Rural Project Examples Addressing Substance use and misuse

Cross-Walk: Integrating Behavioral Health and Primary Care

Updated/reviewed May 2024

Need: To address and treat substance use disorder (SUD) and depression in the Upper Great Lakes region.
Intervention: Cross-Walk, a program that integrates behavioral healthcare into primary care services, was developed in Michigan's Marquette County.
Results: The collaborative efforts strengthened care management services in local healthcare facilities as primary care patients were referred to a behavioral health specialist.

Updated/reviewed April 2023

Need: To improve the health and well-being of young people in the rural area of Massachusetts's Franklin County and North Quabbin, and to reduce youth drug and alcohol use.
Intervention: A community-based prevention coalition was formed to improve youth health and well-being and reduce youth drug and alcohol use use. The coalition brings together stakeholders from across the community and uses the Communities That Care evidence-based community planning system.
Results: CTC has seen significant reductions in substance abuse among local youth in the 30 rural towns they serve.

Updated/reviewed June 2022

Need: To reduce smoking rates of pregnant women and adolescents in Appalachian regions of eastern Kentucky and Ohio.
Intervention: A web-based smoking cessation program that offered monetary incentives to reducing smoking.
Results: Participants significantly reduced smoking rates or quit altogether.

Updated/reviewed May 2025

Need: To provide affirming, destigmatized healthcare and support to thousands of Tennesseans living with HIV/AIDS, mental illness, substance use disorder, and homelessness – and prevention services for individuals at risk of contracting HIV.
Intervention: Positively Living & Choice Health Network provides services including a medical clinic, pharmacy, therapy, case management, client services like housing aid and transportation, HIV prevention, and a harm reduction program.
Results: The program currently serves 5,000 individuals and families through its offices in Knoxville, Chattanooga, Memphis, and Cookeville and its mobile medical unit for rural communities in Cocke and Claiborne counties.

Updated/reviewed April 2025

Need: To provide housing and recovery services for rural Kentuckians dealing with substance use.
Intervention: Recovery Kentucky has 8 rural locations and provides apartments within a congregate living environment and an opportunity to begin recovery from substance use disorder in a structured, peer-led 12-step environment.
Results: The rural and urban centers serve up to 2,200 people annually. An independent university-led resident outcome evaluation showed significant improvements in clients' drug and alcohol use, housing and employment status, decrease in criminal justice improvement, and improved health and mental health.

Updated/reviewed March 2025

Need: To connect people in need in Allegany County, Maryland, to health and human services and to items like hygiene products, food, and clothing.
Intervention: The Possibility Shop partners with health organizations, insurance navigators, food banks, and other agencies.
Results: In 2024, 15,246 service encounters occurred and 940 intakes to services were performed.

Updated/reviewed December 2024

Need: To reduce stigma around mental illness and substance use in North Carolina.
Intervention: The Beaufort County Behavioral Health Task Force created the Riverfront Talks: Substance Matters podcast to interview people with lived experience.
Results: As of December 2024, the podcast has 11 episodes.

Updated/reviewed November 2024

Need: To help people who use drugs and their families access treatment and counseling in rural Missouri.
Intervention: The CMH Addiction Recovery Program provides medication-assisted treatment, counseling, peer and family support, and other related services through a Rural Health Clinic.
Results: The program operates 5 days a week and sees 400 patients each month.

Updated/reviewed November 2024

Need: To support pregnant and parenting women with a history of substance use, mental health, or co-occurring disorders in rural areas of Montana.
Intervention: One Health, a consortium of Federally Qualified Health Centers (FQHCs), developed a team of "recovery doulas" – individuals who are dual-certified as doulas and peer-support specialists. The One Health recovery doula program offers group and individual services to women and their partners from pregnancy through the first years of parenthood.
Results: A team of nine recovery doulas (or doulas-in-training) employed by One Health offer services in 13 rural Montana counties. Recovery doulas have provided essential support to women with substance use disorder, survivors of sexual abuse, unhoused individuals, and individuals facing other complex challenges.

Added November 2024

Need: To reduce barriers to employment for people in substance use recovery in Marinette County, Wisconsin.
Intervention: An initiative in which community members in recovery train local employers in recovery friendly workplace guidelines and provide recovery coaching to employees.
Results: One business in Marinette County has been fully trained, and more than 50 people in recovery have been referred to the Wisconsin Department of Workforce Development's Worker Connection Program in the program's first year.