Attached, Addicted, and Adrift: Understanding the Rural Opioid Crisis

The United States has an opioid abuse problem. Addressing it remains an intractable challenge, particularly in rural areas. This article proposes that an attachment theoretical orientation helps conceptualize why rural states appear to be vulnerable and suggests solutions. A de-identified clinical case study woven throughout the article illustrates the concepts and complexities. The functional importance of attachment is outlined and then applied to addiction. Finally, rurality is defined and described. In keeping with social work’s person-in-environment (PIE) perspective of understanding the individual in context, attachment concepts are applied to rurality. Considering rural opioid use through the PIE frame, applying attachment theory both individually and systemically provides a compelling model for approaches to social work practice addressing rural opioid addiction