Rural Health
Resources by Topic: Substance use and misuse
Illegally Made Fentanyl Use in the United States: 2022 and 2023
Report highlights findings from the 2022 and 2023 National Survey on Drug Use and Health (NSDUH) on the use of illegally made fentanyl across the U.S. Explores co-usage with other drugs, emergency room visits/hospitalizations, and breaks down user characteristics by age, poverty level, and rurality, among other measures.
Citation: NSDUH Data Brief, 2(2)
Date: 07/2025
Sponsoring organizations: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration
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Report highlights findings from the 2022 and 2023 National Survey on Drug Use and Health (NSDUH) on the use of illegally made fentanyl across the U.S. Explores co-usage with other drugs, emergency room visits/hospitalizations, and breaks down user characteristics by age, poverty level, and rurality, among other measures.
Citation: NSDUH Data Brief, 2(2)
Date: 07/2025
Sponsoring organizations: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration
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Report to Congress on Medicaid and CHIP, June 2025
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations related to transitions from pediatric to adult care for Medicaid-covered children and youth with special health care needs (CYSHCN). Also discusses appropriate access to residential behavioral health treatment services for children, findings from MACPAC's analytic work on access to medications for opioid use disorder (MOUD) in Medicaid, an overview on the Program of All-Inclusive Care for the Elderly, and self-direction for Medicaid home- and community-based services. Includes rural references throughout.
Date: 06/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations related to transitions from pediatric to adult care for Medicaid-covered children and youth with special health care needs (CYSHCN). Also discusses appropriate access to residential behavioral health treatment services for children, findings from MACPAC's analytic work on access to medications for opioid use disorder (MOUD) in Medicaid, an overview on the Program of All-Inclusive Care for the Elderly, and self-direction for Medicaid home- and community-based services. Includes rural references throughout.
Date: 06/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Rural Access to Certified Community Behavioral Health Clinics (CCBHCs)
Examines access to, and services offered by, Certified Community Behavioral Health Clinics (CCBHCs) in rural and urban communities. Also compares services at CCBHCs with those offered at other mental health clinics. Features state-level maps showing CCBHC counts by state, and statistics on services counts in CCBHCs and other mental health facilities, with breakdowns by urban and rural areas.
Author(s): Aaron P. Smith, Jeffrey Talbert
Date: 05/2025
Sponsoring organization: Rural and Underserved Health Research Center
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Examines access to, and services offered by, Certified Community Behavioral Health Clinics (CCBHCs) in rural and urban communities. Also compares services at CCBHCs with those offered at other mental health clinics. Features state-level maps showing CCBHC counts by state, and statistics on services counts in CCBHCs and other mental health facilities, with breakdowns by urban and rural areas.
Author(s): Aaron P. Smith, Jeffrey Talbert
Date: 05/2025
Sponsoring organization: Rural and Underserved Health Research Center
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Impact of Alcohol Use Disorder on Inpatient Hospitalizations: A Comparison of Outcomes Between Urban and Rural Veterans Affairs Hospitals
Analyzes Veterans Health Administration hospital admissions data from 2016 to 2020 to determine the burden of alcohol use disorder on 129 rural and urban hospitals. Data shows break down of patient characteristics, hospital characteristics, and admissions characteristics. Discusses mortality and the potential impact of COVID-19.
Author(s): James Willey, Peter Kaboli, Andrea Holcombe, et al.
Citation: Journal of Hospital Medicine, 20(5), 463-470
Date: 05/2025
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Analyzes Veterans Health Administration hospital admissions data from 2016 to 2020 to determine the burden of alcohol use disorder on 129 rural and urban hospitals. Data shows break down of patient characteristics, hospital characteristics, and admissions characteristics. Discusses mortality and the potential impact of COVID-19.
Author(s): James Willey, Peter Kaboli, Andrea Holcombe, et al.
Citation: Journal of Hospital Medicine, 20(5), 463-470
Date: 05/2025
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Controlled Substance Prescribing Patterns Among Fatal Overdose Decedents with an Opioid, Stimulant, or Both Contributing to Death — Pennsylvania, 2017–2022
Reports on deaths involving opioids without stimulants, deaths involving stimulants without opioids, and deaths involving both opioids and stimulants in Pennsylvania between 2017 and 2022. Includes data for rural and urban areas. Discusses the role of opioid prescribing on overdose deaths.
Author(s): Stephanie Hayden, Stanley M. Murzynski, Ashley Bolton, Carrie Thomas Goetz
Citation: MMWR (Morbidity and Mortality Weekly Report), 74(12), 205-209
Date: 04/2025
Sponsoring organization: Centers for Disease Control and Prevention
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Reports on deaths involving opioids without stimulants, deaths involving stimulants without opioids, and deaths involving both opioids and stimulants in Pennsylvania between 2017 and 2022. Includes data for rural and urban areas. Discusses the role of opioid prescribing on overdose deaths.
Author(s): Stephanie Hayden, Stanley M. Murzynski, Ashley Bolton, Carrie Thomas Goetz
Citation: MMWR (Morbidity and Mortality Weekly Report), 74(12), 205-209
Date: 04/2025
Sponsoring organization: Centers for Disease Control and Prevention
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The Rural and Urban Supply of Clinicians With a DEA Waiver to Prescribe Buprenorphine in 2022 Prior to the Elimination of the Waiver Requirement
Report explores the differences in rates of clinicians with DEA waivers to prescribe buprenorphine in 2022 in rural versus urban counties. Highlights the rural gaps in access to buprenorphine to treat opioid use disorder prior to the elimination of the DEA waiver requirement in 2023. Provides rural, urban, and regional comparisons.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Report explores the differences in rates of clinicians with DEA waivers to prescribe buprenorphine in 2022 in rural versus urban counties. Highlights the rural gaps in access to buprenorphine to treat opioid use disorder prior to the elimination of the DEA waiver requirement in 2023. Provides rural, urban, and regional comparisons.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Synthetic Opioid and Stimulant Co-Involved Overdose Deaths by Occupation and Industry — United States, 2022
Examines occupations and industries with higher percentages of psychostimulant involvement in synthetic opioid overdose deaths. Includes information on occupations such as mining and farming, fishing, and forestry that are more common in rural areas.
Author(s): Eric W. Lundstrom, Alexandria Macmadu, Andrea L. Steege, Matthew Groenewold
Citation: MMWR (Morbidity and Mortality Weekly Report), 74(10), 173–178
Date: 03/2025
Sponsoring organization: Centers for Disease Control and Prevention
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Examines occupations and industries with higher percentages of psychostimulant involvement in synthetic opioid overdose deaths. Includes information on occupations such as mining and farming, fishing, and forestry that are more common in rural areas.
Author(s): Eric W. Lundstrom, Alexandria Macmadu, Andrea L. Steege, Matthew Groenewold
Citation: MMWR (Morbidity and Mortality Weekly Report), 74(10), 173–178
Date: 03/2025
Sponsoring organization: Centers for Disease Control and Prevention
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Enhancing Rural Access to Medications for Opioid Use Disorder: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Assessing the Needs of Rural Families Affected by the Opioid Crisis: Issue Brief and Recommendations to the Secretary
Explores the considerations for addressing social determinants of health that influence opioid use disorder (OUD) and the role of community efforts in prevention, treatment, and recovery in rural areas, with a focus on prevention efforts in Las Vegas, New Mexico. Discusses youth and family prevention and well-being; stigma; adverse childhood experience; school-based health centers and youth and family resource centers; access to stable housing, food, and other social supports; the importance of trusted community resources for support; and workforce. Offers recommendations related to reducing stigma and promoting the enhanced utilization of the Community Services Block Grant (CSBG) to help rural communities address OUD and substance use disorders.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Explores the considerations for addressing social determinants of health that influence opioid use disorder (OUD) and the role of community efforts in prevention, treatment, and recovery in rural areas, with a focus on prevention efforts in Las Vegas, New Mexico. Discusses youth and family prevention and well-being; stigma; adverse childhood experience; school-based health centers and youth and family resource centers; access to stable housing, food, and other social supports; the importance of trusted community resources for support; and workforce. Offers recommendations related to reducing stigma and promoting the enhanced utilization of the Community Services Block Grant (CSBG) to help rural communities address OUD and substance use disorders.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Opioid Use Among Rural Medicare Beneficiaries
Examines trends in prescription opioid use among Medicare beneficiaries in rural areas, utilizing 2010-2017 Medicare Current Beneficiary Survey (MCBS) data. Provides data on receipt of opioid prescriptions among community-dwelling and facility-dwelling beneficiaries, associations between prescribing and chronic overlapping pain conditions (COPCs), and prescriptions exceeding CDC guidelines. Includes rural-urban comparisons.
Author(s): Yvonne Jonk, Heidi O'Connor, Karen Pearson, et al.
Date: 01/2025
Sponsoring organization: Maine Rural Health Research Center
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Examines trends in prescription opioid use among Medicare beneficiaries in rural areas, utilizing 2010-2017 Medicare Current Beneficiary Survey (MCBS) data. Provides data on receipt of opioid prescriptions among community-dwelling and facility-dwelling beneficiaries, associations between prescribing and chronic overlapping pain conditions (COPCs), and prescriptions exceeding CDC guidelines. Includes rural-urban comparisons.
Author(s): Yvonne Jonk, Heidi O'Connor, Karen Pearson, et al.
Date: 01/2025
Sponsoring organization: Maine Rural Health Research Center
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