One mother's story helps show how recovery from addiction, difficult anywhere, is even harder in much of rural Kentucky

Megan Simpson works after group class at Living Clean transitional

housing in Manchester. She recently completed peer support training

and passed her certification test. She started as a peer support specialist

in Corbin and is scheduled to go to court in April to regain custody of

her three children. (Photo by Silas Walker, Lexington Herald-Leader)

Kentucky Health News

The continuing struggle of Megan Simpson of Manchester helps show the difficulty that rural and small-town Kentuckians have getting treatment for substance-use disorder.

Simpson's story of addiction, treatment, relapse and recovery has been told in two long installments by Liz Moomey of the Lexington Herald-Leader. The latest appeared Sunday, along with a story by Moomey about the limited access that rural Kentuckians have to treatment.

She reports, "In many rural areas, resources are often few and far between to get treatment and return to life after recovery. Sober living housing is scarce. Transportation is limited. Childcare is sparse. Broadband internet for telehealth appointments or for virtual recovery meetings is unreliable."

“Many people don’t have all those stars aligned and they have a very difficult path ahead of them,” said Matt Brown, Addiction Recovery Care’s senior vice president of administration, who "struggled with substance use disorder for 18 years," Moomey writes. "He considers himself fortunate to have a wife who stayed with him through his addiction, an education and a job."

Rural areas not only lack a choice of providers for counseling and treatment, there is a lack of anonymity in small towns, Moomey notes, quoting Brown: “Everybody knows everything.”

The Kentucky Access to Recovery program of the nonprofit Federation of Appalachian Housing Enterprises, a 37-county program that "connects participants recovering from opioid-use disorder or stimulant use disorder to housing, childcare, dental care, transportation and other services," Moomey writes. 

KATR map via Herald-Leader, adapted by Kentucky Health News; to enlarge, click on it.

Aaron Brown, a Western Carolina University professor who researched the issue and KATR, "said the types of jobs available and the benefits provided are more limited in rural areas," Moomey reports. From his research on rural areas, good-paying jobs were often more taxing and didn’t always provide the option to take off work to participate in recovery opportunities."

Brown told Moomey that the ideal recovery model has these steps: medical detoxification, inpatient rehabilitation and a sober living facility with intensive outpatient services, such as group and individual treatment. But that's not always realistic in rural areas "because of lack of services and health professional shortages," Moomey writes.