Rural Project Examples: Illicit drug use

Evidence-Based Examples

keepin' it REAL Rural

Updated/reviewed March 2026

• Need: A drug and alcohol prevention program for middle school students that is specific to rural culture.
• Intervention: An adaptation of the evidence-based keepin' it REAL curriculum was customized for rural middle school students.
• Results: Students showed a reduction in all substance use and less personal acceptability of substance use.

Effective Examples

Vermont Hub-and-Spoke Model of Care for Opioid Use Disorder

Updated/reviewed November 2025

• Need: In the early 2010s, needed increase access to medication treatment for opioid use disorder in rural Vermont.
• Intervention: 2012-2016 implementation of a statewide hub-and-spoke treatment access system.
• Results: The original system's increased treatment capacity and care coordination successes now are a permanent system of integrated care overseen by the Vermont state health department and Vermont Blueprint for Health.

Other Project Examples

Arukah Institute's Living Room Program

Added December 2023

• Need: To address high rates of substance use in Princeton, Illinois and the surrounding area.
• Intervention: The Arukah Institute, a local nonprofit organization providing mental health services, adapted a statewide model to provide support and a safe space for people in need of substance use resources.
• Results: The Living Room program had 1,485 visits in its first year, with 100% of clients served by recovery support specialists.