A Phenomenological Study of Barriers and Needs Related to Opioid Prevention, Treatment, and Recovery in Rural Alabama

Rural areas with limited access to preventive care, treatment, and recovery services are particularly affected by the opioid crisis. This study identified four rural areas in Alabama that had higher opioid prescription rates than the state and national average. This study explores the views of three groups [healthcare service providers, persons who use/used opioids (PWUO), and community stakeholders] on the barriers to and needs for opioid prevention, treatment, and recovery services using a phenomenological qualitative design. Purposeful and snowball sampling was used to recruit 95 participants across 12 focus groups which were audio-recorded and transcribed verbatim. A seven-member analysis team conducted a directed content analysis using a semi-structured script and seeded themes with a rigorous plan to promote trustworthiness. Regardless of group type, commonly identified barriers and needs related to rural locality, financial factors, cultural norms, and stigma among others. Prominent needs included education and healthcare coordination. Findings suggest recommendations for community and provider interventions to address the knowledge gaps and recovery needs. They also supported the suitability of the Telehealth Extension for Community Healthcare Outcomes, a videoconferencing tool that networks multidisciplinary experts and professionals around specialty topics, as a promising intervention to increase training among providers.