Older Adults and Opioid Education: Lessons Learned From Experiences in Rural Arkansas

Nearly one-third of all Medicare participants were prescribed an opioid by their physician in 2015 (AARP, 2017) and in 2017, Arkansas had the 2nd highest opioid prescribing rate in the nation (CDC, 2019). Approaching older adults (OA) about opioids and pain management can be a sensitive topic. Educating and altering long-term treatment with opioids is especially challenging in rural areas where literacy, especially health literacy, is suboptimal. The Arkansas Geriatric Education Collaborative (AGEC) is a HRSA Geriatric Workforce Enhancement Program with an objective to improve health outcomes including an emphasis to decrease the misuse and abuse of opioids among older Arkansans. To address this crisis, the AGEC partnered with local leaders such as the AR Drug Director, academia, Department of Health and Human Services, and multiple community based organizations to create age-tailored educational programs. Unique aspects of approaching and educating rural OA about opioids and pain management will be reviewed. Outcomes will be discussed such as their lack of knowledge about: what is an opioid, why they were prescribed, and what are viable alternatives. Also discussed will be lessons learned that resulted in more effective methods of reaching and teaching rural OA. Partnering with the AR Farm Bureau helped the AGEC reach 100’s of farmers in the extremely rural and mostly agricultural areas. Learning to not use the word opioid resulted in more participants and in a more positive attitude and outlook on attempts to change the culture of opioid use, misuse and abuse among older Arkansans.

Sowing Discontent

In 1921 New Mexicans approved a constitutional amendment that prohibited “aliens ineligible for citizenship” from owning land in the state. Reflecting the post-World War I nationalistic fervor and its racialization of “Americanism,” the amendment targeted the state’s tiny Japanese population, partly under pressure from institutions like the Farm Bureau, the American Legion, and even the Ku Klux Klan. While some Hispanos (or Nuevomexicanos) benefited by claiming an exclusionary “Spanish American” identity, others had worked alongside and intermarried with Japanese immigrants. Yet, although some predominantly Nuevomexicano counties rejected the amendment, many Nuevomexicanos joined with their Anglo neighbors to enact this discriminatory policy, ostensibly on the grounds of protecting the state from a huge influx of foreign farmers who would displace the state’s real citizens. The discriminatory language remained in the constitution until 2006.

Special Collections to Digitize Historic Tobacco and Crop Science Materials

Thanks to support from the North Carolina Farm Bureau, the North Carolina Tobacco Foundation, and the North Carolina Research Commission, the NCSU Libraries' Special Collections Research Center will construct, enhance, and maintain the “Living Off the Land” Web site. The site will provide digital access to collections of rare and unique items on tobacco and crop science history in North Carolina dating from 1850 through 1950. Tobacco has figured prominently not only in the economy of the state, but also in its culture, from colonial times to the present. Agricultural history is a frequent area of interest for researchers and visitors alike to North Carolina's cultural repositories. Completion of this project will result in expanded access to the resources available for the study of the state's tobacco and crop science history.