Opioids: Rural America’s Real Threat

By Matt Niswander

According to the Centers for Disease Control and Prevention, approximately 100 farmers and agriculture workers suffer a lost-work-time injury every single day. Even with safety measures in place, farm and ranch work is labor-intensive, and not without risk. Rural primary care physicians and emergency rooms are no strangers to farm-work injuries, and CDC numbers indicate that one out of five of those farm patients will receive a prescription for opioid pain medication before they walk out the door. As a cattle farmer and family nurse practitioner in rural, southern middle Tennessee, I have seen first-hand the impact of these injuries and the need for greater awareness and education on the risks of opioid use.

My family has had our fair share of injuries and surgeries due to farm-work related accidents, and I see patients every day who are seeking treatment for injuries from these types of accidents as well. The injuries range from joint sprains to back injuries to cuts, scrapes and broken bones, to name a few. People receiving care for these injuries have often come to expect an opioid prescription for relief, regardless of their level of perceived pain, and about half of the time they receive that prescription according to a CDC study.

Often, in the farming community, opioid use starts with treatment for pain from legitimate injuries with legal prescriptions obtained from healthcare providers.

CDC studies also show that adults over age 40 are more likely to receive opioids from their primary care providers, and that primary care offices account for about half of all opioid pain relievers dispensed in the U.S. At the average age of 58, most farmers and ranchers fall into the demographic likely to obtain opioid prescriptions. Add those statistics to the risk of farm-work injuries, and you can begin to see how America’s opioid epidemic is affecting the farming community in much higher percentages.

The American Farm Bureau Federation and National Farmers Union conducted a survey with Morning Consult, which showed 74 percent of farmers or farm workers are, or have been, directly impacted by opioid addiction. Yet in that same study only 31 percent of rural Americans said that the opioid crisis was mostly in rural communities. I have always been told that when you find yourself in a hole to stop digging, and sadly we are just starting to recognize we are in a hole that rural America has been quietly and quickly shoveling deeper.

Often, in the farming community, opioid use starts with treatment for pain from legitimate injuries with legal prescriptions obtained from healthcare providers. Farmers are not only saying they get prescriptions from their community healthcare providers legally, but according the Morning Consult survey, three out of four farmers say opioids can be easily obtained illegally in their communities.

The hemorrhagic state of the opioid crisis cannot be covered with a Band-Aid. We need rural America’s farmers and ranchers to unite and remove the stigma and veil of shame surrounding opioid use and addiction, and we need additional training for rural healthcare providers to be empowered as strong advocates for non-opioid treatment options. If we choose to ignore the problem, this epidemic will continue to spread, leaving a devastating impact that will undermine the current state of agriculture in rural America.

Rural America’s opioid crisis is here right now. Our focus on national regulations and global trade are real issues that need to be addressed, but the future of farming and ranching may be just as dependent on our awareness of curbing the opioid dependency in our grassroots communities where individuals influence national changes.

Matt Niswander, a member of AFBF’s Partners in Advocacy Leadership program, raises cattle with his wife and three sons on their first-generation farm in Lawrenceburg, Tennessee.

For more resources on the opioid epidemic in rural America, visit farmtownstrong.org.