Corresponding Author

Laurie L. Meschke, PhD


Author Affiliations

Ashlyn N. Schwartz

Public Health, The University of Tennessee, Knoxville, TN

ORCID iD: 0000-0002-2359-6893

Zeruiah V. Buchanan

Arizona Health Care Cost Containment System, Phoenix, Arizona

Laurie L. Meschke

Public Health, The University of Tennessee, Knoxville, TN

ORCID iD: 0000-0002-9019-9927

Author Area of Expertise

Ashlyn Schwartz: Substance Use Disorders

Zeruiah Buchanan: Community Health

Laurie Meschke: Community Based Participatory Research; Substance Use Disorders


Introduction: Appalachia, particularly Rural East Tennessee, has been and continues to be disproportionately impacted by opioid use disorder and its many tragic ramifications.

Purpose: Community-engaged strategies can inform and support the development of relevant prevention efforts. Hence, people connected to a ten-county rural Appalachian region in East Tennessee were asked to identify and prioritize strengths and challenges related to opioid use disorder (OUD).

Methods: Adult community members (n=577) completed a brief survey administered across 11 days in 2019.

Results: Of the respondents, 85.3% never had been addicted to opioids, but 74.0% had someone close to them with OUD. The most frequently selected community strength was support for people with OUD to seek help and the most frequently selected challenge was lack of treatment and recovery services. People with personal OUD experience reported significantly higher mean levels of OUD-related stigma compared to persons without such experience.

Implications: The number of respondents indicates a local concern and commitment related to OUD in rural Appalachia. The findings prioritized areas of focus—both in needs to be addressed and strengths on which to capitalize. These community insights will guide the selection and development of OUD-related overdose prevention for this region.



Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

Schwartz AN, Buchanan ZV, Meschke LL. Community strengths and challenges related to opioid use disorder in rural counties of East Tennessee. J Appalach Health 2022;4(1):20–30. DOI: https://doi.org/10.13023/jah.0401.04.