Addressing the Opioid Crisis in Small and Rural Communities in Western Massachusetts

The opioid crisis is having a devastating impact on public health in the Commonwealth of Massachusetts with specific challenges in rural and small communities in Western Massachusetts. A detailed literature review and 24 stakeholder interviews helped identify those challenges as well as describe action steps being taken in the region and highlight recommendations for future success. Several themes emerged including: the vitality of collaboration and the role of community coalitions in ensuring an effective response, the rehabilitative role of the criminal justice system, innovative solutions aimed to engage more people on medications for opioid use disorder (MOUD), and the necessities of harm reduction strategies and recovery support services (RSS).  

Beyond the economic toll, the intergenerational impact of this opioid addiction epidemic has left infants born dependent on opioids, grandparents raising grandchildren, an increase of children in the foster care system, and an increasing incarcerated population struggling with opioid use disorder (OUD). While much is being done, the crisis continues. Appropriate access to treatment and supportive recovery in the region is hindered by challenges including socioeconomic distress, inadequate treatment infrastructure and housing, rural isolation, stigma, transportation, and trauma. What was made clear is the degree of community willingness, leadership, innovation, and compassion that the people of Western Massachusetts exemplify, from regional collaborations, to the criminal justice system, to healthcare providers and hospital systems, to harm reduction specialists.