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Rural Health
Resources by Topic: Illicit drug use

The Opioid Epidemic: A Geography in Two Phases
Examines population and geographic data on 2 phases of the U.S. opioid epidemic. Examines the association between overdose deaths and chronic pain, physical disability rates, and economic hardship. Discusses the shift from overdose mortality associated with prescription opioids to illicit and synthetic opioids in the early 2010s, including in rural areas and the Northeastern U.S.
Additional links: Report Summary
Author(s): David A. McGranahan, Timothy S. Parker
Date: 04/2021
Type: Document
Sponsoring organization: USDA Economic Research Service
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Addressing Opioid-Related Outcomes Among Individuals With Co-Occurring Behavioral Health Conditions: An Environmental Scan of Quality Measures
Presents the results of an environmental scan of healthcare quality measures relevant to addressing polysubstance use among individuals with co-occurring behavioral health conditions. Includes information on access to buprenorphine providers in rural communities.
Date: 04/2021
Type: Document
Sponsoring organization: National Quality Forum
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Expanding Access to Methadone Treatment in Ohio Through Federally Qualified Health Centers and a Chain Pharmacy: A Geospatial Modeling Analysis
Examines the provision of methadone at opioid treatment programs (OTP) in Ohio. Compares how well existing OTPs meet the need for opioid use disorder treatment by urban-rural classification. Explores how expanding methadone administration to Federally Qualified Health Centers (FQHCs) could expand access to OUD treatment in urban and rural areas.
Author(s): Suzan Iloglu, Paul J. Joudrey, Emily A. Wong, Thomas A. Thornhill, Gregg Gonsalves
Citation: Drug and Alcohol Dependence, 220, 108534
Date: 03/2021
Type: Document
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An Examination of Telehealth Policy Impacts on Initial Rural Opioid Use Disorder Treatment Patterns During the COVID‐19 Pandemic
Explores changes in the patterns of medication for opioid use disorder (MOUD) in western North Carolina during the COVID-19 pandemic. Examines the impact of telehealth policy changes during the pandemic on the patient population seen for MOUD, access to MOUD services for rural patients, overall MOUD clinic volume, and changes to the provision of MOUD.
Author(s): Phillip M. Hughes, Genevieve Verrastro, Carriedelle Wilson Fusco, Courtenay Gilmore Wilson, Bayla Ostrach
Citation: Journal of Rural Health, 37(3), 467-472
Date: 03/2021
Type: Document
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Urban–Rural Differences in Drug Overdose Death Rates, 1999–2019
Examines age-adjusted drug overdose deaths in urban and rural counties. Includes urban-rural data on overdose deaths overall and for selected types of opioids and stimulants from 1999 through 2019. Identifies states with higher overdose deaths in rural counties, higher rates in urban counties, and states with no significant difference between rural and urban overdose death rates.
Author(s): Holly Hedegaard, Merianne Rose Spencer
Date: 03/2021
Type: Document
Sponsoring organization: National Center for Health Statistics
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Traffic Safety in Appalachia: Final Report
Defines the traffic safety culture in Appalachia and discusses causes of common safety problems in the region, including drug- and alcohol-impaired driving. Explores environmental concerns of Appalachian drivers, such as expansive rural regions, mountainous and curved terrain, and dense forests exposed to extreme weather elements. Includes analysis of Appalachian traffic fatalities, fatal crash data statistics, and an evaluation of the Appalachian Development Highway System as a possible intervention measure for treating traffic safety problems. Also includes a case study of severe crashes in Appalachian North Carolina, featuring statistics with breakdowns by rural and urban areas.
Additional links: Research Brief
Author(s): Wesley Kumfer, Katherine Harmon, Bo Lan, et al.
Date: 02/2021
Type: Document
Sponsoring organization: Appalachian Regional Commission
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Opioid and Substance Use Strategies for Critical Access Hospitals
Recording of a February 26, 2021, webinar discussing the role of Critical Access Hospitals (CAHs) in addressing opioid and substance use disorders (O/SUDs) in local systems of care. Provides a framework to support CAH opioid and substance use initiatives. Highlights examples of O/SUD activities taken by CAHs and offers lessons learned.
Additional links: Presentation Slides
Date: 02/2021
Type: Video/Multimedia
Sponsoring organization: Flex Monitoring Team
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Projected Estimates of Opioid Mortality After Community-Level Interventions
Presents a study on the effectiveness of different evidence-based practices to prevent opioid overdose mortality in simulated rural and urban communities. Highlights data by evidence-based practice and by projected rural and urban population group, which is broken down by age, sex, and opioid injection versus non-injection.
Author(s): Benjamin P. Linas, Alexandra Savinkina, R. W. M. A. Madushani, et al.
Citation: JAMA Network Open, 4(2), e2037259
Date: 02/2021
Type: Document
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Opioid-Related Visits to Rural Emergency Departments
Explores the impact of the opioid crisis on rural emergency departments (EDs) by analyzing 2006 and 2013 Nationwide Emergency Department Sample (NEDS) data. Compares opioid-related ED visits in rural and urban hospitals by type of opioid involved and year. Breaks down data by patient characteristics, comorbid diagnosis at admission, and outcome of ED visit.
Author(s): Erika C. Ziller, Jean A. Talbot, Deborah Thayer, Carly Milkowski
Date: 02/2021
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Opioid-Related and Stimulant-Related Adult Inpatient Stays, 2012-2018
Presents statistics on inpatient hospital stays related to the dependence, abuse, and adverse effects of opioids and stimulants between 2012 and 2018. Examines data by patient characteristics, including age, sex, race/ethnicity, urban or rural location of residence, and income.
Date: 02/2021
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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