Substance use disorders (SUDs) represent a critical health crisis impacting over 20 million Americans, according to the U.S. Department of Health and Human Services. Unfortunately, despite these daunting numbers, many individuals who need care face obstacles that prevent them from accessing treatment. In light of this urgent issue, researchers at The University of New Mexico College of Population Health (COPH) are taking steps to combat the substance use crisis within the state.
In New Mexico, the substance use crisis is particularly pronounced, with researchers noting that longstanding barriers have exacerbated the situation. Substance use has emerged as one of the state’s most significant public health challenges. To better understand the complexities of SUDs, it is vital to recognize their ties to social and economic frameworks that often leave marginalized communities at a disadvantage. Research indicates that stigma not only contributes to the development of substance use disorders but also undermines treatment efforts, widening the gaps in care.
Stephanie Chambers, MPH, a Lecturer III at COPH, states, “The interconnected nature of substance use disorders and social determinants of health creates complex challenges that require comprehensive, community-based solutions.” In particular, health care disparities are glaring within New Mexico’s rural communities, where limited transportation options and fewer treatment facilities create significant barriers. These issues are further pronounced in close-knit communities where anonymity is challenging to maintain.
The New Mexico Department of Health (NMDOH) reports that the state has ranked among the top three for alcohol-related deaths since 1981, with rates nearly double the national average. Furthermore, since 1990, New Mexico’s death rates due to drug overdoses have remained above the national average, costing the state approximately $890 million due to prescription opioid misuse, according to NMDOH data.
Chambers and her colleagues are actively implementing overdose prevention training programs aimed at lowering these alarming statistics. Their overdose first aid program has trained over 300 teens in Narcan administration techniques. These young participants not only gain confidence in their ability to assist others in crisis situations but also go on to empower their peers, promoting better community norms around overdose rescue measures.
Despite these positive strides, there remains a pressing need to address the underlying social barriers that prevent many individuals from seeking treatment for SUDs. While community programs are beneficial for immediate intervention, the deeper roots of stigma need to be tackled for more sustainable change. Verlin W. Joseph, PhD, MPH, an epidemiologist and assistant professor at COPH, highlights that stigma can deter individuals from making the decision to seek help. In rural areas, this stigma often compounds issues related to geographic isolation, creating “treatment deserts.”
The World Health Organization (WHO) identifies social stigma as a significant barrier to seeking help for substance abuse disorders. It disproportionately affects marginalized groups, including rural populations and those entangled in the criminal justice system. The stigma against substance use disorders significantly hampers treatment engagement at multiple levels, influencing the quality of care received and leading to poor treatment outcomes.
Dr. Joseph’s public health research delves into understanding the intricate ties between social stigma and substance use treatment. He reveals that the stigmatization of SUDs varies depending on the substance involved, contributing further layers of confusion and shame for individuals grappling with addiction. His research emphasizes the urgency of developing measurement tools that assess stigma’s multifaceted nature across diverse treatment settings, a crucial step towards enhancing treatment initiation and completion.
To truly support individuals impacted by substance use disorders, New Mexico’s healthcare providers and community organizations must prioritize assisting those engaged in cycles of substance abuse, both during and after treatment. Addressing structural issues like complicated systems of care, lack of interagency coordination, and transportation barriers is essential. These challenges are particularly acute in rural areas, which often lack consistent funding and infrastructure for effective treatment and prevention.
Fortunately, there are pathways forward. Promising solutions like technology and telehealth are emerging as viable ways to enhance service delivery in rural areas. These innovations can help bridge the gap in treatment access and offer comprehensive health communications that are increasingly critical in today’s landscape.
UNM researchers continue their vital work to develop better treatment approaches and create in-depth assessments that consider cultural differences among communities. By combining these efforts with initiatives aimed at breaking down stigma, addressing systemic barriers, expanding treatment options, and implementing culturally responsive interventions, New Mexico may begin to turn the tide against its substance use crisis.
The urgency of improving access to SUD treatment cannot be overstated. Particularly in New Mexico, where the dual forces of stigma and structural barriers significantly hinder progress, it is essential to foster understanding and implement effective strategies that resonate with the specific needs of affected communities. The path towards addressing New Mexico’s substance use crisis requires collaboration, compassion, and the will to tackle this pressing public health issue on multiple fronts.
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