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ORAU Releases Report Titled Communicating about Opioids in Appalachia - Challenges, Opportunities, and Best Practices

On behalf of the Appalachian Regional Commission (ARC) with funding from the Centers for Disease Control and Prevention (CDC)’s National Center for Injury Prevention and Control, ORAU conducted research with communities and experts across Appalachia to identify best practices for communicating about opioids.

The Appalachian Region is 205,000 square miles and stretches from New York to Mississippi. In the region, 84 out of the 420 counties are economically distressed and 42% of the total area is considered rural. Appalachia has higher mortality rates than the nation in seven of America’s leading causes of death, including heart disease, cancer, chronic obstructive pulmonary disease (COPD), injury, stroke, diabetes, and suicide.

According to a report commissioned by ARC, overdose mortality rates among 25 to 44 year olds are greater than 70 percent higher than the non-Appalachian U.S. Despite high rates of opioid misuse, abuse, and overdose throughout the Region, research conducted by ORAU in 2016 found that no published best practices exist for communicating about opioids in the Region. To fill this gap, ORAU set out to conduct the first known study of its kind to research what and how to communicate about the opioid crisis in Appalachia and focus the work on local community perspectives and equipping local organizations.

To better understand how opioids are impacting parts of Appalachia differently and to establish communication best practices, the ORAU team conducted virtual calls with 27 experts from each of the 13 Appalachian states and 12 in-person focus groups in four Appalachian communities. The discussions and focus groups uncovered information about the regional differences in how opioids are impacting communities, lessons learned from previous communication campaigns, and unique geographic, economic, and socio-cultural factors that influence how messages and spokesperson are perceived.

Experts represented a variety of fields including anti-drug coalitions, local health departments, state health departments, treatment and recovery facilities, medicine, academia, pharmacy, local law enforcement, and state offices of drug control policy. Focus groups included participants of diverse ages, education, and income-levels and four groups were with individuals in recovery from opioid addiction.

Interestingly, the expert interviews and community focus groups yielded similar findings in terms of the opioid-prevention messages most needed in the Region, the key target audiences for these messages, and the ways in which information should be disseminated for maximum impact. The strongest findings of the research included

  1. the need for messages to combat the stigma of addiction (including messages about addiction being a chronic disease that is treatable and not a “moral failure”),
  2. the need for prevention messages aimed at youth that promote and normalize not using drugs, and
  3. the need for messages to be conveyed through story-telling, particularly the stories of community members who have been in long-term recovery from opioid addiction.

Other research findings included that the terms “prescription pain meds” or “prescription pain pills” are better received than the term “opioids.” If using the term opioids, it should be defined and include examples of common brand-names of opioid medications. When communicating about opioid misuse, messages containing calls-to-action and solutions have a better impact and vivid but clear language is preferred over “beating around the bush.” For example, stating that someone “died” as opposed to “passed” is a better choice. In addition, local organizations are best positioned to combat the opioid crisis as they can tailor the solution to the individual community needs which are often different from other communities even within the same state.

This research conducted by the ORAU team adds to the very limited body of knowledge about health communication in Appalachia and serves as a guide to help local organizations tackle the epidemic using messages and tactics that will be seen and understood by communities in Appalachia in the hopes of saving as many lives as possible.

For more information, contact Jennifer Reynolds.