11 Feb 2021 admin


Substance use disorders are a leading cause of global concern. Although often regarded as urban and megacity problems, substance use and abuse are quite prevalent in rural areas. In urban and rural areas, many resorts to the use and abuse of substances to relax, for relief from stress, to have fun, or experiment out of curiosity. Opioid use disorder is described as a chronic impulsive need to use opioids even if they cause clinically significant distress or discomfort. Over 16 million people globally are affected by opioid use disorders. Canada is currently the second-highest per capita consumer of prescription opioids in the world. In Canada, it is estimated that about 9.6% of the population who used opioid medications reported some form of misuse.

Limited healthcare in rural communities

Opioid Use Disorders in Rural Areas

Different reports have shown that substance use disorders are even more prevalent in rural communities when compared to urban communities. According to the Canadian Institute for Health Information, “Opioid poisoning hospitalization rates in smaller communities were more than double (2.5X) those in Canada’s largest cities in 2017.” Different factors may be responsible for this prevalence, some of which are:

Socioeconomic Factors

Socioeconomic factors such as low income and unemployment may account for some of the reasons why the rural population may abuse opioids. Some may use opioids to deal with the stress of day-to-day living, while others use them as recreational drugs.

High-Risk Jobs

According to a publication by, most of the jobs in the top five riskiest jobs in Canada are exclusive to rural areas. These jobs are:

  • Fishing & Trapping
  • Mining, Quarrying and Oil Wells
  • Logging and Forestry
  • Construction
  • Transportation and Storage

These jobs require heavy manual labour and are prone to dangerous occupational hazards. Many rural Canadians turn to abuse prescription or non-prescription opioids to cope with the stress and accompanying injuries.

Limited Access to Healthcare

People living in rural regions generally have limited access to healthcare compared to those in urban areas. With limited options that are relatively expensive, a large part of the rural community resorts to self-medication, which often leads to abuse. Something that started as a means to relieve pain may grow into unmanaged compulsive use. Even when it becomes a problem, many communities can’t access doctors for the care they need. A contributing factor to this is the geographical isolation of many of the rural communities. The nearest well-equipped clinics or hospitals may be hundreds of kilometres away, with expensive travelling costs. Even in the cases where some clinics are accessible, the rural communities are generally so close-knitted, and community members may worry that word about their conditions will get out.

Strategies for Addressing Opioid Use Disorders in Rural Areas

Dealing with the rising opioid use disorder crisis in rural areas is not isolated and has to be through a multidimensional approach

The Role of The Government

In most urban regions, the federal and provincial governments have provided easy access to doctors, substance abuse centers, and medication for managing opioid use disorder. Unfortunately, these services are not easily accessed by those in rural communities. Opioid Agonist Therapy (OAT) is often recommended for people with opioid use disorder. Suboxone and methadone are two of the most effective OAT medications for dealing with substance use disorders, yet it is not easily accessible to people in rural regions. It would help significantly if more substance abuse treatment centers and medication providers were set up in rural areas to tackle the growing crisis.

The Role of Telehealth in Addressing Opioid Use Disorders

Telehealth uses digital information and communication technology to provide healthcare services. Most of the barriers to tackling opioid use disorders in rural areas can be addressed through telemedicine.

Telehealth Reduces Physical Barriers Between Health Practitioners and Patients in Rural Areas

A major barrier to accessing quality healthcare by people in rural regions is their geographical locations. With telemedicine, quality healthcare can be accessible to those in rural communities irrespective of their location. With proper check-ups and monitoring, patients can be assured of effective treatment similar to what they would get in traditional in-person care. Instead of traveling kilometers to receive treatment for their opioid use disorder, patients can easily connect to their physicians through telemedicine platforms.

Patients Who Received Telemedicine Treatment May Perform Better than In-person Patients

Because of the ease of receiving treatment through telemedicine, it may be easier for patients to continue treatment and achieve full recovery. A particular study involving 3500 Canadian patients on either methadone or buprenorphine showed that those who received telemedicine care had a higher retention rate of 50% than in-person patients of 39% in one year.

Telehealth Reduces The Cost Of Treatment

Without the expensive transport costs required by rural settlers to get treatment, the total cost of receiving treatment is reduced. People in rural communities would only have to worry about consultation and medication fees. This may reduce the prevalence of self-medication and abuse of opioids in the case of injuries or illnesses.


The growing opioid crisis in Canada also affects the rural regions, probably more than the data suggests. With timely governmental intervention and telemedicine, opioid use disorders can be minimized and contained in rural areas. Do you struggle with substance use disorders, and would you like to talk to a substance abuse expert? You can book a consultation at