Rural communities are taking different approaches to addressing the stigma associated with substance
use disorder (SUD) and behavioral health care. In small rural communities where there is little
anonymity, people with an SUD may not seek treatment due to the stigma
associated with asking for help and receiving health services. Some rural SUD programs are integrating
behavioral health services into primary care settings, which allows patients to receive
behavioral health screenings and referrals during their regularly scheduled primary care visits. If
the behavioral health and primary care services function in a co-location
patients can also receive behavioral health services at their primary care location, instead of
traveling to a separate location.
of substance use also contributes to stigma for those with SUD. Some rural communities are addressing
stigma by educating community members about the causes of SUD and enacting Good
Samaritan protections at the local level. These protections may help to reduce concerns about the
legal implications of calling for emergency medical services or helping someone who is overdosing.
Further, rural programs are conducting cultural sensitivity trainings and providing technical
assistance to healthcare providers to help them support people with SUDs.
Community Action Guide suggests four action steps to help address SUD-related stigma in rural
Understand the portfolio of SUD research to mitigate stigma and support evidence-based treatment.
Educate the community about the science of SUDs by disseminating resources and educational
Create and implement a tailored marketing plan to reduce stigma. Understand the stigma concerns,
the best way to reach the community, and create a campaign to address stigma.
Disseminate positive recovery stories to support the recovery community.
Resources to Learn More
of Interventions for Reducing Stigma Related to Substance Use Disorders: A Systematic Review
Outlines studies exploring how to reduce substance use disorder-related stigma. Includes information
about reducing self-stigma and social stigma.
Authors: Livingston, J., Milne, T., Lan Fang, M., & Amari, E.
Citation: Addiction, 107(1), 39-50
Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma
Analysis of how stigma relates to SUDs, including effective
communication regarding stigma, approaches to reducing stigma, and recommendations.
Organization: National Academies of Sciences, Engineering, and Medicine
Community Action Guide: Building Stronger, Healthy, Drug-Free Rural Communities
Review of the impact of addiction in rural communities,
prevention, treatment, and recovery. Contains a section by Addiction Policy Forum on "Moving Beyond
Stigma in Rural Communities."
Organization: The Office of National Drug Control Policy