Members of Piedmont CRUSH, including Rappahannock Rapidan Community Services Executive Director Jim LaGraffe (right) pose with Office of National Drug Control Policy Director Jim Carroll (center) during a recent visit to Washington, D.C.

Culpeper area community leaders continue to pursue multi-level collaboration in battling drug addiction, a complex illness that keeps plaguing the region, state and country.

An entourage representing Piedmont CRUSH—Community Resources United to Stop Heroin—recently traveled to Washington, D.C., for the launch of the Rural Community Resource Guide distributed by the Office of National Drug Control Policy.

The 97-page guide—at—includes background data, action steps and promising practices for a range of issues related to drug addiction in rural America.

In attendance for its launch was Rappahannock-Rapidan Community Services Executive Director Jim LaGraffe and fellow Piedmont CRUSH board members and Warrenton Town Councilman Sean Polster, Orange County Director of Social Services Director Crystal Hale, Andy Johnson with PATH Foundation and Fauquier Fire Chief Darren Stevens.

“One of the largest takeaways from the meeting was that we as a community really need to work at overcoming the stigma of a substance abuse disorder, both from a community leadership perspective and from an individual treatment perspective,” LaGraffe said.

The Rural Community Action Guide aims to empower local leaders to meet the challenges of developing effective responses to the disease of addiction, Office of National Drug Control Policy Director Jim Carroll said in a prepared statement.

“The Trump Administration’s whole-of-government approach includes partnering with those on the front lines of this fight, and we will continue supporting local leaders to build healthy and safe communities for all Americans,” he said.

The action guide is specifically for rural leaders combatting drug addiction in their communities, said Anne Hazlett, a White House senior advisor for rural affairs. The document includes sections identifying the faces of addiction, impacts of addiction on rural communities, prevention, treatment and recovery.

The Office of National Drug Control Policy developed the guide with rural stakeholders, including the American Farm Bureau Federation and National Farmers Union. Its companion supplement, listing best practices nationwide, is the Rural Community Action Guide: Promising Practices.

The companion document names a few Virginia programs among best practices, including the PROmoting School-community-university Partnerships to Enhance Resilience (PROSPER) program in Southwest Virginia that works to prevent alcohol and drug misuse among youth. A High Risk Patient Education Program, also in place in Southwest, educates patients who receive opioids and their families about the dangers of the drugs and what to do in the case of an overdose.

The companion document also named among best practices nationwide the Veritas Adult Drug Treatment Court in the city of Bristol, a 12- to 18-month program for adult criminal offenders dependent on drugs or alcohol. In Culpeper County, the commonwealth’s attorney’s office is working with others in local government and the justice system to implement a drug court here, starting in 2021.

According to the Rural Community Resource Guide, more than 70,000 Americans died in 2017 from a drug overdose; rural communities have been particularly hard hit, according to Carroll.

“While no two rural communities are the same, there are promising practices gleaned from rural leaders in one town that can be replicated in another,” he stated in the Guide’s introduction.

From 1999 to 2015, drug overdose deaths in rural counties jumped 325 percent, compared with 198 percent in metropolitan areas, according to the Guide. Stigma, as LaGraffe mentioned, prevents many people in rural America from seeking and accepting help.

“Once people get treatment, there is a substantial need for better connection to recovery support, such as stable housing, employment and job training, education, medical services, transportation and childcare in a manner that takes into account the infrastructure challenges inherent in many rural places,” the Guide states.

The first section addresses moving beyond the stigma of drug use, noting more than 20 million Americans struggle with it. However, about half of the population does not believe addiction is a disease, even though it clearly is.

Addiction is a chronic, relapsing disorder affecting brain tissue function, including in the cortex, which houses impulse control and decision making abilities. Brain scans show that parts of the brains impaired by addiction can improve during recovery, the Guide stated: “Stigma will fade in the face of education about the negative impacts of untreated addiction on families and communities and increase the likelihood that those who need help can access it.”

Employment, access to high-speed internet and transportation are all key to maintaining one’s sobriety in rural America, the Guide stated, mentioning Cooperative Extension as one tool in the belt of prevention along with chronic pain self-management and Mental Health First Aid education and training, as has been offered frequently in the Culpeper area.

The Guide also addresses drug use in the farming community, noting 74 percent of farmers and farm workers are or have been directly impacted by illicit opioid use. “Making drug courts work for rural America” is also addressed along with the long road to recovery and the many options—many of which are not available in rural America.

Faith-based leaders should be part of the conversation, the Guide advises, also advocating for more recovery housing, including peer-based. The first peer recovery residence in Culpeper, an Oxford House, opened last month.

Asked about local addiction treatment options, LaGraffe mentioned last year’s opening in Culpeper of SaVida Health. Pinnacle Treatment Center may be opening an area location in the near future as well, he said. “We have availability of treatment, can always use more,” LaGraffe said, adding, “We really need to change mindsets.”

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