We’ve talked a lot about substance abuse problems on this blog. And we’ve talked before about our state’s problems with getting rural folks the healthcare they need. These problems intersect, and a recent conference in Hickory started to address why — and how to find solutions.
In April, Hickory — a town of only 40,000 — was rated fifth in the nation for opioid abuse. People were understandably upset. So on October 14th, some 350 clinicians, providers and concerned citizens gathered at a summit on the subject at the Hickory Metro Convention Center.
Their conclusions? One huge gap in the treatment of substance abuse involves the treatment of co-occurring mental health issues. That situation is referred to as a dual diagnosis, and it’s really common. Think, for instance, about mental health patients who can’t sleep well. They may begin to use pain pills to knock themselves out — and you can imagine from there.
Our public health system isn’t set up to treat dual diagnosis very well. For one thing, specialists tend to concentrate on one problem or the other, not both at the same time. And in rural areas — which is most of the state — it can be difficult to find one mental health provider within a convenient driving distance, much less two.
Some say this problem may be compounded by the recent consolidation of the state’s LME/MCOs, the organizations that treat mental health and substance abuse patients who are on Medicaid. They’ve gone from eight regional centers down to four. The fear now is that rural patients will be left with fewer local treatment options, so they’ll have to figure out how to travel even further to get the help they need.
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