Financial and transportation problems often make opioid-addiction treatment difficult for rural residents to get

Opioid addicts can take prescription drugs that conquer withdrawal symptoms without making the patients high, but some medications like methadone can only be dispensed in person. That means a daily trip to a clinic for many, making recovery "even tougher for rural residents who live miles from treatment clinics," Lurissa Carbajal reports for Arizona State University's Cronkite News. "Most clinics in the U.S., built in response to the heroin epidemic of the 1970s, are in big cities. These days, drug abuse has expanded to the suburbs and rural areas but the facilities to treat it have lagged because of funding shortages and the stigma around drug-treatment facilities."

Though opioid overdose deaths have quadrupled over the past decade, the number of people in methadone treatment has increased by less than 25%, according to the Centers for Disease Control and Prevention, Carbajal reports. She illustrates how difficult it can be for rural residents to seek such treatment, following homemaker and mother of three Maggie Phillips as she makes the daily trip to the clinic an hour away. She began methadone treatments at 25 when she was pregnant with her second child, and used to have to travel nearly three hours each way to a clinic in Tucson every day.

New addiction-treatment patients are generally only eligible for the once-a-day dosage, but if they stay sober long enough can sometimes qualify for a longer-acting shot. Because Phillips has been in treatment for several years and because a nearer treatment clinic opened up recently, it's much easier for her to get treatment: she now only has to drive one hour each way, once a month, to receive a methadone shot, Carbajal reports.

Phillips is fortunate that she has a reliable car and the money to make the journey, though. "Patients spend nearly $50 per week just on travel costs, and they often have to use back roads. The lack of transportation leads to patients missing treatments, which results in more relapses," Carbajal reports. "Then there are the hidden costs, such as Phillips gathering up her boys and hauling them for a journey that takes most of the day."

Why aren't there more clinics in rural areas? Opponents believe that outpatient drug centers bring crime with them, but "new research from Johns Hopkins Bloomberg School of Public Health suggests there may actually be less serious crime near clinics than other community businesses. The study found that there was 25 percent more violent crime around liquor stores and corner stores compared with drug treatment centers," Carbajal reports. "Government and private funding for such clinics also is lacking. Only a handful of commercial insurance plans have recently begun paying for such treatment. About a dozen states, mostly in the Midwest and Southeast,have prohibited their Medicaid programs from covering methadone-based therapy, according to the Pew Research Center."