Rural Communities and the Prevalence of Substance Abuse

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Rural Communities and the Prevalence of Substance Abuse among Adolescents :

Rural Communities and the Prevalence of Substance Abuse among Adolescents Mansfield University Racheal Fuller

“Good ole Tioga County, Pennsylvania”:

“Good ole Tioga County, Pennsylvania” MILLERTON Tioga Together these two rural towns form a community.

Introduction :

Introduction Although Millerton and Tioga are small, they present themselves with warm, welcoming arms as visitors come and go. With that being said, these two towns that I call home are far from perfect. There has been a significant number of individuals that have been abusing drugs, especially adolescents. http://nationalpainreport.com/new-addiction-treatment-drug-could-be-alternative-to-suboxone-8815195.html

Demographics (United States Census Bureau, n.d.):

Demographics (United States Census Bureau, n.d.) Millerton Population: 2,095 residents Foreign born population: 2 Median age: 47.8 Median household income: $52,928 Veterans: 242 Education: 85.5% of the residents have a high school level of education or higher Poverty: 13.3% of the residents live below the poverty line Tioga Population: 666 residents Foreign born population: 6 Median age: 38.3 Median household income: $35,368 Veterans: 103 Education: 79.3% of the residents have a high school level of education or higher Poverty: 18.2% of the residents live below the poverty line Together these two rural towns form a community.

Significance :

Significance 5 basic variables to the community’s core (physiological, Psychological, Developmental, Sociocultural, and spiritual)

Rural Community :

Rural Community

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The roads range from dirt and loose stone to asphalt. Google maps

Living Arrangements :

There is a variety of living styles within the community. Some are superb and well-managed and others are not as affluent. Lower socioeconomic living individuals are more vulnerable to substance abuse behaviors. Living Arrangements

Living Arrangements :

Living Arrangements There are a total of 3 trailer parks within the community. Properties for sale Apartment housing

Living Arrangements :

Living Arrangements Some historical buildings are still being used; however, they have a different purpose. Dodge City now serves as an apartment building.

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Active farms and run-down farms. Some houses are surrounded by agriculture.

Community Resources :

Community Resources Family restaurants Gas stations Home/ personal businesses Hardware stores Firework shops Brings in visitors Automobile repair shops Ice cream stands Dollar General

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Community member photobombing my photo  Community Resources

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Community Resources

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Community Resources Automobile repair shops and community storage

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Family restaurants and personal businesses Community Resources

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Community Resources Hardware, home, and lumber

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Community Resources

Community Resources:

Community Resources Mom and pop shops

Banks within the Community:

Banks within the Community Millerton Tioga

Post Offices Within the Community:

Post Offices Within the Community Millerton Tioga

Protective Services :

Protective Services Millerton Tioga Fire Departments

Protective Services :

Protective Services Tioga Damn

Protective Services :

Protective Services

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Health Care Opportunities Located in Lawrenceville, Pennsylvania

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Community’s Parks and Playgrounds

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Recreational Activities Available for Adolescents Outdoor basketball court Baseball field Community swimming pool

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Tioga’s Roll-arena has been condemned. It once provided a safe place for the younger population to “hang out.” Recreational Activities Available for Adolescents

Recreational Activities Available for Adults :

Bar and Grill (x2) Gentlemen’s Club Recreational Activities Available for Adults

Educational Opportunities :

Educational Opportunities R.B. Walter Elementary School Williamson Junior-Senior High School

Educational Opportunities :

Educational Opportunities https://www.thinglink.com/scene/572668248605065218 Mansfield University, Mansfield Pennsylvania

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Wesleyan United Methodist Baptist Baptist United Methodist Religious Activity within Millerton

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Tabernacle Baptist Biblical Anglican Orthodox Baptist Trinity United Presbyterian Religious Activity within Tioga

History and Events :

History and Events Millerton Bicentennial Poker run/ walk and Fall foliage fun run/ walk Antique tractor pull Parades New book published regarding the history of the town. (past vs. present)

History and Events :

History and Events Tioga Old Homes Day Parades Poker Run

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Community’s Involvement

Influence of Substance Abuse:

Influence of Substance Abuse Focusing on Adolescents in rural communities

Substance Abuse among Adolescents (Pruitt, 2009):

Substance Abuse among Adolescents (Pruitt, 2009) Why are adolescents in the area abusing? Rural area According to the Tioga Borough Office, kids in the area are “bored with a capital ‘B.’” Law enforcement’s tolerance, lenience, and informal responses to substance abuse does not provide consequences for illegal actions. Increase in poverty rates Fewer educational opportunities and social support Scarce resources Latchkey kids

Affects of Substance Abuse (Tioga County Courthouse, n.d.) :

Affects of Substance Abuse (Tioga County Courthouse, n.d.) Community Increased fraud Increased crimes and vandalism Individuals driving under the influence Family violence Individual Job loss decreased social activity and difficulties in school Fatal overdoses (deaths) Spontaneous abortion Collapsed veins Infectious diseases (HIV, AIDS, hepatitis) Pneumonia Infection in the lining of the heart

Importance of Promoting Health :

Importance of Promoting Health Decrease the incidence of substance abuse within the community Decrease criminal behaviors, vandalism, and violence Community will feel safer Decrease mortality and morbidity rates within community Prevent chronic illnesses Increase community’s awareness Promote positive attitudes throughout the community

Substance Abuse in Tioga County, Pennsylvania:

Substance Abuse in Tioga County, Pennsylvania According to WENY News, back in December of 2012, heroin was the number one drug of choice in Tioga County. “Law enforcement officials are fighting an increasing amount of heroin in the area, and it’s not just the adults who are using. Kids are also abusing heroin at a much higher rate than seen before” (WENY News, 2012). There is a significant prevalence of heroin abuse in the area and it has become a major epidemic for Tioga County

Substance Abuse in Tioga County, Pennsylvania:

Substance Abuse in Tioga County, Pennsylvania Thirty-seven residents were arrested this past September in relation to drug abuse. This drug bust was said to be “the most impactful event” the local area has seen in several years (Barb, 2015). The drug bust had targeted illicit drugs such as methamphetamine, cocaine, bath salts, marijuana, and most importantly heroin. This specific drug bust was a major eye opener for the community and because of it, there has been an increase in awareness towards drug abuse throughout the neighborhood.

Substance Abuse in Tioga County, Pennsylvania:

Substance Abuse in Tioga County, Pennsylvania “Law enforcement officers say criminals tend to take advantage of the Northern Tier because of its close proximity to New York City and Philadelphia. It's also a rural area, so they feel protected from watching eyes” (Bard, 2015). http://www.tiogapublishing.com/free_press_courier/news/charged-during-drug-sweep-sept/article_754043ae-620f-11e5-ba28-875ab10aa32c.html

Statistics :

Statistics “At least seven Pennsylvanians die each day from drug-related causes” ( Bumsted, 2015 ). T otal of 2,489 documented deaths throughout Pennsylvania related to drugs (Bumsted, 2015 ) Teen Addiction Photo from “Creative Commons”

Community’s Involvement :

Community’s Involvement White-out Simulation Local high school participated in a white-out simulation to support addicts in the area and in the school. Students covered their face with white paint and did not interact with their peers. Significance: to support addicts, raise awareness, and recognize the impact drugs can have http://mysticalayna.blogspot.com/2012/11/prisoners-of-void-part-17-of-saturn-in.html

Community’s Involvement :

Community’s Involvement Open doors Two specific family members opened their homes for adolescents that were struggling with addiction. Provides support and encouragement for recovery. Teach addicts in the community the value of hard work, accountability, and the love of God. “Our 3 sons...not perfect, but we love them !” Photos retrieved from Facebook

Barriers to Care :

Barriers to Care One available health clinic located in Lawrenceville, Pa Travel time to emergency centers and hospitals Volunteer fire departments and first responders are not readily available in an emergency http://www.susquehannahealth.org/patients-visitors/patients-visitors/page.aspx?id=3028 http://www.hunt-eas.com/portfolio/markets-served/health-care-and-hospital/arnotogden

Primary Prevention :

Primary Prevention Educating adolescents and the community about addiction. Focus on addiction rather than the addictive substance “80 million people, while not addicted, use addictive substances in ways that threaten public health and safety…it makes no sense to focus on only one manifestation of addiction…instead, we much address the disease broadly to avoid costly [interventions] involving one drug only to see the problem reemerge in the form of another” (Richter, 2013). http://www.njsrc.org/aarc-education-programs

Secondary Prevention :

Secondary Prevention Screening and analyzing the community. Determine who has used illegal drugs and what population is most at risk. Determine what substance is most prevalent? Testing and screening individuals for illegal substances. http://datcs.com/drug-testing-texarkana-ar-business-needs-testing-policy/

Tertiary Prevention :

Tertiary Prevention Treatment and Recovery for addicts Recovery Revolution https://www.facebook.com/tiogacountyrecoveryrevolution/?fref=ts

Current Best Practice: Ways to prevent substance abuse among adolescents (Pruitt, 2009):

Current Best Practice: W ays to prevent s ubstance abuse among adolescents (Pruitt, 2009) Stronger law enforcement in rural communities Provide more educational opportunities Provide after school activities Prevent latchkey kids Activities with adult supervision Suggest programs such as D.A.R.E. and STARS Educate students and families about substance abuse and addiction Identify individuals who are at risk Photo from “Creative Commons” Photo from “Creative Commons”

Current Best Practice: The nurse’s role (Felicilda-Reynaldo, R. D. 2014) :

Current Best Practice: The nurse’s role ( Felicilda -Reynaldo, R. D. 2014 ) Identify patients with a substance abuse addiction Screen patients for alcohol and illicit drug use Provide brief questionnaire and administer a drug-screen test by collecting patients’ urine. Assess the patient and determine whether they are a low, moderate, or high risk Photo from “Creative Commons”

Evidence-Based Health Promotion Strategies :

Evidence-Based Health Promotion Strategies Supervised programs for adolescents After school activities D.A.R.E and STARS D.A.R.E. Song Increases peer support Prevents latchkey kids Education regarding addiction Be realistic and avoid “sugar coating” effects of addiction Focus on addiction rather than the substance of addiction Photo from “Creative Commons”

Evidence-Based Health Promotion Strategies :

Evidence-Based Health Promotion Strategies Involving families in education Study: Implementation and Impact of a Family-Based Substance Abuse Prevention Program in Rural Communities Goals: “To increase resiliency and protective factors including family cohesion, communication skills, school attachment, peer attachment, and appropriate attitudes” (Pilgrim, Abbey, Hendrickson, & Lorenz, 1998). Conclusion: Families that participated in the program found that providing similar communication skills to parents and youth is an effective way to prevent substance abuse. Photo from “Creative Commons”

Resources for More Information :

Resources for More Information Rural Assistance Center Product of the U.S. Department of Health and Human Services’ Rural Initiative Helps rural communities access available programs, findings, and research Provide quality healthcare to rural residents Used by local providers of healthcare Substance Abuse and Mental Health Services Administration (SAMHSA) A gency within the U.S. Department of Health and Human Services Mission: is to reduce the impact of substance abuse and mental illness on America's communities Focuses on prevention, treatment, and recovery https://www.raconline.org/ http://www.samhsa.gov/

Resources for More Information :

Resources for More Information Study: Rural Adolescent Substance Abuse: Prevention Implications from the Evidence Purpose: “To identify appropriate adolescent substance abuse prevention programming for rural populations through the application of three concepts: effectiveness (best clinical evidence ), efficiency (benefit to rural populations), and equality (access )” (Gregg, J. A., 2012). Conclusion: Including parents and internet resources in prevention programs is a positive way to educate and prevent substance abuse in rural communities. Evidence shows that prevention programs has to be unique and designed for the targeted community.

Conclusion :

Conclusion Living in rural areas pose several obstacles Lack clinics and emergency centers Lack of resources, funding, and transportation More vulnerable populations Lower socioeconomic levels pose an increase in substance abuse behaviors Supervised programs can decrease prevalence of substance abuse in adolescents Educating adolescents and community about addiction is essential in prevention.

Slide58:

References Bard, J. (2015, September 23). 37 Charged In Northern Tier Drug Sweep. Retrieved from http://www.mytwintiers.com/news/local-news/37-charged-in-northern-tier-drug-sweep Bumsted, B. (2015, May 6). Report: Drug overdoses kill at least seven Pennsylvanians each day. Retrieved from http://triblive.com/news/adminpage/8317421-74/counties-deaths-drug#axzz3pjLzLCuG Gregg , J. A. (2012). Rural Adolescent Substance Abuse: Prevention Implications from the Evidence. Online Journal Of Rural Nursing & Health Care, 12(2), 41-50 10p. Felicilda -Reynaldo, R. D. (2014). Recognizing Signs of Prescription Drug Abuse and Addiction, Part I. MEDSURG Nursing, 23(6), 391-396 6p. Pilgrim, C., Abbey, A., Hendrickson, P., & Lorenz, S. (1998). Implementation and Impact of a Family-Based Substance Abuse Prevention Program in Rural Communities. The Journal of Primary Prevention , 18 (3), 341-361. doi:10.1023/A:1024659012360 Pruitt, L. R. (2009). THE FORGOTTEN FIFTH: RURAL YOUTH AND SUBSTANCE ABUSE. Stanford Law & Policy Review, 20(2), 359-404. Richter, L. (2013, June 21). Letter to U.S. News and World Report responding to "Study: Heroin Abuse Increase May Be Due to Prescription Painkiller Crackdown". Retrieved from http:// www.casacolumbia.org/newsroom/letters/letter-us-news-and-world-report-responding-study-heroin-abuse-increase-may-be-due Rural Assistance Center. (n.d.). Rural Health Information. Retrieved from https://www.raconline.org / Substance Abuse and Mental Health Services Administration. (n.d.). SAMHSA. Retrieved from http://www.samhsa.gov / Tioga County Courthouse. (n.d.). Community Matters. Retrieved from http://www.tiogacountypa.us/humans_services/Pages/CommunityMatters.aspx Tioga County Department of Human Resources. (n.d.). Mental/ Behavioral Health: Heroin. Retrieved from http://tioga.pa.networkofcare.org/mh/library/article.aspx?id=417 United States Census Bureau. (n.d.). American FactFinder . Retrieved from http://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml WENY News. (2012, December 18). Tioga Co. Heroin Problem. Retrieved from http:// www.weny.com/news/All/heroin-problem-121812 Youtube . (n.d.). D.A.R.E. Song With Lyrics [Video file]. Retrieved from https://www.youtube.com/watch?v=xAnqME7VGcE

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