Developing a Framework to Reduce Overdose and Deliver Positive Change for People Who Use Psychostimulants in Rural Environments During COVID-19

Overdose deaths involving people who use psychostimulants (PWUP) are increasing across rural America. In 2019, of the 30,173 Americans who lost their lives to psychostimulants, those in rural areas had the highest age-adjusted rate of psychostimulant-involved overdose death. The increase in psychostimulant-related death occurs in tandem with an even more dramatic upsurge in opioid-related deaths. While psychostimulant use alone can cause fatal toxicity, opioids are now involved in most psychostimulant overdoses. This has only worsened during the COVID-19 pandemic due to (1) unpredictability in the drug supply, (2) isolation and mental distress, and (3) interruption of harm reduction, medications for opioid use disorder, contingency management, behavioral health, recovery, and other key services. The result has been a jump in psychostimulant-related overdoses following 2020’s lockdowns. Despite dramatic increases in psychostimulant death, many rural service providers are still not providing PWUP the tools needed to stay alive.

In this session, technical experts and Health Resources and Services Administration (HRSA) representatives will discuss evidence-based interventions that keep people alive and reduce their health and legal risks while using psychostimulants. Law enforcement will weigh in on promising partnerships using discretion, diversion, post-overdose response programs, and legal reforms to link PWUP to care without their incurring criminal consequences that impact their long-term well-being. HRSA will discuss promising early results from programs serving PWUP through its fall 2021 investment of $7,500,000 in the RCORP-Psychostimulant Support Program, which strengthens and expands prevention, harm reduction, treatment, and recovery services for rural PWUP.