Original Research

A rural community’s perspective on the causes of and solutions to the opioid crisis in southern Virginia: a qualitative study


name here
Angelina J Hargrove1
MS, MPH, CHES, Research Assistant *

name here
Carlin Rafie2
PhD, RD, Assistant Professor

name here
Emily Zimmerman3
PhD, MS, MPH, Director

name here
Dawn E Moser4


1, 2, 4 Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University, 321 Wallace Hall, 295 West Campus Drive, Blacksburg, VA 24061, USA

3 Division of Epidemiology, Center on Society and Health, Virginia Commonwealth University, 830 East Main Street, Suite 5035, Richmond, VA 23298-0212, USA

ACCEPTED: 8 April 2022

early abstract:

Introduction: Opioid use disorder (OUD) is a leading public health issue in the United States, with complex drivers requiring a multi-level response. Rural communities are particularly affected by opioid misuse. Due to variability in local conditions and resources, they require community-specific responses.
Objective: The aim of this study was to gain insight into the perceptions, knowledge, and experiences of members of a rural community impacted by the opioid crisis to inform the development of local strategies to address the crisis.
Methods: Stakeholder focus groups were conducted by a participatory research team as part of a larger project using the Stakeholder Engagement in Question Development and Prioritization Method, (SEED).
Results: Key findings from the focus groups included the importance of family dynamics and social networks as risk and resiliency factors, addressing hopelessness as a preventive strategy, the need for holistic approaches to treatment, childhood exposure resulting in intergenerational substance use, the needs of overburdened healthcare providers, the expansion of long-term rehabilitation programs, and the need for judicial reform towards those with OUD. Specific and well-defined strategies are needed for more comprehensive methods to address the complexity of OUD. Understanding factors that contribute to OUD in rural communities through a stakeholder engagement process should be the first responsive strategy in developing actions.
Conclusion: This study shows that rural community stakeholders provide important perspectives that can be useful in solving the drug epidemic in their neighborhoods. Their understanding of the internal dynamics of the communities’ needs offers a unique roadmap in which prioritized actions can be customized and adapted for improving health outcomes.