The epidemic of death and despair caused by heroin and prescription painkillers has hit every corner of the country, but it’s had a greater impact in poor, rural communities throughout the U.S.

New data from the Centers for Disease Control and Prevention show that, while the overall number of opioids dispensed dropped between 2010 and 2015, prescriber habits still vary widely from one county to the next. In 2015 — the year with the most recently available data — six times more opioids per resident were doled out in the highest-prescribing counties compared with the lowest-prescribing ones.

Many of those counties are in already-vulnerable rural areas, according to the CDC, characterized by small cities, a higher percentageof white residents, more uninsured and unemployed individuals, and higher instances of diabetes, arthritis and disability.

As the American Hospital Association notes, rural hospitals provide services to more than 54 million people across the country, including about 9 million Medicare beneficiaries. Because they serve more patients on Medicare and have fewer resources, rural hospitals are hit hard by cuts in government spending.

“What we know, with respect to the incidence and prevalence of substance abuse, particularly opioids, in rural communities is that it’s reached crisis levels in many states,” says John Supplitt, senior director of the AHA’s Section for Small or Rural Hospitals. “And so, many are concerned that their intervention programs for substance abuse, mental health and addiction specialties are going to be cut. That would be devastating to the rural communities that already have scarce resources.”

That’s one reason why the AHA is hosting a Rural Hospital Policy Forum today in D.C. with Sen. Chuck Grassley (R-Iowa) and officials from the Health Resources and Services Administration as a means to advocate for critical rural payment programs that are set to expire. The AHA is also urging rural hospital leaders in attendance to schedule time with their elected officials to voice their concerns.

If you couldn’t make it to the forum, Supplitt says it’s still crucial that you reach out to elected officials by phone or email. “It’s very important for rural hospital leaders — and that means the CEO and board of trustees — to engage and work with their members of Congress in both the House and Senate to make them understand how vulnerable the rural health care safety net is to cuts to Medicaid in their states.” You can find a few key resources in this fight on this AHA webpage, including the association’s rural advocacy agenda, rural-related bills that are in the works, and alerts about the latest developments.

There’s also help elsewhere if your small or rural hospital is feeling the pinch from the opioid epidemic. HRSA, for one, has a Rural Health Opioid Program that’s providing grants of $250,000 per year to help expand the delivery of opioid-related health care services in vulnerable communities. Applications are due Friday.   

And in the previously mentioned CDC publication, the centers have tips on how your organization can begin turning the opioid tide. Those include implementing programs to improve provider prescribing practices, harnessing data to identify “high-risk” prescribing habits, and increasing access to medication-assisted treatment for those with addictions. You can also check out H&HN’s past coverage on this topic for more info.