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Rural Health
Resources by Topic: Substance use and misuse

Effectiveness of Syringe Services Programs
Presents a literature review of the studies evaluating SSP interventions across the country. Report aims to evaluate the overall efficacy of SSPs at reducing the transmission of HIV/HCV. Four of the 100 studies were conducted in completely rural settings, and 5 were conducted in both rural and urban settings. Makes recommendations for VA policy makers.
Additional links: Appendices, Executive Summary
Author(s): Katherine M. Mackey, Erin H. Beech, Beth E. Williams, et al.
Date: 12/2023
Type: Document
Sponsoring organization: VA Health Services Research & Development Service
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Use of Primary Care and Emergency Departments for Substance Use Treatment: The Rural and Urban Divide
Explores the use of primary care and emergency departments for substance use treatment in rural and urban areas. Draws from the National Survey on Drug Use and Health from 2015-2019 and breaks down data by age, race, and rurality, among other measures.
Author(s): Nathaniel Albright, Christina Dyar, Ethan Morgan
Citation: Substance Use & Misuse, 59(2), 300-305
Date: 12/2023
Type: Document
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Changes in Perceptions of First Responders after Witnessing a Drug Overdose: Individual and Contextual Variations among People Who Use Opioids in West Virginia
Evaluates changes in attitude toward first responders among people who witnessed an overdose and stayed until first responders arrived. Utilizes interview data from 50 nonmedical users of prescription opioids from 3 rural Appalachian West Virginia counties. Identifies personal and contextual factors associated with changed perceptions of first responders.
Author(s): Kathleen L. Egan, Kelly Gurka, Alexandria Macmadu, Herb Linn
Citation: Journal of Appalachian Health, 5(3), 22-37
Date: 12/2023
Type: Document
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Disparities in Mortality Between Appalachian and Non-Appalachian Regions of Kentucky
Compares all-cause, drug-related, and opioid-related mortality in Kentucky, with breakdowns by metropolitan/nonmetropolitan and Appalachian/non-Appalachian counties. Utilizes 2000-2019 CDC WONDER mortality data. Identifies mortality trends, and discusses related demographic, geographic, and socioeconomic factors.
Author(s): Sonali S. Salunkhe, Sahal Alzahrani, Beatrice Ugiliweneza
Citation: Journal of Appalachian Health, 5(3), 38-52
Date: 12/2023
Type: Document
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2023 - 2028 Oklahoma State Health Improvement Plan
Offers overview of Oklahoma resident health indicators and improvement goals with specific focus on social determinants of health, mental health, substance use, obesity, diabetes, and cardiovascular disease. Notes statewide resources and assets for each indicator. Includes a health inequity map at the census tract level.
Date: 12/2023
Type: Document
Sponsoring organization: Oklahoma State Department of Health
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Differences in Buprenorphine Prescribing Readiness Among Primary Care Professionals With and Without X-Waiver Training in the US
Examines readiness of primary care providers (PCPs) to prescribe buprenorphine to patients with opioid use disorder (OUD). Analyzes PCP knowledge of and confidence in buprenorphine, attitudes toward patients with OUD, and stress and/or empathy toward patients with OUD. Utilizes survey data from 403 PCPs in Ohio and discusses the challenges of addressing OUD in rural contexts.
Author(s): Berkeley Franz, Lindsay Y. Dhanani, O. Trent Hall, et al.
Citation: Harm Reduction Journal, 20, 180
Date: 12/2023
Type: Document
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High-Risk Individuals and Naloxone Use: Implications for THN Programs in Rural Appalachian Communities
Presents thematic analysis of factors influencing opioid overdose and naloxone use from interviews with 16 people who use opioid drugs in 4 rural, Appalachian Pennsylvania counties. Identifies opioid overdose risk factors, including substance use habits, as well as factors facilitating or preventing effective naloxone interventions. Covers naloxone access and knowledge, experiences, attitudes toward first responders, and disconnects between naloxone intervention and opioid dependence treatment.
Author(s): Victor Garcia, Lisa McCann, Erick Lauber, et al.
Citation: Journal of Appalachian Health, 5(3), 9-21
Date: 12/2023
Type: Document
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Rural and Urban Differences in Disparities in Substance Use and Substance Use Disorders Affecting Sexual Minority Populations
Examines substance use (SU), substance use disorders (SUD), and SUD treatment in heterosexual and sexual minority populations. Analyzes 2015 to 2019 National Survey on Drug Use and Health data with information broken down by demographics, SU, and large metro, small metro, or nonmetro location.
Author(s): Christina Dyar, Ethan Morgan
Citation: Journal of Rural Health
Date: 12/2023
Type: Document
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Retention in Telehealth Treatment for Opioid Use Disorder Among Rural Populations: A Retrospective Cohort Study
Highlights a study on the efficacy of telehealth-based treatment of opioid use disorder (OUD) for rural populations. Draws patient data from 2020-2022 across 14 states and breaks down data by patient characteristics, such as insurance status, education, and rurality, among other measures. Explores retention in care and adherence over a 6 month treatment period.
Author(s): Marlene C. Lira, Cynthia Jimes, M. Justin Coffey
Citation: Telemedicine and e-Health, 29(12), 1890-1896
Date: 12/2023
Type: Document
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Oversight Hearing titled, "Fentanyl in Native Communities: Federal Perspectives on Addressing the Growing Crisis"
Recording of a Congressional hearing addressing fentanyl among Native communities. Includes testimony from federal officials discussing previous efforts and future priorities for solving the opioid crisis. Subtitles available in the video player.
Additional links: Adam W. Cohen Testimony, Glen Melville Testimony, The Honorable Roselyn Tso Testimony, The Honorable Vanessa Waldref Testimony
Date: 12/2023
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Indian Affairs
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