The Effects of Opioid Abuse in the Midwest

While Chicago, home to over 2.7 million people and the country’s third largest city, is located within the Midwest, the majority of counties in the region are rural. While most of the country’s rural counties have seen shrinking populations for years, the problem is worse for Midwestern municipalities. Subsequently, the impact of Opioid abuse in the Midwest has been exponentially more destructive. In Austin, Indiana, for example, a town of 4,000 experienced an HIV outbreak of 190 new cases in just one year–equivalent to nearly 410,000 new cases in a city the size of New York.

In small towns and counties across the Midwest, the negative effects of Opioid abuse have been similarly overwhelming. In 2016, there were more than 40,000 overdose deaths involving Opioids nationwide; approximately 9,853 of which occurred in the Midwest. Typically, the effects of an addiction and overdose crisis influence states on two levels: the individual and the community. The table below illustrates the negative impact addiction has on these levels.

Ongoing health complications Increased crime to support drug habits
Overdose death Increased rates of domestic violence, child abuse, and prostitution
Increased risk of homelessness Strained health care, social service, and criminal justice resources
Exposure to HIV and hepatitis viruses Declining property values
Incarceration Deteriorating community pride

What Factors Contribute to Opioid Abuse in the Midwest?

The Midwest includes the states of Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, North Dakota, South Dakota, and Wisconsin. About 20% of the U.S. population lives within the Midwestern region (approximately 63,304,744 people), the third-largest region behind the South and West. Midwesterners typically reside in rural areas with low population densities.

The primary factors contributing to Opioid abuse in the Midwest include:

  • Isolation
  • Hazardous behaviors
  • Poverty
  • Low scholastic completion
  • Unemployment

Opioid Use In The Midwest Is Affecting Some States And Cities More Harshly Than OthersIn 2017, drug overdose fatalities in rural areas surpassed urban rates–upending the myth that drugs are a bigger problem for cities. In addition to having higher rates of cigarette smoking, high blood pressure, and obesity, people in rural areas also tend to be older and sicker than people in urban areas. Access to healthcare is likewise worse than it is in urban areas. Many counties rely on volunteer emergency services who may not be fully trained or equipped to handle an overdose. For this reason, overdose fatality rates are higher in rural areas. Often, by the time first responders arrive to provide life-saving care, the individual has already passed.

The Opioid Epidemic is a pivotal challenge for many rural places. More than a health concern, the Opioid crisis is an issue of rural prosperity and will take the commitment, collaboration, and creativity of a wide range of partners to address.

Anne Hazlett
USDA Assistant to the Secretary for Rural Development, 2017

Compounding the problems of Opioid abuse in the Midwest are a lack of recovery resources. More than 82% of people in rural areas have no access to detox services in their county, despite high rates of drug abuse among youths and groups likely to be prescribed long-term Opioid medications (i.e. the elderly and people working in labor-intensive industries like agriculture). Moreover, 60% of rural counties don’t have a physician with a Drug Enforcement Administration waiver to prescribe Buprenorphine (a common addiction treatment medication). These resources are vital to treating addiction in the long-term because many people don’t want to leave home for months to attend a rehab center.

Opioid Abuse Statistics by State

Number of Opioid-Related Overdoses in 2016
Rate of deaths per 100,000 residents
Illinois 1,040 15.3
Indiana 794 12.6
Iowa 183 6.2
Kansas 146 5.1
Michigan 1,762 18.5
Minnesota 396 7.4
Missouri 914 15.9
Nebraska 44 2.4
North Dakota 54 7.6
Ohio 3,613 32.9
South Dakota 42 5
Wisconsin 865 15.8

The national rate of Opioid-related deaths per 100,000 people was 13.3 in 2016.

Overcoming the Stigma of Addiction

In a number of municipal surveys, a majority of Midwestern respondents reported that the stigma of addiction is a major barrier to seeking recovery. One study found that half of rural adults reported viewing addiction as a choice as opposed to what it is: a medical disorder requiring clinical treatment. As such, thousands of people don’t look for treatment despite struggling with the consequences of addiction.

Compared to urban populations, rural residents were far more likely to enter addiction treatment following referral from the criminal justice system. Over half of rural treatment admissions came as a result of criminal charges; only 22.8% entered themselves into treatment. In order to increase rates of rehab admissions and decrease addiction and overdose fatalities, Midwestern communities will need to adopt more prevention programs and evidence-based treatment centers.

Asking for Help

For those suffering from an Opioid Use Disorder, getting through each day can be grueling, depressing, and isolating. But, as more addiction treatment resources come to the Midwest, more options become available for residents within their own communities. Check the Substance Abuse and Mental Health Services Administration website for certified recovery resources near you.