The “Regulatory Fog” of Opioid Treatment

Over 300,000 Americans depend on opioid treatment programs (OTPs), commonly known as methadone clinics, as the sole source of substances used to reduce their addictive cravings for prescription opioid and heroin. Though considered creatures of the federal regulatory process, OTPs are also regulated by state and local authorities and are required to maintain accreditation. The result of this complex and multi-layered regulation is a focus on rule and process, not on client outcomes or program performance. This research explores the effectiveness of state regulation within the context of “regulatory fog” in which the very regulations intended to standardize provision of services may obscure the true value of policies

Mental Well-Being of Black, Latino, and Women Farmers in Georgia

Farming is a stressful occupation associated with increased anxiety and depression; it consistently ranks as having the highest death rate caused by stress-related and psychiatric conditions. Georgia farmers die by suicide at higher rates than non-farmers in the state. The Georgia Agricultural Census (2017) reports that the majority of farmers in the state are older (57.9), white (95%), and male (66%). Current literature shows a link between race, gender, and stress, with stress, disproportionally impacting historically marginalized people. This study aimed to understand the mental well-being of Black, Latino, and Women farmers in Georgia by exploring stressors, time spent worrying, negative affect, suicidal ideation, job satisfaction, and the mechanisms used to cope. We also examined health care access, including mental health care, and what barriers the farming community faces in accessing care. The results of this analysis will help public health professionals develop mental health prevention and intervention initiatives that are informed by and specific to historically marginalized farmers. keywords: farmer, mental health, mental well-being, Black Farmers, Latino Farmers, Women Farmer

Stress and Suicidal Ideation Among First-Generation Farmers: A Cross-Sectional Study with 1,288 Farmers in GA

Background: The suicide rate among farmers is much higher than that of the overall working population. Literature on farmer mental health in Georgia has been scarce and mostly focused on farmer suicide. Literature that does focus on stressors or coping, are mostly qualitative studies. This study looks at the influence of being a first-generation farmer on farm-related stressors and coping mechanisms.Methods: This cross-sectional study inventories mental well-being, stressors, and coping mechanisms for different types of farmers in GA, USA. The online survey ran from January 2022 through April 2022. Participants (N=1,281) were asked demographics, household composition, work descriptors, healthcare access, specific stressors, stress levels, and coping mechanisms.Results: Two-thirds of our sample consisted of first-generation farmers. First-generation farmers had a higher stress score on average, as well as being more likely to feel scared to lose the farm, feel unhappy with their role, feel lonely, feel sad or depressed, and feel hopeless. They also showed less diverse coping mechanisms than generational farmers, while having alcohol in their top 3 of coping mechanisms for stress. They were more likely to draw/paint or meditate, and to kick or hit themselves/objects. Alarmingly, first-generation farmers were also much more likely to have suicidal ideation: 9% daily, and 61% at least once in the past year (vs generational: 1% daily; 20% once in the past year). Binary logistic regression indicated that having more diverse coping mechanisms is a protective factor against suicidal ideation within the previous year. The same model indicated that being farm owner, or farm manager, being first generation, being unhappy with one’s role, feeling sad or depressed, and feeling hopeless were all risk factors.Conclusion: First-generation farmers experience more stress and exhibit more risk factors than generational farmers, even though farming in general is already a stressful occupatio