With rural opioid deaths now outnumbering urban deaths, representatives of the United States Department of Agriculture (USDA) recently came to Lincoln to hold a roundtable discussion on what can be done to combat this growing nationwide problem.

While Nebraska has a relatively low rate of addiction, members of law enforcement, lawmakers, health experts and the insurance industry agreed at the roundtable that they must remain vigilant.

“We’re here to make sure it doesn’t become an issue in Nebraska,” said Karl Elmshaeuser, USDA’s Nebraska director of rural development.

The state’s Prescription Drug Monitoring Program (PDMP) has made it easier for doctors and pharmacies to communicate when a patient receives an opioid prescription. But the lack of electronic prescribing in some rural areas has made it hard to track how many times a prescription is filled.

The Drug Enforcement Administration said rural residents are also using the internet to purchase opioids from foreign countries.

Lawmakers have tried to address the problems with prescription limits for anyone under age 18, requiring a photo ID and educating providers on what to look for.

Still, rural hospitals like Fillmore County Hospital in Geneva want more coordination. Administrators told the USDA that Highway 81 has provided easy access to those seeking opioids after emergency room visits. With emergency rooms having access to the PDMP, staff could find out what drugs a patient is already taking or to report opioid fraud.

Then there are treatment issues. Blue Valley Behavioral Health warns the stigma around addiction must change.

“Treatment should be seen as an act of love instead of a punishment,” said Eric Thomalla, Blue Valley Behavioral Health substance abuse counselor. “Addiction is not a selfish act.”

As part of our efforts to combat opioid misuse, Blue Cross and Blue Shield of Nebraska has adopted Centers for Disease Control (CDC) guidelines that support not prescribing opioids as first or second lines of pain therapy in most clinical situations.

“It will take coordination at every level—hospitals, providers and law enforcement—to keep the opioid crisis at bay,” said Dr. Debra Esser, Blue Cross and Blue Shield of Nebraska’s chief medical officer. “We will continue to educate our providers and members about the dangers of using opioids.”

USDA funding is available for opioid initiatives in rural Nebraska, including promoting telemedicine treatment and health care provider training.