State of Addiction in Florida

Rural Florida Substance Problems

Based on the 2010 Census published by the Florida Department of Health, there are 30 rural counties in the state of Florida. To be considered a rural county, the county must have a population density of less than 100 residents per square mile, and the average rural county had a population density of 45.1 in 2010.

Rural counties dot the state of Florida and often include a different population demographic than urban counties do. For instance, the Rural Health Information Hub (RHI hub) publishes that rural counties are often plagued with high unemployment and poverty rates, and low levels of education. These factors, combined with isolation, can contribute to high-risk behaviors, including drug and alcohol abuse. Residents in rural counties are often less likely to be insured as well, and residents may then be less likely to seek medical or mental health services.

Rural counties are often considered Health Professional Shortage Areas (HPSAs), meaning that there are not enough medical and specialty providers in close enough proximity to residents. Rural Florida residents may have to travel out of the county they reside in to obtain services. The Rural Health Plan Update, February 2009 reports that substance abuse treatment needs were ranked as the third highest unmet need among consumers.

Drugs are not only an issue within inner cities; they are prevalent in rural areas as well. Addiction treatment can improve communities, families, and individuals’ overall quality of life and wellbeing. Fortunately, there are options for residents of rural Florida to find and obtain treatment for drug abuse and addiction.

Rural Florida and High-Risk Behaviors

 Alcohol is also a factor in motor vehicle crashes and deaths. In Walton County, the rate for alcohol-related crashes is 162.0 per 100,000 population compared to the state average of 89.9 per 100,000 population. The rate for alcohol-related crash fatalities was 13.2 per 100,000 in Walton County as opposed to a state average rate of 8.4 per 100,000 population.

Rural communities in Florida are often agricultural, which may contribute to illicit drug cultivation and manufacturing. Methamphetamine production and abuse are often associated with rural communities. The wide-open spaces and lack of nearby neighbors may allow for the presence of more clandestine laboratories and illegal activities.

The North Florida High Intensity Drug Trafficking Area (HIDTA), which includes several rural counties, including Baker and Columbia, cites cocaine, methamphetamine, heroin, marijuana, and prescription drugs as drugs of concern in the area, according to the Drug Market Analysis 2009. Marijuana growing operations and small-scale methamphetamine production are some of the more common drug production operations in the North Florida HIDTA and rural Florida, often run by Mexican drug cartels and drug trafficking organizations (DTOs).

Just like in other parts of the state, opioid drug abuse is an issue in rural Florida.

Controlled prescription opioids were widely dispensed through “pill mills” throughout Florida, and shady doctors contributed to the opioid abuse epidemic that the country is facing today. As pill mills were shut down due to increased law enforcement efforts, and drugs like OxyContin (oxycodone) were reformulated and became less easily accessible for recreational use, other opioids started rising up. For example, Opana (oxymorphone) abuse increased after OxyContin was reformulated and became especially prevalent in rural communities. Additionally, Reuters reports that residents of rural communities are twice as likely to overdose on prescription pills than urban residents.

Heroin and fentanyl abuse is up in Florida as well. The Guardian publishes that there was a spike in overdose deaths related to the two potent opioids between 2014 and 2015. Heroin is often a cheap alternative to controlled prescription opioids while fentanyl, which is around 50 times more potent than heroin and thus deadly in much smaller amounts, can be synthesized in illicit laboratories. Fentanyl may be used to “cut” and “stretch” heroin to make the product go further. It is also pressed into fake prescription pill resembling Xanax (alprazolam), sometimes called “death pills.” People buying these products may be unaware of what they are getting; thus, they run a high risk of suffering from a life-threatening overdose.

Florida Prescription Drug Abuse Stats

The United States has struggled with prescription drug abuse in various forms for decades. The most recent epidemic predominantly involves prescription narcotic painkillers, which are chemically similar to heroin. Since the early 2000s, these drugs have been widely prescribed to treat moderate to severe pain, in many cases with the intention that the individual would heal and stop taking them.

Unfortunately, greater access to opioid painkillers has led many Floridians to develop addictions to these drugs. With tighter restrictions on the prescription, diversion, and sale of opioid drugs, many of these individuals have turned to heroin rather than struggle to get oxycodone or hydrocodone drugs. Many people in Florida also struggle with addiction to other types of prescription substances, including benzodiazepines and stimulants.

Although the southern state’s Prescription Drug Monitoring Program (PDMP) and strict laws against pill mills have helped slow the increase in prescription drug addiction, there are still many people who suffer form this condition in Florida.

Florida’s Decade of Prescription Drug Abuse and Death

A report from National Public Radio (NPR) in 2011 stated that, at the time, Florida was the center of the US’s prescription drug abuse epidemic with opioids surfacing as the leading problem. In fact, areas of the state with severe opioid addiction and overdose problems were referred pejoratively to as “The Oxy Express,” largely due to the startling rise of pain management clinics that were essentially barely legal drug distribution fronts.

Since these reports surfaced, Florida has taken many steps to improve its prescription drug abuse problems. In March 2018, Governor Rick Scott signed the latest piece of legislation aimed at preventing people with prescription painkillers from developing an addiction to these substances with the help of pharmacists and physicians.

Unfortunately, the Sunshine State still battles prescription drug abuse and death. The Centers for Disease Control and Prevention (CDC) reports that, between 2015 and 2016, Florida was one of the states with a significant increase in drug overdose deaths. From the previous year’s stats, the state experienced a 46.3 percent increase, which was overshadowed only by Maryland’s increase of 58.9 percent. However, in the 2014-2015 measurements, Florida also saw a statistically significant increase with 22.7 percent more drug overdose deaths. In 2016, there were about 4,728 overdose deaths in the southern state; in 2015, there were 3,228 deaths; and in 2014, there were 2,634 deaths.

According to the Florida Department of Law Enforcement’s Medical Examiners Commission report for 2016, opioids and benzodiazepines were the two prescription drugs most commonly found in overdose deaths. Prescription versions of amphetamine and methamphetamine were not separated in the autopsy reports, and the only other prescription drug that caused deadly harm was zolpidem, the active medication in Ambien.

 The commission noted that prescription drugs, which they listed as benzodiazepines, carisoprodol/meprobamate, zolpidem, and all opioids aside from heroin and fentanyl, were more often the causes of or present at death than illicit drugs like cocaine, marijuana, or hallucinogens.