving, housing, and, of course, health care, and many older people are suffering as a result, often without care, attention, or support,” says John Feather, PhD, CEO of Grantmakers In Aging.

"Some older people do suffer from opioid misuse and addiction problems, but the fallout reaches well beyond the addicted individuals, and the response from foundations and service providers must be broader as well, to address that wider set of needs.”

Some issues of particular concern to older people include:

  • High rates of chronic pain, which is sometimes treated with opioids. This must be considered when making changes to the regulation and prescribing of opioids, and more alternative treatment options are needed.
  • Cultural and generational sensitivities that may stop older people from seeking help when they do have a dependency. Reducing stigma and improving access to specialized help in rural communities are key objectives.
  • Increased risk of elder abuse, and the need for stronger prevention and intervention options.
  • Recognition and support for older people who take on additional responsibilities, such as raising grandchildren whose parents cannot care for them.

Rural communities bring certain unique strengths to this challenge, such as cohesive, supportive kinship and community networks and flexible, innovative local institutions. By understanding both the needs and the potential of rural communities, funders of all kinds can form better funding relationships and achieve greater impact on this sweeping national problem.

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