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Rural Response to the Opioid Crisis – Resources

Selected recent or important resources focusing on Rural Response to the Opioid Crisis.

Addressing Opioid Overdose Deaths: The Vision for the HEALing Communities Study
Highlights a study on the effect of the COVID-19 pandemic on the ongoing HEALing Communities Study (HCS), which began in 2019 with the goal of reducing opioid overdose deaths by 40% over 3 years. Discusses the intersection of the two crises across the country and discusses the variations in rural and urban locations.
Author(s): Redonna K. Chandlera, Jennifer Villani, Thomas Clarke, et al.
Citation: Drug and Alcohol Dependence, 217(1),
Date: 10/2020
Type: Document
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SAMHSA: Coronavirus (COVID-19)
Guidance and resources to help providers respond to COVID-19 while providing care and treatment of mental and substance use disorders. Includes guidance specific to opioid treatment programs.
Date: 10/2020
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Tracking FY2019 Federal Funding to Combat the Opioid Crisis
Report covering the allocation of federal resources for opioid initiatives at the federal, state, and local level. Presents data on federal funding and offers case studies of state and county-level spending data for Ohio, Arizona, Louisiana, Washington, Tennessee, and New Hampshire. Makes policy recommendations and briefly discusses grant initiatives that target rural-specific barriers to treatment.
Date: 09/2020
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Rural Variation of Medicaid Expansion on Access to Naloxone
Poster examining the rate of naloxone prescriptions dispensed by retail pharmacies between 2011 and 2017. Compares the rate of naloxone prescriptions before and after Medicaid expansion and as the rural population increased.
Author(s): Yue Cheng, Minji Sohn, Patricia R. Freeman,Eugene Shin, Chris Delcher
Date: 09/2020
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Results from the 2019 National Survey on Drug Use And Health: Detailed Tables
Presents data on use of illicit drugs, alcohol, and tobacco, trends in substance use disorder and mental health, and access to treatment for youth and adults. Features statistics for a variety of demographic and geographic characteristics, including rural versus urban status.
Date: 09/2020
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Nonfatal Drug and Polydrug Overdoses Treated in Emergency Departments — 29 States, 2018–2019
Reports on changes in rates and proportions of suspected nonfatal drug and polydrug overdoses treated in the emergency department (ED) between 2018 and 2019, based on data from 29 states. Includes data for urban and rural counties on ED visits for opioids, cocaine, amphetamines, and benzodiazepines, as well as for opioids in combination with each of the other types of drugs.
Author(s): Stephen Liu, Lawrence Scholl, Brooke Hoots, Puja Seth
Citation: MMWR (Morbidity and Mortality Weekly Report), 69(34), 1149-1155
Date: 08/2020
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Addressing Opioid Use in Rural Communities: Examples from Critical Access Hospitals
Highlights strategies adopted by Critical Access Hospitals (CAHs) to combat opioid use in their communities. Describes lessons learned from the featured CAHs regarding the development and implementation of projects targeting opioid use. Identifies ways that State Flex Programs and State Offices of Rural Health can support the efforts of CAHs in addressing opioid use in their communities. Provides list of opioid-related resources for CAHs and State Flex Programs.
Author(s): John Gale, Sara Kahn-Troster, Karen Pearson, Nathan First
Date: 08/2020
Type: Document
Sponsoring organization: Flex Monitoring Team
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The Opioid Crisis and the Hispanic/Latino Population: An Urgent Issue
Report highlights the opioid crisis in Hispanic/Latino populations. Details rates of illicit opioid use and prescription drug misuse, as well as overdose and death rates. Discusses measures taken in to provide treatment and prevention in Latino communities, including in rural and border areas.
Date: 07/2020
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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COVID-19 and Rural Harm Reduction Challenges in the U.S. Southern Mountains
Explores the relationship between drug use and COVID-19 infections in the Southern Mountains region of Appalachia. Highlights the changes caused by COVID-19 and the challenges harm reduction programs face in providing services, such as syringe exchanges, naloxone access, and COVID-19-related services.
Author(s): Bayla Ostrach, Lesly-Marie Buer, Sam Armbruster, et al.
Citation: Journal of Rural Health
Date: 07/2020
Type: Document
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Integrating Telemedicine for Medication Treatment for Opioid Use Disorder in Rural Primary Care: Beyond the COVID Pandemic
Discusses adapting expanded telehealth services used during the COVID-19 pandemic to provide treatment of opioid use disorder (OUD). Highlights the successes of telehealth expansion during COVID-19 and suggest ways it could be used to increase access to medication treatment for OUD.
Author(s): Yih-Ing Hser, Larissa J. Mooney
Citation: Journal of Rural Health
Date: 06/2020
Type: Document
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Social Determinants of Health and County Population Rates of Opioid-Related Inpatient Stays and Emergency Department Visits, 2016
Examines characteristics of U.S. counties, comparing counties with high and low rates of opioid-related inpatient stays and treat-and-release emergency department (ED) visits among patients 15 years and older. Includes data for metro, rural adjacent to metro, and rural remote counties, as well as by urban-rural location and poverty rate.
Additional links: Appendix
Author(s): Pamela L. Owens, Audrey J. Weiss, Marguerite L. Barrett, Lawrence D. Reid
Date: 06/2020
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Rural Community Toolbox: Funding & Tools to Build Healthy Drug-Free Rural Communities
Provides access to federal funding programs and information related to substance use disorder (SUD), including opioids, to help rural communities and stakeholders address SUD and issues related to SUD in their communities. Offers resources for technical assistance, training, treatment, and recovery support services for rural communities. Features a community assessment tool that provides county-level data on SUD and a resource guide that provides guidance and recommendations for communities to address SUD.
Additional links: Federal Rural Resource Guide
Date: 06/2020
Type: Website
Sponsoring organizations: U.S. Department of Agriculture, White House Office of National Drug Control Policy
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CMS Roadmap: Strategy to Fight the Opioid Crisis
An overview of the efforts the Centers for Medicare and Medicaid Services is undertaking to address the opioid epidemic. Highlights a three-pronged approach focusing on prevention, treatment, and data utilization to target prevention and treatment activities.
Date: 06/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Virtually Possible: Using Telehealth to Bring Reproductive Health Care to Women with Opioid Use Disorder in Rural Maine
Describes a program implemented by a Maine family planning clinic, in which HIV counseling, contraception, and pregnancy testing and counseling were made available to women with opioid use disorder (OUD) through meetings with a community educator and through telehealth. Explores challenges in receiving OUD care in rural Maine and discusses findings.
Author(s): Terri-Ann Thompson, Katherine A. Ahrens, Leah Coplon
Citation: mHealth
Date: 05/2020
Type: Document
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Hospital Burden of Opioid-Related Inpatient Stays: Metropolitan and Rural Hospitals, 2016
Examines burden on hospitals of opioid-related hospitalizations for metropolitan, rural-adjacent to metro, and rural remote hospitals. Includes data by region. Provides detailed information by urban-rural location, including information on the distribution of opioid-related stays, bed size, and occupancy level.
Author(s): Pamela L. Owens, Audrey J. Weiss, Marguerite L. Barrett
Date: 05/2020
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Pain in the Nation Update: Alcohol, Drug, and Suicide Deaths in 2018
Report details updated rates of deaths related to drugs, alcohol, and suicide for 2018. Breaks down data by race, age, and regionally, including rural versus metro areas.
Date: 05/2020
Type: Document
Sponsoring organization: Trust for America's Health
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Improving Access to Evidence-Based Medical Treatment for Opioid Use Disorder: Strategies to Address Key Barriers Within the Treatment System
Presents a study on the barriers to evidence-based treatment for opioid use disorder (OUD). Identifies nine common barriers to evidence-based care for people with OUD, including stigma, workforce training, and financial barriers, among others. Includes rural references throughout.
Author(s): Bertha K. Madras, N. Jia Ahmad, Jenny Wen, et al.
Citation: NAM Perspectives
Date: 04/2020
Type: Document
Sponsoring organization: National Academy of Medicine
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Tackling the Trifecta: State Approaches to Addressing Co-Occurring Substance Use Disorders, HIV, and Hepatitis C
Highlights the approaches to addressing co-occurring substance use disorder, HIV, and HCV in New York, West Virginia, and Louisiana. Breaks down data in each state by gender and details considerations for rural areas.
Author(s): Eliza Mette, Jodi Manz, Kristina Long
Date: 04/2020
Type: Document
Sponsoring organization: National Academy for State Health Policy
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Rural and Urban Differences in Primary Care Pain Treatment by Clinician Type
Explores the differences in opioid prescribing patterns of nurse practitioners and primary care physicians in both rural and urban areas. Also compares physical therapy referrals by location and clinician type.
Author(s): Hannah Neprash, Laura Barrie Smith, Shailendra Prasad, Bethany Sheridan, Katy Kozhimannil
Date: 04/2020
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Hospital Inpatient Stays Related to Opioid Use Disorder and Endocarditis, 2016
Examines inpatient stays for adults 18 years and older related to opioid use disorder (OUD) and endocarditis, stays related to OUD but not endocarditis, and stays related to endocarditis but not OUD. Includes data by patient location for metropolitan, rural adjacent to metro, and rural remote areas.
Author(s): Audrey J. Weiss, Kevin C. Heslin, Carol Stocks, Pamela L. Owens
Date: 04/2020
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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The Opioid Crisis and Community-Level Spillovers onto Children's Education
Presents a study on the link between the opioid epidemic and children's educational outcomes. Evaluates community-level resources for handling the opioid crisis and how that correlates with educational outcomes, specifically in rural and underserved areas.
Author(s): Rajeev Darolia, John Tyler
Date: 04/2020
Type: Document
Sponsoring organizations: Brookings Institute, Brown Center on Education Policy
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COVID-19 During the Opioid Epidemic – Exacerbation of Stigma and Vulnerabilities
Explores how the lack of healthcare infrastructure in rural areas and the COVID-19 pandemic create particular challenges for people who use drugs (PWUDs). Discusses the stigma of seeking care during a pandemic and the difficulty of accessing living resources, among other issues affecting PWUDs in rural areas.
Author(s): Wiley D. Jenkins, Rebecca Bolinski, John Bresett, et al.
Citation: Journal of Rural Health
Date: 04/2020
Type: Document
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A Primary Care Response to COVID‐19 for Patients with an Opioid Use Disorder
Discusses the challenges of treating patients with opioid use disorder (OUD) during the COVID-19 pandemic. Highlights decisions made by primary care physicians regarding harm reduction related to COVID-19 that may have detrimental effects for OUD patient.
Author(s): Courtenay Gilmore Wilson, Melinda Ramage, E. Blake Fagan
Citation: Journal of Rural Health
Date: 04/2020
Type: Document
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Rural Health Care and Medicaid Telehealth Flexibilities, and Guidance Regarding Section 1009 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (Pub. L. 115-271), entitled Medicaid Substance Use Disorder Treatment via Telehealth
Discusses the benefits of utilizing telehealth services to expand access to Medicaid services in rural areas and the flexibility states have in covering these services. Provides guidance on options states have to receive federal reimbursement for substance use disorder treatments provided via telehealth services.
Date: 04/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Nonfatal Drug Overdoses Treated in Emergency Departments — United States, 2016–2017
Examines nonfatal overdoses for all drugs, all opioids, nonheroin opioids, heroin, benzodiazepines, and cocaine. Looks at changes from 2016 to 2017, with data by drug type, patient, facility, and visit characteristics. Includes data by county urbanization level for metropolitan and nonmetro counties.
Author(s): Alana M. Vivolo-Kantor, Brooke E. Hoots, Lawrence Scholl, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 69(13), 371-376
Date: 04/2020
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Federal SUD/OUD Resources and Funding Opportunities in Support of Rural Communities
Highlights the slides of several breakout sessions from the 2020 RCORP conference discussing funding and resources pertaining to opioid use disorder in rural communities. Features presentations from representatives of the Department of Labor, Bureau of Justice Assistance, Appalachian Regional Commission, Bureau of Health Workforce, and the Federal Transit Administration.
Additional links: Agenda, Session 2 Presentations
Date: 03/2020
Type: Document
Sponsoring organization: Rural Communities Opioid Response Program - Technical Assistance
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Your Recovery Is Important: Virtual Recovery Resources
Information providers and programs can share with people in recovery, to help them find virtual support options for recovery from mental and substance use disorders. Includes resources to help recovery programs create virtual meetings.
Date: 03/2020
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Drug and Opioid-Involved Overdose Deaths — United States, 2017–2018
Examines drug overdose deaths involving all opioids, prescription opioids, heroin, and synthetic opioids other than methadone. Includes data by county urbanization level for metropolitan and nonmetro counties.
Author(s): Nana Wilson, Mbabazi Kariisa, Puja Seth, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 69(11), 290-297
Date: 03/2020
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Addressing Rural Substance Use with the RCORP Rural Centers of Excellence
Webinar recording discusses the Rural Communities Opioid Response Program (RCORP) - Rural Centers of Excellence on Substance Use Disorder grantees' efforts to curb substance use disorder in rural communities. Highlights the ways RCORP - RCOEs are implementing measures to prevent and expand access to treatment for substance use disorders.
Additional links: Audio Recording, PowerPoint Handout, Webinar Transcript
Date: 03/2020
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Medications for Opioid Use Disorder: The Treatment Improvement Protocol (TIP) 63
Details guidelines for implementing medication assisted treatment (MAT) of opioid use disorder (OUD) for healthcare professionals, policymakers, patients, and families. Discusses the different medications available to treat OUD, how and when to administer them, as well as what to watch for when using MAT for OUD.
Date: 02/2020
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Rural-Urban Differences in Hospitalizations for Opioid Use-Associated Infective Endocarditis in the United States, 2003-2016
Using 2003-2016 National Inpatient Sample data compares trends between rural and urban populations in hospitalization for opioid use-associated infective endocarditis, a serious heart infection that can result from injection drug use.
Author(s): E Katherine Nenninger, Jenny L Carwile, Katherine A Ahrens, Brett Armstrong, Kinna Thakarar
Citation: Open Forum Infectious Diseases, 7(2)
Date: 02/2020
Type: Document
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National Drug Control Strategy
Report highlights the White House's overall strategy for controlling drug use across the country. Addresses prevention, education, and prescribing practices, as well as increasing access to treatment in rural, tribal, and underserved areas.
Date: 02/2020
Type: Document
Sponsoring organization: The White House Office of National Drug Control Policy
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Socioeconomic Risk Factors for Fatal Opioid Overdoses in the United States: Findings from the Mortality Disparities in American Communities Study (MDAC)
Highlights a study that correlates demographic and socioeconomic status with opioid overdose fatalities. Draws data from the Mortality Disparities in American Community Study (MSAC) and compares results by rural/nonrural residence, race, employment, and educational attainment, among other measures.
Author(s): Sean F. Altekruse, Candace M. Cosgrove, William C. Altekruse, Richard A. Jenkins, Carlos Blanco
Citation: PLoS One, 15(1)
Date: 01/2020
Type: Document
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Geographic Disparities Affect Access to Buprenorphine Services for Opioid Use Disorder
Results of a national study to determine the patient capacity of healthcare providers who received waivers to prescribe buprenorphine and the extent to which they were located in rural or urban areas with high rates of opioid abuse. Features county-level maps showing rates of patient capacity and counties with high need for treatment services, as of 2018.
Author(s): Christi A. Grimm
Date: 01/2020
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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A Public Health Emergency: State Efforts to Curb the Opioid Crisis
Presents the U.S. House of Representatives Energy and Commerce Committee hearing on the outcomes of public health efforts to combat the opioid crisis. Features testimony from representatives of the Rhode Island Department of Health, the Massachusetts Department of Public Health, the North Carolina Department of Health and Human Services, the West Virginia Department of Health and Human Resources, and the Pennsylvania Department of Drug and Alcohol Programs.
Date: 01/2020
Type: Video/Multimedia
Sponsoring organization: House Energy and Commerce Committee
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Rural Community Action Guide: Building Stronger, Healthy, Drug-Free Rural Communities
Provides an overview of challenges rural communities face related to substance use disorder (SUD), including prescription opioid misuse. Identifies action steps rural communities can take related to prevention, treatment, recovery, and SUD-related issues such as stigma, transportation barriers, and lack of employment opportunities. Features programs that are working to address these issues in rural communities.
Additional links: Promising Practices Supplement
Date: 01/2020
Type: Document
Sponsoring organization: Office of National Drug Control Policy (ONDCP)
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Opioid Use Disorder: Barriers to Medicaid Beneficiaries' Access to Treatment Medications
Examines Medicaid beneficiaries' access to medication-assisted treatment (MAT) for opioid use disorder. Identifies state and federal policies that can impose barriers to MAT medications. Highlights how 3 states and the District of Columbia are addressing these barriers. Discusses challenges to medication deliveries to rural and small practices and access to addiction medicine providers in rural areas.
Additional links: Full Report
Date: 01/2020
Type: Document
Sponsoring organization: Government Accountability Office
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Trends in Opioids Prescribed at Discharge From Emergency Departments Among Adults: United States, 2006–2017
Examines trends in emergency department (ED) discharge opioid prescribing for adults from 2006–2007 through 2016–2017. Provides data by selected patient and hospital characteristics and the type of opioids prescribed. Table 1 includes data on the percent of ED patients prescribed an opioid at discharge by location of patient residence for metropolitan and nonmetropolitan areas.
Author(s): Pinyao Rui, Loredana Santo, Jill J. Ashman
Date: 01/2020
Type: Document
Sponsoring organization: National Center for Health Statistics
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Annual Surveillance Report of Drug-related Risks and Outcomes, 2019
Summarizes latest information on opioid prescribing, drug use, and overdose mortality from 2018-2019. Features statistics with breakdowns by large metropolitan, small metropolitan, non-metropolitan urbanized, non-metropolitan less urbanized, and completely rural. Highlights notable differences in the report from 2018 to 2019.
Date: 2020
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Stem the Tide: Opioid Stewardship Measurement Implementation Guide
Identifies best practices for hospitals and health systems to use data to improve opioid stewardship. Addresses six elements that can support facilities through implementing a data-driven opioid stewardship program. Provides a list of quality improvement measures for hospitals and health systems to track progress. Highlights a consortium of providers serving rural communities across Minnesota, North Dakota, and Wisconsin focused on access to treatment and interventions that address social determinants of health.
Date: 2020
Type: Document
Sponsoring organization: American Hospital Association
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DEA COVID-19 Information Page
Guidance for DEA-registered telehealth practitioners to issue prescriptions for controlled substances to patients for whom they have not conducted an in-person medical evaluation, for the duration of the COVID-19 public health emergency.
Date: 2020
Type: Website
Sponsoring organizations: Drug Enforcement Administration, U.S. Department of Justice
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Opportunities to Improve Opioid Use Disorder and Infectious Disease Services: Integrating Responses to a Dual Epidemic
Examines opioid use and drug-related infectious diseases. Identifies the barriers to integration of opioid use disorder (OUD) and infectious disease services, including barriers faced in rural areas such as workforce shortages. Offers strategies to overcome those barriers. Offers case studies of programs that have successfully integrated services, including programs serving rural areas. Includes policy recommendations.
Additional links: Read Online, Report Highlights
Author(s): Board on Population Health and Public Health Practice
Date: 2020
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Migration to the US among Rural Puerto Ricans Who Inject Drugs: Influential Factors, Sources of Support, and Challenges for Harm Reduction Interventions
Details a study of the migration patterns of rural people who inject drugs (PWID) from Puerto Rico to the United States. Breaks down data by age, gender, and HIV and HCV status among other measures.
Author(s): R. Abadie, P. Habecker, C. Gelpi-Acosta, K. Dombrowski
Citation: BMC Public Health, 19, 1710
Date: 12/2019
Type: Document
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A Systematic Review of Rural-specific Barriers to Medication Treatment for Opioid Use Disorder in the United States
Analyzes a number of studies looking at medication-assisted treatment (MAT) for opioid use disorder in rural areas. Explores barriers to accessing MAT in rural areas and makes rural and urban comparisons.
Author(s): Jamey J. Lister, Addie Weaver, Jennifer D. Ellis, Joseph A. Himle, David M. Ledgerwood
Citation: The American Journal of Drug and Alcohol Abuse
Date: 12/2019
Type: Document
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Comparison of Rural vs Urban Direct-to-Physician Commercial Promotion of Medications for Treating Opioid Use Disorder
Results of a cross-sectional county-level study using all reported direct-to-physician pharmaceutical payments from manufacturers of opioid use disorder medications from 2014-2017, as well as demographic and economic data from 3,140 counties. Features statistics with breakdowns by metropolitan, micropolitan, and rural areas.
Author(s): Thuy Nguyen, Barbara Andraka-Christou, Kosali Simon, W. David Bradford
Citation: JAMA Network Open, 2(12)
Date: 12/2019
Type: Document
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The Impact of the Opioid Epidemic on the Aging Services Network and the Older Adults They Serve
Report highlights the results of a survey of National Council on Aging (NCOA) grantees and partners on the effect of the opioid epidemic on older adults. Details the percentage of respondents from rural areas and offers recommendations and resources to address the epidemic among the aging population.
Date: 12/2019
Type: Document
Sponsoring organization: National Council on Aging
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Creating a Consortium to Combat the Opioid Epidemic in Ohio
Highlights a program formed to address the opioid crisis in five counties in Ohio. Discusses the use of the Federal Office of Rural Health Policy's Rural Communities Opioid Response Program (RCORP) to form a hub-and-spoke consortium of state, county, and community partners.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 11/2019
Type: Document
Sponsoring organization: Rural Health Information Hub
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Characterizing the Rural Opioid Use Environment in Kentucky Using Google Earth: Virtual Audit
Presents a study on the reliability of using Google Earth to track physical environment data correlating with rural opioid use. Examines data drawn from 5 rural counties in Kentucky using Google Earth between 2017 and 2018.
Author(s): Natalie Danielle Crawford, Regine Haardöerfer, Hannah Cooper, et al.
Citation: Journal of Medical Internet Research, 21(10), e14923
Date: 10/2019
Type: Document
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The Opioid Hydra: Understanding Overdose Mortality Epidemics and Syndemics Across the Rural-Urban Continuum
Documents the trends in drug overdose mortality by opioid type along the rural‐urban continuum. Identifies the opioid overdose mortality epidemics and opioid syndemic mortality rates by core-based statistical area (metropolitan and non-metropolitan county). Discusses the socioeconomic indicators including demographic, drug risk, and economic characteristics of communities affected by the different classes of opioid overdose epidemics.
Author(s): David J. Peters, Shannon M. Monnat, Andrew L. Hochstetler, et al.
Citation: Rural Sociology, 2019, 1-3
Date: 10/2019
Type: Document
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Analysis of Buprenorphine Prescribing Patterns Among Advanced Practitioners in Medicaid
Presentation slides from an October/November 2019 public meeting, describing the effects of the Comprehensive Addiction and Recovery Act of 2016 on access to opioid use disorder treatment for Medicaid beneficiaries. Includes information on urban and rural trends in prescribing.
Author(s): John Wedeles
Date: 10/2019
Type: Presentation Slides
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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SORH Response to the National Substance Use Disorder Crisis
Looks at the role of State Offices of Rural Health (SORHs) in state-level substance use disorder and opioid use disorder initiatives. Highlights the activities of SORHs in several states as case studies and details the lessons learned in those states.
Date: 10/2019
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Addressing a Crisis: Cross-Sector Strategies to Prevent Adolescent Substance Use and Suicide
Report discusses different methods for adolescent substance use and suicide prevention. Highlights rates of suicide and substance use, such as binge drinking, misuse of pain medication, and vaping. Explores differences in rates for youth in rural and urban areas.
Date: 10/2019
Type: Document
Sponsoring organization: Trust for America's Health
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Electronic Prescribing of Controlled Substances among Office-Based Physicians, 2017
Examines rates of electronic prescribing of controlled substances (EPCS), with information by type of physician practice, including rural or urban location, practice size, practice ownership, physician specialty, and technology available. EPCS is mandated for Medicare Part D providers by 2021, through the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.
Author(s): Sonal Parasrampuria, Martin Blanco, Wesley Barker
Date: 09/2019
Type: Document
Sponsoring organization: Office of the National Coordinator for Health Information Technology
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Needs Assessment Methodologies in Determining Treatment Capacity for Substance Use Disorders: Final Report
Presents the results from an environmental scan reviewing the literature on needs assessment methods and substance use disorder (SUD) needs assessment reports representing diverse interests, including rural and urban areas, researchers, government agencies, and private consultants. Highlights best practices for conducting SUD needs assessments, identifies gaps and opportunities for improvement in the available data, and discusses why SUD needs assessments are necessary.
Date: 09/2019
Type: Document
Sponsoring organizations: Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy, U.S. Department of Health and Human Services
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State Strategies to Address Opioid Use Disorder Among Pregnant and Postpartum Women and Infants Prenatally Exposed to Substances, Including Infants with Neonatal Abstinence Syndrome
Identifies state strategies to improve outcomes for pregnant and postpartum women with opioid use disorder and infants prenatally exposed to substances, including opioids. Discusses strategies focused on access to and coordination of quality services, including approaches such as telemedicine that are useful in rural areas. Also discusses strategies related to provider awareness and training and other topics.
Author(s): Charlan D. Kroelinger, Marion E. Rice, Shanna Cox, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 68(36), 777-783
Date: 09/2019
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Dismantling Buprenorphine Policy Can Provide More Comprehensive Addiction Treatment
Commentary focused on the impact buprenorphine prescribing policy has on access to opioid addiction treatment. Discusses the lack of providers waivered to prescribe buprenorphine in rural areas. Includes a map showing counties that lack providers who can prescribe medications for opioid use disorder.
Author(s): Alex E. Woodruff, Mary Tomanovich, Leo Beletsky, et al.
Date: 09/2019
Type: Document
Sponsoring organization: National Academy of Medicine
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Acceptability of Safe Drug Consumption Spaces among People Who Inject Drugs in Rural West Virginia
Presents a study on the acceptability of safe consumption spaces among people who inject drugs in rural West Virginia. Breaks down data by demographic data, overdoses, and drugs used, among other characteristics.
Author(s): Allison O'Rourke, Rebecca Hamilton White, Ju Nyeong Park, et al.
Citation: Harm Reduction Journal, 16, 51
Date: 08/2019
Type: Document
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Doctor Hopping and Doctor Shopping for Prescription Opioids Associated with Increased Odds of High‐risk Use
Presents a study on doctor hopping by people with opioid use disorder. Defines doctor hopping, a variant of doctor shopping, and uses data from the Arkansas Prescription Drug Monitoring Program to illustrate the behavior and its outcomes. Compares doctor hopping and doctor shopping in both rural and urban areas.
Author(s): Sean G. Young, Corey J. Hayes, Jonathan Aram, Mark A. Tait
Citation: Pharmacoepidemiology and Drug Safety, 28(8), 1117–1124
Date: 08/2019
Type: Document
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Factors that Influence Access to Medication-Assisted Treatment
Results of a study examining factors that influence access to medication-assisted treatment and substance use disorder treatment, including rural location, stigma, shortage of providers, and insurance coverage. Uses data from an electronic survey distributed to 59 State Opioid Treatment Authorities or Single State Authorities in the spring of 2019.
Additional links: Policy Brief
Author(s): Dana Foney, Shannon Mace
Date: 08/2019
Type: Document
Sponsoring organizations: National Council for Behavioral Health, University of Michigan Behavioral Health Workforce Research Center
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Urban-Rural Differences in Injury and Drug Overdose Death Rates: Data from the National Vital Statistics System
Webinar recording discusses two reports from the National Center for Health Statistics detailing mortality from injuries and opioids in rural versus urban areas. Features presentations by representatives form the National Center for Health Statistics.
Additional links: Audio Recording, PowerPoint Handout, Webinar Transcript
Date: 08/2019
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Report of Recommendations: Appalachian Regional Commission's Substance Abuse Advisory Council
Report outlines the recommendations of the ARC's Substance Abuse Advisory Council on designing and implementing a substance abuse recovery system in rural Appalachia. Details the need for workforce training and employment via support services post-treatment.
Date: 08/2019
Type: Document
Sponsoring organization: Appalachian Regional Commission
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Evidence Brief: Barriers and Facilitators to Use of Medications for Opioid Use Disorder
Report details an analysis of barriers and facilitators to administering medication-assisted treatment (MAT) for opioid use disorder (OUD) that are applicable to the Veterans Health Administration. Highlights a synthesis of data extracted from a number of selected studies from 2014-2019, as well as VA data from 2006-2019. Includes data focusing on rural areas.
Date: 08/2019
Type: Document
Sponsoring organization: Veterans Health Administration
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Unclassified Drug Overdose Deaths in the Opioid Crisis: Emerging Patterns of Inequity
Presents a study that explores correlations between certain geographic, economic, or demographic characteristics and missing data pertaining to drug overdose deaths. Looks at unclassified drug overdose deaths and breaks down data by sex, age, race, and economic status, among other factors. Depicts overdose mortality data in nationwide, county-level maps.
Author(s): Andrew J Boslett, Alina Denham, Elaine L Hill, Meredith C B Adams
Citation: Journal of the American Medical Informatics Association, 26(8-9), 767–777
Date: 08/2019
Type: Document
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Rural Access to MAT in Pennsylvania (RAMP): A Hybrid Implementation Study Protocol for Medication Assisted Treatment Adoption among Rural Primary Care Providers
Presents a study on the implementation of an intervention designed to expand access to medication-assisted treatment for people with opioid use disorder in rural Pennsylvania. Highlights the collaborators and roles within the intervention, breaking down the delivery and support infrastructure.
Author(s): Gerald Cochran, Evan S. Cole, Jack Warwick, et al.
Citation: Addiction Science & Clinical Practice, 14, 25
Date: 08/2019
Type: Document
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Evidence Brief: Managing Acute Pain in Patients with Opioid Use Disorder on Medication-assisted Treatment
Brief details the Veterans Health Administration's best practice on acute pain treatment for patients undergoing medication-assisted treatment for opioid use disorder. Includes supplemental materials that highlight search strategies and evidence tables among other materials.
Additional links: Supplementary Materials
Author(s): Stephanie Veazie, Katherine Mackey, Donald Bourne, Kim Peterson
Date: 08/2019
Type: Document
Sponsoring organization: Veterans Health Administration
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Life-Saving Naloxone from Pharmacies
Describes the role naloxone plays in reversing the effects of an opioid overdose. Discusses the need for greater access to naloxone, particularly in rural areas, and highlights trends in opioid and naloxone prescribing. Includes links to related CDC resources.
Date: 08/2019
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Vital Signs: Pharmacy-Based Naloxone Dispensing — United States, 2012–2018
Reports on trends and characteristics of naloxone dispensing from retail pharmacies. Includes data for metropolitan, micropolitan, and rural counties on high-dose opioid and naloxone prescriptions. Also includes county-level maps of naloxone prescriptions per 100,000 people and naloxone prescriptions per 100 high-dose opioid prescriptions.
Author(s): Gery P. Guy Jr., Tamara M. Haegerich, Mary E. Evans, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 68(31), 679-686
Date: 08/2019
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Urban-Rural Differences in Drug Overdose Death Rates, by Sex, Age, and Type of Drugs Involved, 2017
Data brief examining differences in urban and rural areas, using the most recent data from the National Vital Statistics System. Features statistics including age-adjusted rates of overdose rates from 1999-2017 by urban and rural residence, and rates of overdose death in 2017 by sex, age group, and type of drug, with breakdowns by urban and rural areas.
Author(s): Holly Hedegaard, Arialdi M. Minino, Margaret Warner
Citation: NCHS Data Brief, No. 345
Date: 08/2019
Type: Document
Sponsoring organization: National Center for Health Statistics
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IHS Needs to Improve Oversight of Its Hospitals' Opioid Prescribing and Dispensing Practices and Consider Centralizing Its Information Technology Functions
Reports on a review of Indian Health Service (IHS) hospitals with a focus on opioid prescriptions and dispensing, information technology (IT), and cybersecurity. Identifies deficiencies related to opioid policies and procedures and supports centralizing IHS IT systems.
Date: 07/2019
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Access to Primary Care Clinics for Patients With Chronic Pain Receiving Opioids
Results of a study of 194 Michigan primary care clinics, to assess their willingness to continue prescribing opioids to new patients and to determine whether this differs across payer types. Includes statistics on characteristics of clinics accepting new patients currently taking opioids, with breakdowns by urban and rural location.
Author(s): Pooja A. Lagisetty, Nathaniel Healy, Claire Garpestad
Citation: JAMA Network Open 2(7)
Date: 07/2019
Type: Document
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Psychosocial Supports in Medication-Assisted Treatment: Site Visit Findings and Conclusions
Profiles 5 programs that offer medication-assisted treatment (MAT) for opioid use disorder (OUD), including several with rural components. Covers psychosocial support offered, staffing and staff training, collaboration and coordination, financing, data collection and quality improvement, lessons learned, and next steps for each program. Discusses the aspects of psychosocial support that are most important for positive outcomes, types of psychosocial support being used, and factors helping or impeding psychosocial support implementation, including stigma and workforce challenges. Appendix B reviews the literature on psychosocial support in MAT.
Additional links: Appendix B: Psychosocial Supports in Medication-Assisted Treatment: Recent Evidence and Current Practice
Date: 07/2019
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Team-Based Clinic Redesign of Opioid Medication Management in Primary Care: Effect on Opioid Prescribing
Study examines an opioid medication management redesign in 20 rural primary care clinics. Looks at daily opioid usage rates of long-term opioid therapy patients before and after the redesign.
Author(s): Michael L. Parchman, Robert B. Penfold, Brooke Ike, et al.
Citation: Annals of Family Medicine, 17(4), 319-325
Date: 07/2019
Type: Document
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The Role of Primary Care in Improving Access to Medication-Assisted Treatment for Rural Medicaid Enrollees with Opioid Use Disorder
Examines the utilization of primary care among rural Medicaid enrollees in Pennsylvania diagnosed with an opioid use disorder (OUD). Describes the relationship between primary care utilization, distance to a medication-assisted treatment (MAT) prescriber, and MAT utilization.
Author(s): Evan S. Cole, Ellen DiDomenico, Gerald Cochran, et al.
Citation: Journal of General Internal Medicine, 34(6), 936-943
Date: 06/2019
Type: Document
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Determining Spatial Access to Opioid Use Disorder Treatment and Emergency Medical Services in New Hampshire
Highlights a study on the effect of geospatial determinants on access to opioid use disorder treatment and emergency medical services in New Hampshire. Breaks down data by metropolitan, micropolitan, small town, and rural communities.
Author(s): Yanjia Cao, Kathleen Stewart, Eric Wish, et al.
Citation: Journal of Substance Abuse Treatment, 101, 55-66
Date: 06/2019
Type: Document
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Pain in the Nation: Building a National Resilience Strategy: Alcohol and Drug Misuse and Suicide and the Millennial Generation - a Devastating Impact
Report highlights the rates of alcohol and drug misuse and suicide among the millennial generation (people in their 20s and 30s). Discusses the role of the opioid crisis in the increases in "deaths of despair" among millennials. Chart on page 6 compares rates in rural and metro areas.
Date: 06/2019
Type: Document
Sponsoring organizations: Trust for America's Health, Well Being Trust
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Location of Medication-Assisted Treatment for Opioid Addiction: In Brief
Examines the location of providers who offer medication-assisted treatment (MAT) for opioid use disorder based on the location of providers with Drug Addiction Treatment Act (DATA) waivers and federally certified opioid treatment programs. Includes maps showing the location of both by county. Addresses the number of rural counties with no providers and policy options for rural access to MAT.
Date: 06/2019
Type: Document
Sponsoring organization: Congressional Research Service
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3 Questions to Integrate Substance Use Disorder Services into Primary Care
Fact sheet providing examples of tools and potential mentoring opportunities for providing substance use disorder treatment services in rural areas.
Date: 06/2019
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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At the Front Lines in Tennessee: Rural Clinic Offers Trauma-Informed Treatment for Substance Use Disorder
Describes the work of a rural Tennessee physician who uses medication-assisted treatment, cognitive behavioral therapy, and group therapy sessions to treat patients struggling with substance use disorder. Explores the connection between adverse childhood experiences and substance abuse, and stigma associated with seeking treatment.
Author(s): Mariel Gingrich
Date: 06/2019
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Tailoring Crisis Response and Pre-arrest Diversion Models for Rural Communities
Outlines a guide for rural communities to develop crisis response and pre-arrest diversion programs for people with mental health or substance use disorders. Discusses the use of technology to connect law enforcement with behavioral health programs, as well as building off of current programs to address the specific needs of the community.
Date: 06/2019
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Characteristics of US Counties With High Opioid Overdose Mortality and Low Capacity to Deliver Medications for Opioid Use Disorder
Highlights a study on opioid overdose mortality in U.S. counties that lack the capacity to treat opioid use disorder. Breaks down counties by patient demographic and geographic region, as well as by rural, metropolitan, and micropolitan status.
Author(s): Rebecca L. Haffajee, Lewei Allison Lin, Amy S. B. Bohnert, Jason E. Goldstick
Citation: JAMA Network Open, 2(6)
Date: 06/2019
Type: Document
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How the Federal Government Supports State and Local Efforts to Improve Rural Health: A Q&A with Tom Morris
Provides a Q&A with Tom Morris, associate administrator of rural health policy at the Health Resources and Services Administration (HRSA). Focuses on how government agencies are addressing rural hospital closures, population health, rural workforce development, and the opioid epidemic.
Date: 06/2019
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Binge Drinking and Prescription Opioid Misuse in the U.S., 2012-2014
Explores the relationship between binge drinking and opioid misuse. Analyzes data from the 2012-2014 National Survey on Drug Use and Health and presents data by age, race, and rural versus urban status, among other measures.
Author(s): Marissa B. Esser, Gery P. Guy Jr., Kun Zhang, et al.
Citation: American Journal of Preventive Medicine
Date: 06/2019
Type: Document
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Regional and Rural–Urban Variation in Opioid Prescribing in the Veterans Health Administration
Examines geographic variation in opioid prescribing patterns at Veterans Health Administration (VHA) facilities, including by region and for rural and urban veterans. Addresses opioids prescribed per capita, prescription incidence, length of use, and prevalence of use. Includes a chart showing rural/urban per capita prescriptions over time.
Author(s): Brian C. Lund, Michael E. Ohl, Katherine Hadlandsmyth, Hilary J. Mosher
Citation: Military Medicine
Date: 05/2019
Type: Document
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Understanding the Public Health Consequences of Suspending a Rural Syringe Services Program: A Qualitative Study of the Experiences of People Who Inject Drugs
Details a study on the public health outcomes associated with discontinuing syringe services programs (SSPs) in rural areas where people who inject drugs (PWIDs) are prevalent. Focuses on the Kanawha-Charleston Health Department in West Virginia.
Author(s): Sean T. Allen, Suzanne M. Grieb, Allison O'Rourke, et al.
Citation: Harm Reduction Journal, 16
Date: 05/2019
Type: Document
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Opioids in Appalachia: The Role of Counties in Reversing a Regional Epidemic
Details the state of the opioid epidemic in Appalachia and presents recommendations to help county leaders respond to the opioid crisis. Features individual county case studies highlighting the challenges and strategies in addressing the opioid crisis.
Additional links: Executive Summary
Date: 05/2019
Type: Document
Sponsoring organization: National Association of Counties
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An Update on the President's Commission on Combating Drug Addiction and the Opioid Crisis: One Year Later
Report details a one year update to the President's Commission on Combating Drug Addiction and the Opioid Crisis. Highlights the commission's accomplishments and examines its initial objectives. Includes rural references throughout.
Date: 05/2019
Type: Document
Sponsoring organization: The White House
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Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic: Proceedings of a Workshop
Reports on a workshop with multiple stakeholders discussing pain management in the context of the opioid misuse epidemic. Reviews the opioid epidemic, how responses to it have affected people with serious illness and pain, the pain management needs of people with substance use disorder, policy responses, and next steps. Includes a few examples from rural areas and addresses some challenges specific to rural.
Additional links: Read Online
Date: 05/2019
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Community Pharmacies as Access Points for Addiction Treatment
Investigates the distribution of community pharmacies in rural and urban counties of Wisconsin, and the connection it has on county-level opioid-related overdose death rates and the number of treatment facilities.
Author(s): Kevin A. Look, Mercedes Kile, Katie Morgan, et al.
Citation: Research in Social & Administrative Pharmacy, 15(4), 404-409
Date: 04/2019
Type: Document
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Buprenorphine Prescribing by Nurse Practitioners, Physician Assistants and Physicians After CARA 2016
Investigates the differences in buprenorphine prescribing patterns among nurse practitioners (NPs), physician assistants (PAs) and physicians in Medicaid following implementation of the Comprehensive Addiction and Recovery Act (CARA) addressing opioid use disorder (OUD). Retail pharmacy claims from July 2017 to June 2018 were analyzed to identify prescriber type, number of patients, payer type, rural and urban differences, and Medicaid trends for FDA-approved buprenorphine drugs for the treatment of OUD.
Author(s): Rekha Varghese, Karin Johnson, Bo Feng, et al.
Date: 04/2019
Type: Document
Sponsoring organizations: IMPAQ International, LLC, Medicaid and CHIP Payment and Access Commission
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Using Health Information Technology to Enhance Opioid Use Disorder Treatment
Provides a webinar recording on using health information technology practices and tools with opioid use disorder treatment, including medication assisted treatment (MAT). Features examples from community health centers, including sites in rural areas.
Date: 04/2019
Type: Video/Multimedia
Sponsoring organization: Health Information Technology, Evaluation, and Quality Center
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Opioid Addiction: Meeting the Need for Treatment in Michigan
Analyzes survey data from village, township, city, and county leaders throughout Michigan to identify drug treatment needs across the state. Discusses access issues related to treatment programs that are particularly present in rural areas, and information on providing local treatment programs. Offers policy implications and recommendations to improve treatment options.
Author(s): Amy Bohnert, Jennifer Erb-Downward, Thomas Ivacko
Date: 04/2019
Type: Document
Sponsoring organization: Poverty Solutions at the University of Michigan
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Opioid Treatment and Rural Health Clinics: Part 2
Second webinar focusing on rural health clinics and opioid treatment. Dr. Reid Lofgran addresses running medication assisted treatment (MAT) in a rural health clinic with minimal community resources in Gooding, Idaho. Covers challenges faced, medications used for MAT, staffing needs, the importance of contracts, sigmas associated with addiction, and more.
Additional links: Medication Assisted Treatment Program Consent Form, Medication Assisted Treatment Program Contract, Medication Assisted Treatment Program Financial Agreement, Medication Assisted Treatment Program Information & Instructions, Opiate and Other Substance Use Questionnaire, Presentation Slides, Transcript
Date: 04/2019
Type: Video/Multimedia
Sponsoring organizations: Federal Office of Rural Health Policy, National Association of Rural Health Clinics
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Health Disparities Related to Opioid Misuse in Appalachia: Practical Strategies and Recommendations for Communities
Offers statistics on opioid misuse and overdose deaths in rural Appalachian communities. Highlights strategies and resources to address opioid issues. Covers recommendations to assist policymakers, funders, and leaders working to reduce opioid related health disparities.
Author(s): Kate Beatty, Nathan Hale, Michael Meit, et al.
Date: 04/2019
Type: Document
Sponsoring organization: Appalachian Regional Commission
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The Opioid Prescribing Rate and Grandparents Raising Grandchildren: State and County Level Analysis
Study highlights the relationship between grandparents raising children and the opioid crisis. Compares American Community Survey data from 2012-2016 with CDC 2016 Opioid Prescribing data. The State and County Level Analysis Poster presents a summary of the study, as well as state and county-level data and maps.
Additional links: State and County Level Analysis Poster
Author(s): Lydia Anderson
Date: 04/2019
Type: Document
Sponsoring organization: U.S. Census Bureau
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Identifying Areas with Disproportionate Local Health Department Services Relative to Opioid Overdose, HIV and Hepatitis C Diagnosis Rates: A Study of Rural Illinois
Highlights a study on access to opioid use disorder treatment services provided by local health departments in rural Illinois. Looks at services available, as well as county rates of opioid overdoses, HIV, and hepatitis C diagnosis rates.
Author(s): Colleen McLuckie, Mai T. Pho, Kaitlin Ellis, et al.
Citation: International Journal of Environmental Research and Public Health, 16(6), 989
Date: 03/2019
Type: Document
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Substance Use Disorder Treatment Policy Recommendations for the State of Louisiana: Final Report - March 2019
Assessment to inform recommendations for the state of Louisiana on timely, comprehensive, evidence-based, and sustainable treatment for opioid use disorder. Includes 8 recommendations, and discusses challenges in rural areas, such as high overdose rates, provider shortages, and lack of access to buprenorphine.
Date: 03/2019
Type: Document
Sponsoring organization: Pew Charitable Trusts
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Recommendations to the Indian Health Service on American Indian/Alaska Native Pregnant Women and Women of Childbearing Age with Opioid Use Disorder
Report details recommendations from the American College of Obstetricians and Gynecologists to the Indian Health Service on best practices for treating pregnant American Indian and Alaska Native women with opioid use disorder (OUD). Discusses screening for OUD, medication-assisted treatment (MAT), and care integration, among other factors.
Date: 03/2019
Type: Document
Sponsoring organization: The American College of Obstetricians and Gynecologists
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STOP Playbook: How Health Plans Are Tackling the Opioid Crisis
Provides examples of strategies used by health plans to address opioid misuse through the Safe, Transparent Opioid Prescribing (STOP) Initiative, which focuses on improving prescribing patterns and practices. Includes strategies and examples for increasing substance abuse treatment access in rural areas. Summarizes the health insurance impacts of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities legislation.
Date: 03/2019
Type: Document
Sponsoring organization: America's Health Insurance Plans
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Cross-Agency Approaches to Substance Use Disorder Prevention and Treatment: National Recommendations
Provides recommendations on how state agencies can work together to prevent and treat substance use disorder, including engaging with state offices of rural health. Offers examples from 8 states and emphasizes state efforts related to opioid misuse disorder.
Date: 03/2019
Type: Document
Sponsoring organization: National Academy for State Health Policy
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Identifying Safety-Net Resources at Health Centers to Prevent Infectious Disease Transmission Resulting from the Opioid Epidemic
Examines challenges faced and strategies used by Community Health Centers (CHCs) in rural areas to reduce the transmission of infectious diseases in relation to opioid use. Focuses on treatment of people with opioid use disorder; prevention of HIV and hepatitis C (HCV) transmission; integration of substance use services with mental health and primary care; information sharing among health centers and Ryan White Part C providers; and challenges related to staffing, administration, finances, and social stigma. Identifies 7 facilitators of successful programs.
Date: 03/2019
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Medications for Opioid Use Disorder Save Lives
Reports on the findings from an expert committee regarding the evidence behind using medications to treat opioid use disorder, as well as issues with accessing medication-based treatment. Chapter 3 includes a section focusing on rural populations and chapter 5 addresses rural/urban differences in the number of healthcare providers waivered to prescribe buprenorphine, a medication used to treat opioid-use disorder.
Additional links: Read Online
Author(s): Committee on Medication-Assisted Treatment for Opioid Use Disorder
Date: 03/2019
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Pain in the Nation Update: While Deaths from Alcohol, Drugs, and Suicide Slowed Slightly in 2017, Rates Are Still at Historic Highs
Issue brief details updated rates of deaths related to drugs, alcohol, and suicide from 2016-2017. Breaks down data by race, age, and regionally, including rural versus metro areas.
Date: 03/2019
Type: Document
Sponsoring organization: Trust for America's Health
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Using Network and Spatial Data to Better Target Overdose Prevention Strategies in Rural Appalachia
Highlights a study aiming to target individuals most likely to need overdose interventions in rural Appalachia. Examines survey data for spacial and networking patterns in rural eastern Kentucky to identify individuals at risk of a drug overdose.
Author(s): Abby E. Rudolph, April M. Young, Jennifer R. Havens
Citation: Journal of Urban Health, 96(1), 27-37
Date: 02/2019
Type: Document
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Opioid Use Disorder: Challenges and Opportunities in Rural Communities
Discusses challenges rural communities face in providing access to evidence-based treatment for opioid use disorder (OUD). Identifies federal and state strategies to address treatment capacity, including expanding the workforce authorized to prescribe buprenorphine and using technology to provide treatment. Highlights how Scott County, Indiana responded to an HIV outbreak related to OUD by addressing the barriers to care faced by people with OUD and HIV.
Date: 02/2019
Type: Document
Sponsoring organization: Pew Charitable Trusts
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Association Among County-Level Economic Factors, Clinician Supply, Metropolitan or Rural Location, and Neonatal Abstinence Syndrome
Highlights a study on demographic factors that correlate with neonatal abstinence syndrome (NAS). Looks at a county's economic factors, rural status, and clinician supply in 8 different states.
Author(s): Stephen W. Patrick, Laura J. Faherty, Andrew W. Dick, et al.
Citation: JAMA, 321(4), 385-393
Date: 01/2019
Type: Document
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The Contributions of Socioeconomic and Opioid Supply Factors to Geographic Variation in U.S. Drug Mortality Rates
Features a study on the geographic variation in opioid overdose mortality. Compares rates of drug mortality from 2000-2002 with 2014-2016 and looks at socioeconomic factors, as well as rural versus urban location.
Author(s): Shannon M. Monnat
Date: 01/2019
Type: Document
Sponsoring organization: Institute for New Economic Thinking
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340B Hospitals on the Front Lines of Addressing the U.S. Opioid Epidemic: Case Examples from the Field
Highlights how six hospitals participating in the 340B drug pricing program are helping address the opioid epidemic. Includes case studies from rural, Critical Access Hospitals in Minnesota.
Date: 01/2019
Type: Document
Sponsoring organization: 340B Health
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Opioid-Related Hospital Stays Among Women in the United States, 2016
Examines opioid-related hospitalizations among women 15 years of age and older. Provides data by location of patient residence for large metropolitan, small/medium metro, and micropolitan/noncore (rural) areas addressing: opioid-related compared to non-opioid stays; co-occurring mental disorder or pregnancy/childbirth; stays related to opioid abuse/dependence, opioid adverse events, and opioid poisoning/self-harm; and patient race/ethnicity by location of residence.
Author(s): Audrey J. Weiss, Kimberly W. McDermott, Kevin C. Heslin
Date: 01/2019
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Association of Pharmaceutical Industry Marketing of Opioid Products With Mortality From Opioid-Related Overdoses
Highlights a study on the correlation between the marketing of opioids and opioid overdose mortality at a county-level. Breaks down data by participants' age, census region, and metro versus nonmetro location, among other factors.
Author(s): Scott E. Hadland, Ariadne Rivera-Aguirre, Brandon D. L. Marshall, Magdalena Cerdá
Citation: JAMA Network Open, 2(1)
Date: 01/2019
Type: Document
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Opioid Prescribing Rates in Nonmetropolitan and Metropolitan Counties Among Primary Care Providers Using an Electronic Health Record System — United States, 2014–2017
Examines opioid prescribing rates among primary care providers for six urban-rural classification categories of counties, before and after the March 2016 release of CDC's Guideline for Prescribing Opioids for Chronic Pain.
Author(s): Macarena C. García, Charles M. Heilig, Scott H. Lee, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 68(2), 25-30
Date: 01/2019
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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The SUPPORT for Patients and Communities Act (P.L.115-271): Medicare Provisions
Provides a section-by-section description of Medicare provisions in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Addresses rural in two sections: Section 6083 seeks to expand access to addiction treatment in Federally Qualified Health Centers and Rural Health Clinics by paying for training costs to obtain a DATA waiver to furnish OUD treatment; Section 6042 authorizes a demonstration project testing expanded access to MAT drugs through teams with a primary care provider.
Date: 01/2019
Type: Document
Sponsoring organization: Congressional Research Service
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Drug and Opioid-Involved Overdose Deaths - United States, 2013-2017
Reports on the annual number and age-adjusted rate of drug overdose deaths in 2013 and 2017 by state, involving all opioids and prescription opioids, and heroin and synthetic opioids other than methadone. Includes statistics with breakdowns by metropolitan, micropolitan, and noncore areas.
Author(s): Lawrence Scholl, Puja Seth, Mbabazi Kariisa, Nana Wilson, Grant Baldwin
Citation: MMWR (Morbidity and Mortality Weekly Report), 67(5152), 1419-1427
Date: 01/2019
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Tribal Opioid Response: Healing Our Nations Together - National Strategic Agenda
Addresses the tribal opioid epidemic, with recommendations based on input from tribal policymakers, service providers, and community members. Offers insights from experts, feedback from people with opioid use disorder, and tips for creating a plan to collect and analyze opioid data from local communities.
Date: 2019
Type: Document
Sponsoring organizations: National Indian Health Board, Northwest Portland Area Indian Health Board
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Opioid Epidemic in the United States: Empirical Trends, and A Literature Review of Social Determinants and Epidemiological, Pain Management, and Treatment Patterns
Analyzes trends in U.S. drug overdose mortality by key social determinants. Reports findings from a selective review of the literature on how the opioid crisis is impacting different segments of the population, including rural residents.
Additional links: PDF, Supplemental Material
Author(s): Gopal K. Singh, Isaac E. Kim, Mehrete Girmay, et al.
Citation: International Journal of Maternal and Child Health and AIDS, 8(2), 89-100
Date: 2019
Type: Document
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Overcoming Barriers to Prescribing Buprenorphine for the Treatment of Opioid Use Disorder: Recommendations from Rural Physicians
Details a study based on interviews with rural physicians who reported treating high numbers of opioid use disorder patients with buprenorphine. Discusses the common barriers to treating patients with buprenorphine in rural areas. Breaks down data by census region, practice type, and DEA waiver type, among other measures.
Author(s): C. Holly A. Andrilla, Tessa E. Moore, Davis G. Patterson
Citation: Journal of Rural Health, 35(1), 113-121
Date: 2019
Type: Document
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Comparing Buprenorphine-Prescribing Physicians Across Nonmetropolitan and Metropolitan Areas in the United States
Highlights a study comparing buprenorphine prescribing rates between metro and nonmetro areas. Looks at physician treatment practices, characteristics, and practice location.
Author(s): Lewei (Allison) Lin, Hannah K. Knudsen
Citation: Annals of Family Medicine, 17(3), 212-220
Date: 2019
Type: Document
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The Ecology of Neonatal Abstinence Syndrome
Summarizes results from an 8-state study of neonatal abstinence syndrome (NAS), a drug withdrawal condition that may occur in newborns exposed to opioids during pregnancy. Discusses correlations to rurality, unemployment rates, poverty, and the supply of healthcare providers, and identifies potential policy interventions that could help. For interactive, county-level data, see the Simulation of County Neonatal Abstinence Syndrome (NAS) Rates Tool based on study findings.
Additional links: Simulation of County Neonatal Abstinence Syndrome (NAS) Rates Tool
Date: 2019
Type: Document
Sponsoring organization: RAND Corporation
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Patterns of Buprenorphine Use and Risk for Re-Arrest among Highly Vulnerable Opioid-Involved Women Released from Jails in Rural Appalachia
Study examining licit and illicit use of buprenorphine by women in the Appalachia region of Kentucky with moderate to severe opioid involvement who had recently been released from jail. Discusses the role of consistent healthcare services in relation to risk for re-arrest, presenting data on demographics, opioid use, and healthcare access over a 3-month tracking period.
Author(s): Hilary L. Surratt, Michele Staton, Carl G. Leukefeld, Carrie B. Oser, J. Matthew Webster
Citation: Journal of Addictive Diseases, 37(1-2), 1-4
Date: 12/2018
Type: Document
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Mandatory Reporting of Fatal and Nonfatal Opioid Overdoses in a Rural Public Health Department
Describes a mandatory reporting initiative in rural Clallam County, Washington of fatal and nonfatal opioid overdoses. Offers data on reported cases from 2016-2017 including age, gender, participation in syringe exchanges, overdose characteristics, and public health services provided per case.
Author(s): Christopher J. Frank, Siri E. Kushner, David A. Doran, Jeanette Stehr-Green
Citation: American Journal of Public Health, 108(12), 1646-1648
Date: 12/2018
Type: Document
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Red Flags and Warning Signs Ignored: Opioid Distribution and Enforcement Concerns in West Virginia
Report highlights a U.S. House Committee on Energy and Commerce investigation into the opioid crisis in West Virginia. Examines the policies of the various drug distribution companies who shipped opioids into the state, as well as the effectiveness of the Drug Enforcement Administration's (DEA) oversight.
Date: 12/2018
Type: Document
Sponsoring organization: House Energy and Commerce Committee
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Public Health and Other Related Provisions in P.L 115-271, the SUPPORT for Patients and Communities Act
Summarizes Title VII and VIII provisions in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Addresses provisions affecting access to opioid abuse treatment and providers, data collection, child welfare, the Department of Justice, substance abuse prevention, and more. Sections highlighting rural authorize grants for first responder training, data collection on adverse childhood experiences, recovery support services, and reauthorization of the the State and Tribal Response to the Opioid Abuse Crisis grant program with technical assistance for rural and underserved communities.
Date: 12/2018
Type: Document
Sponsoring organization: Congressional Research Service
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Buprenorphine and the Opioid Crisis: A Primer for Congress
Discusses the use of buprenorphine in Medication-Assisted Treatment (MAT) of opioid addiction. Report addresses questions for U.S. lawmakers to craft opioid treatment policy. Looks at the effectiveness, demand, and access of buprenorphine.
Date: 12/2018
Type: Document
Sponsoring organization: Congressional Research Service
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The Special Registration for Telemedicine: In Brief
Describes changes to the Controlled Substance Act (CSA) authorizing special registration for telemedicine to increase access to healthcare providers that can prescribe controlled substances using telemedicine, with the goal of helping address the opioid crisis and shortage of mental health providers. Outlines the seven categories for the practice of telemedicine under the authority of the CSA. The Drug Enforcement Administration plans to publish the related proposed rule to finalize the registration process and procedures.
Date: 12/2018
Type: Document
Sponsoring organization: Congressional Research Service
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A Large HCV Transmission Network Enabled a Fast-growing HIV Outbreak in Rural Indiana, 2015
Highlights a study of the co-infection of hepatitis C among HIV patients who inject opioids in rural Indiana. Details the age, race, and county of residence, as well as several risk factors of the patients.
Author(s): Sumathi Ramachandran, Hong Thai, Joseph C. Forbi, et al.
Citation: EBioMedicine, 37, 374-381
Date: 11/2018
Type: Document
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Using Telehealth to Support Opioid Use Disorder Treatment
Provides an issue brief on how telehealth can increase access to medication-assisted treatment (MAT) for opioid use disorder (OUD). Addresses how telehealth is used, implemented, and reimbursed, highlighting the implications for MAT.
Date: 11/2018
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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House Select Committee on Opioids and Substance Abuse: Interim Report to the 86th Texas Legislature
Provides a comprehensive report on substance abuse and opioid misuse in Texas, summarizing the current issues and what Texas programs, policies, and agencies are doing to address them. Reviews implementation of the state prescription monitoring program; state Good Samaritan laws; and the impact of substance abuse on various stakeholders and population groups, such as pregnant women and first responders. Addresses rural throughout and includes a map showing opioid-related deaths by county.
Date: 11/2018
Type: Document
Sponsoring organization: Texas House Select Committee on Opioids and Substance Abuse
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Medication-Assisted Treatment for Opioid Use Disorder in the Child Welfare Context: Challenges and Opportunities
Discusses challenges and opportunities related to medication-assisted treatment (MAT) for parents with opioid use disorder, focusing on child welfare. Highlights the importance of counseling to address mental health and parenting issues as part of the treatment. Covers difficulties faced with accessing counseling services, particularly in rural areas. Based on a qualitative mixed methods study that included rural and urban counties experiencing a high level of drug overdoses and emergency room visits.
Author(s): Laura Radel, Melinda Baldwin, Gilbert Crouse, Robin Ghertner, Annette Waters
Date: 11/2018
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Responding to the HIV Crisis in Scott County, Indiana: Q&A with Dr. William Cooke
An interview with Dr. William Cooke, the only physician in Austin, Indiana at the time of the country's largest rural HIV outbreak. Highlights the work of Dr. Cooke and his staff to help address HIV, hepatitis C, and opioid/substance use disorder in the community.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 11/2018
Type: Document
Sponsoring organization: Rural Health Information Hub
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The Health and Economic Concerns of Rural Americans
Presentation features a discussion on the role social and economic disparities play in the health of people in rural communities. Highlights the effect the opioid crisis has had in rural areas and discusses ways communities can use local resources to combat opioid abuse.
Date: 11/2018
Type: Video/Multimedia
Sponsoring organization: The Forum, Harvard T.H. Chan School of Public Health
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State Options for Promoting Recovery among Pregnant and Parenting Women with Opioid or Substance Use Disorder
Reports on interviews with health officials in Texas, Colorado, and Pennsylvania regarding how their states help pregnant women and young mothers with substance use disorders, focusing on opioids. Discusses Medicaid's role, funding sources of state initiatives, medication-assisted treatment, and issues for incarcerated women. Includes considerations and examples related to rural health throughout.
Author(s): Becky Normile, Carrie Hanlon, Hannah Eichner
Date: 10/2018
Type: Document
Sponsoring organization: National Academy for State Health Policy
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HRSA's Home Visiting Program: Supporting Families Impacted by Opioid Use and Neonatal Abstinence Syndrome: A Resource for MIECHV Awardees
Details a report for HRSA's Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program grantees on providing support to families impacted opioid use disorder (OUD) and neonatal abstinence syndrome (NAS). Discusses methods of treatments for newborns with NAS and Medication-Assisted Treatment (MAT) for pregnant women with OUD.
Date: 10/2018
Type: Document
Sponsoring organization: Health Resources and Services Administration
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Integrating Opioid Use Disorder Treatment Into Health Workforce Training
Webinar recording discusses different ways to implement healthcare workforce training in methods of treatment for opioid use disorder. Features case studies in Colorado and in Nevada where the epidemic has largely been in rural areas.
Date: 10/2018
Type: Video/Multimedia
Sponsoring organization: Health Resources and Services Administration
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Life in Rural America
Summarizes the results of a survey of rural adults living in the U.S. Includes survey response data and statistics on a variety of topics such as: drug addiction or abuse and opioids; the economy; health conditions; suicide; and more.
Additional links: Full Report
Date: 10/2018
Type: Document
Sponsoring organizations: Harvard T.H. Chan School of Public Health, NPR, Robert Wood Johnson Foundation
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Federal Legislation to Address the Opioid Crisis: Medicaid Provisions in the SUPPORT Act
Brief details the Medicaid provisions in the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. Discusses provisions aimed at treating substance use disorder in rural areas.
Author(s): MaryBeth Musumeci, Jennifer Tolbert
Date: 10/2018
Type: Document
Sponsoring organization: Kaiser Family Foundation
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Characteristics of Prescription Opioid-Impaired and Other Substance-Impaired Drivers in Rural Appalachian Kentucky
Study examining characteristics and behaviors of prescription opioid-impaired drivers in the rural Appalachian region of Kentucky. Data gathered from research interviews with 118 study participants who had been convicted of a DUI in the same county where they lived. Discusses prevalence of substance use, frequency of impaired driving, criminal activity, and mental health for prescription opioid-impaired, other drug-impaired, and alcohol only-impaired drivers.
Author(s): J. Matthew Webster, Megan F. Dickson, Faiyad Mannan, Michele Staton
Citation: Journal of Psychoactive Drugs, 59(5), 373-381
Date: 09/2018
Type: Document
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Opioid Prescribing Rates by Congressional Districts, United States, 2016
Details a study on opioid prescribing rates by U.S. congressional districts. Compares congressional district rates with state-level rates and highlights rates among White populations, in rural areas, and by other variables.
Author(s): Lyndsey A. Rolheiser, Jack Cordes, S.V. Subramanian
Citation: American Journal of Public Health, 108(9), 1214–1219
Date: 09/2018
Type: Document
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Substance Use Disorder Treatment Policy Recommendations for the State of Indiana: Final Report - September 2018
Assessment of Indiana's treatment system for substance use disorders (SUDs), based on interviews with stakeholder groups, consultation with national experts, focus groups, and a review of public data sets. Includes 6 recommendations in the categories of treatment system transformation, SUD workforce, and underserved populations. Discusses barriers to treatment in rural areas.
Date: 09/2018
Type: Document
Sponsoring organization: Pew Charitable Trusts
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Opioid Crisis: Status of Public Health Emergency Authorities
Examines the effectiveness of public health emergency authorities' response to the opioid crisis. Discusses the different public health emergency authorities selected by the U.S. Department of Health and Human Services and the activities underway to combat the opioid crisis.
Additional links: Full Report
Date: 09/2018
Type: Document
Sponsoring organization: Government Accountability Office
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Data Sources and Data-Linking Strategies to Support Research to Address the Opioid Crisis: Final Report
Identifies and describes secondary data sources that can be used in research and evaluations related to the opioid crisis. Discusses common approaches used to link or merge data sources. Describes research needs and challenges related to studying the opioid crisis.
Author(s): Rosanna Smart, Courtney Ann Kase, Amanda Meyer, Bradley D. Stein
Date: 09/2018
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Evidence-Based Interventions for Adolescent Opioid Use Disorder
Presents a study on interventions targeting Opioid Use Disorder (OUD) in adolescents in Ohio. Focuses on interventions aimed at 11-18 year olds in three counties containing both rural and urban communities. Features a literature review of OUD interventions for adolescents.
Author(s): Christal Ramos, Lisa Clemans-Cope, Haley Samuel-Jakubos, Luis Basurto
Date: 09/2018
Type: Document
Sponsoring organization: Urban Institute
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Any Use and Frequent Use of Opioids among Non-elderly Adults in 2015-2016, by Socioeconomic Characteristics
Details a study on the rate of opioid prescribing for adults under the age of 65 from 2015-2016. Presents data regarding poverty status, race, and whether prescription was filled in a Metropolitan Statistical Area (MSA) or not, among other factors.
Author(s): G. Edward Miller, Asako S. Moriya
Date: 09/2018
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Changing Dynamics of the Drug Overdose Epidemic in the United States from 1979 Through 2016
Features a study on the changes in overdose mortality across the U.S. between 1979-2016. Aims to shed light on the current opioid crisis by placing it within a broader data set incorporating all illicit drug overdose deaths in a longer time frame. Details the specific changes in drug overdose mortality in rural areas.
Author(s): Hawre Jalal, Jeanine M. Buchanich, Mark S. Roberts, et al.
Citation: Science, 361(6408)
Date: 09/2018
Type: Document
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Opioid-Affected Births to Rural Residents
Examines rates of diagnosis of maternal opioid use disorder and infant neonatal abstinence syndrome for rural residents at time of childbirth. Includes statistics for delivery location with breakdowns by rural, urban non-teaching, and urban teaching hospitals.
Author(s): Katy Kozhimannil, Tongtan Chantarat, Alexandra Ecklund, Carrie Henning-Smith
Date: 09/2018
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Facing Addiction in America: The Surgeon General's Spotlight on Opioids
Provides data on prevalence of substance use, and opioid misuse, use disorders, overdoses, and related topics. Includes discussion of prevention programs and screening.
Date: 09/2018
Type: Document
Sponsoring organizations: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services
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Implementing an Integrated Medication-Assisted Treatment Program at Community Health Centers: Lessons from a Pilot Project in California
Evaluates the implementation phase of a pilot project to treat patients with opioid use disorder at Federally Qualified Health Centers (FQHCs) in California, including rural FQHCs. The pilot focused on medication-assisted treatment (MAT) and integrating substance use and mental healthcare in a primary care setting.
Author(s): Jane Wishner, Lisa Clemans-Cope, Jeremy Marks, Marni Epstein
Date: 09/2018
Type: Document
Sponsoring organization: Urban Institute
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Rural Health Opioid Program Funds Care Coordination Efforts for Recovery
Highlights programs funded by the Federal Office of Rural Health Policy that provide opioid treatment and recovery care coordination. An Ohio program uses care coordination in an existing syringe exchange program and county family drug court, a Kentucky program focuses on helping prisoners, and a Montana program reaches new and expectant mothers.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 09/2018
Type: Document
Sponsoring organization: Rural Health Information Hub
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Implementing Treatment of Opioid Use Disorder in Rural Settings: A Focus on HIV and Hepatitis C Prevention and Treatment
Presents an overview of the epidemiology of opioid use disorder (OUD) with a focus on HIV and Hepatitis C transmission in the rural U.S. particularly in rural Indiana. Identifies evidence-based treatment for OUD and their effectiveness in reducing other health issues associated with OUD. Discusses barriers to care, and policy and research issues for increasing access to treatment of OUD in rural areas.
Author(s): Jennifer R. Havens, Sharon L. Walsh, P. Todd Korthuis, David A. Fiellin
Citation: Current HIV/AIDS Reports,15(4), 315–323
Date: 08/2018
Type: Document
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Opioid Treatment and Rural Health Clinics
Provides a webinar recording focused on the opioid use disorder crisis and evidence for medication-assisted treatment (MAT). Covers data on the crisis, diagnosis criteria, and medication treatment options. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Audio Recording, Presentation Slides, Transcript
Date: 08/2018
Type: Video/Multimedia
Sponsoring organizations: Federal Office of Rural Health Policy, National Association of Rural Health Clinics
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USDA Road Trip Through Rural America: Q&A with Anne Hazlett
An interview with USDA Assistant to the Secretary for Rural Development Anne Hazlett. Hazlett discusses the role USDA programs play in addressing rural health-related concerns such as broadband access and shares what she has learned from a series of rural roundtables focused on opioid misuse.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2018
Type: Document
Sponsoring organization: Rural Health Information Hub
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Health Impacts of Opioid Misuse in Alaska
Report details the health outcomes of the opioid crisis in Alaska. Discusses patterns of use, morbidity, mortality, and treatment. Breaks down data by sex, race, type of opioid, and region.
Author(s): Jessica Filley, Deborah Hull-Jilly
Citation: State of Alaska Epidemiology Bulletin, 20(3)
Date: 08/2018
Type: Document
Sponsoring organization: Alaska Division of Public Health
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Non-Medical Opioid Use among Rural and Urban Pregnant Women, 2007-2014
Examines data from the National Survey on Drug Use and Health (NSDUH) from 2007 to 2014 to determine differences in non-medical opioid use among rural and urban pregnant women. Covers policy and practice implications to inform program and clinical efforts to address the crisis.
Author(s): Katy Kozhimannil, Carrie Henning-Smith, Tongtan Chantarat, Tongtan Chantarat, Cresta Jones
Date: 08/2018
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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The Impact of the Opioid Epidemic on Children and Youth in Rural Communities - How Schools and Communities Are Responding
Recorded webinar presenting data on the impact of the opioid epidemic in rural communities. Describes federal, state, and local efforts and strategies to address the epidemic focused on prevention, intervention, and treatment. Covers how schools and community-based organizations can address opioids and the epidemic for children and families. Also includes funding opportunities for rural communities to address the opioid epidemic.
Additional links: Download Video Recording
Author(s): Jennifer Loeffler-Cobia, Grace Schoessow
Date: 07/2018
Type: Video/Multimedia
Sponsoring organization: Rural Behavioral Health Initiative for Children, Youth, and Families
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Substance Use Disorder Treatment Policy Recommendations for the State of Wisconsin Final Report - July 2018
Reports on a statewide assessment to inform the Wisconsin Governor's Task Force on Opioid Abuse regarding comprehensive, evidence-based, and sustainable treatment options for substance use disorder (SUD). Includes 18 policy recommendations. Identifies multiple barriers to accessing SUD treatment in rural and remote areas of Wisconsin.
Date: 07/2018
Type: Document
Sponsoring organization: Pew Charitable Trusts
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The Intersection of Hepatitis, HIV, and the Opioid Crisis: The Need for a Comprehensive Response
Brief discusses the infectious diseases co-occurring with the opioid crisis and the need for comprehensive treatment. Details the relationship between opioid use disorder and HIV and hepatitis infection. Looks at barriers to care and presents suggestions to overcome them, such as increasing access to healthcare for low-income populations, among others.
Date: 07/2018
Type: Document
Sponsoring organization: National Alliance of State and Territorial AIDS Directors
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Education and Training for Primary Care Providers in Medication Assisted Treatment and Opioid Use Disorder Care
Twitter chat discusses Medication-Assisted Treatment (MAT) training for primary care providers. Features resources and discussion on effective ways of treating opioid use disorder. Hosted by the SAMHSA-HRSA Center for Integrated Health Solutions.
Date: 07/2018
Type: Website
Sponsoring organizations: Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration
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USDA Maine Rural Opioid Misuse Roundtable
Features a roundtable on the rural opioid crisis in Maine hosted USDA Maine Rural Development. Presents discussion between community leaders, experts, and people working to provide treatment and prevention of opioid addiction in rural Maine.
Date: 07/2018
Type: Video/Multimedia
Sponsoring organization: USDA Rural Development Maine State Office
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Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop
Features the proceedings of a public workshop on the relationship between the opioid epidemic and the spread of infectious diseases. Presents research and policy options, such as integrating infectious disease treatment into opioid treatment and prevention efforts, as well as exploring the role of law enforcement. Discusses barriers to treatment and prevention in rural areas.
Additional links: Read Online
Date: 07/2018
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Challenges Facing a Rural Opioid Epidemic: Treatment and Prevention of HIV and Hepatitis C
Presents a study on the current trends of HIV and HCV infection coinciding with the opioid epidemic and the strategies for treatment and prevention in rural areas. Highlights the barriers to HIV and HCV testing and treatment for rural people who inject drugs.
Author(s): Asher J. Schranz, Jessica Barrett, Christopher B. Hurt, et al.
Citation: Current HIV/AIDS Reports, 15(3), 245-254
Date: 06/2018
Type: Document
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The Opioid Epidemic: National Trends in Opioid-Related Overdose Deaths from 2000 to 2016
Details the rates of death caused by opioid overdoses throughout the U.S. from 2000-2016. Compares deaths caused by heroin and non-heroin opioids, as well as death rates in nonmetro, small/medium metro, and large metro areas. Companion Brief details overdose rates by state.
Additional links: The Opioid Epidemic: State Trends in Opioid-Related Overdose Deaths from 2000 to 2016
Author(s): Colin Planalp, Megan Lahr
Date: 06/2018
Type: Document
Sponsoring organization: State Health Access Data Assistance Center
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Adverse Childhood Experiences: A Driver of the Opioid Epidemic
Webinar recording discusses the role adverse childhood experiences (ACEs) in the opioid epidemic. Defines ACEs and looks at rates of substance abuse. Highlights data nationally and specific to West Virginia.
Additional links: Webinar Slides
Author(s): Michael R. Brumage
Date: 06/2018
Type: Video/Multimedia
Sponsoring organization: North Central Regional Center for Rural Development
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Spurring Innovation: The Role of Child Health Policy
Identifies four target areas to improve child health: Medicaid and the Children's Health Insurance Program (CHIP) delivery and payment reforms; consumer digital health; precision medicine in pediatrics; and addiction and neonatal abstinence syndrome (NAS). Provides recommendations to further develop child health research and policy. Discusses removing barriers and expanding access to telehealth services to deliver care to children living in rural areas, and the rural incidence of NAS.
Date: 06/2018
Type: Document
Sponsoring organization: AcademyHealth
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The Opioid Crisis and Economic Opportunity: Geographic and Economic Trends
Features a study on the relationship between economic opportunity and opioid use. Explores the correlation between poverty and opioid prescriptions, hospitalizations, and overdose rates. Features several nationwide maps of county-level data.
Author(s): Robin Ghertner, Lincoln Groves
Date: 06/2018
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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It's an Addiction Crisis: Across Minnesota, the "Opioid Crisis" Is So Much More Than Just Opioids
Details the opioid crisis in the state of Minnesota. Includes statistics on overdose deaths and treatment admissions for alcohol, heroin, methamphetamine, and other opiates. Covers hospital addition costs and workforce issues posing a barrier to access in rural areas. Reviews three rural community models working to address substance abuse.
Author(s): Marnie Werner
Date: 06/2018
Type: Document
Sponsoring organization: Center for Rural Policy and Development
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Opportunities and Challenges to Utilizing Telehealth Technologies in the Provision of Medication Assisted Therapies in the Medi-Cal Program
Describes advantages and barriers to using telehealth for delivery of medication-assisted treatment (MAT) to California's Medicaid enrollees, especially those in rural and underserved areas. Includes recommendations for changes to California state laws in order to alleviate the challenges. Appendix C lists states allowing telehealth prescribing.
Date: 06/2018
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Report to Congress on Medicaid and CHIP, June 2018
Provides an in-depth examination of and makes recommendations on two critical issues, the high cost of prescription drugs and the opioid epidemic, as they relate to Medicaid. The opioid section includes discussion of rural access to treatment for substance use disorder. Also discusses Medicaid's role as the nation's largest payer for long-term services and supports.
Date: 06/2018
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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SAMHSA Opioid Overdose Prevention Toolkit
Provides strategies for healthcare providers, communities, and local governments to help prevent opioid-related overdoses and deaths. Includes facts for community members, essential steps for first responders, information for prescribers, safety advice for patients and family members, and resources for overdose survivors and their families.
Date: 06/2018
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Prescribing Practices of Rural Physicians Waivered to Prescribe Buprenorphine
Highlights a study on the prescribing practices of rural physicians with buprenorphine waivers, which allow them to provide medication-assisted treatment (MAT) for opioid used disorder. Findings are based on surveys of all rural physicians with a Drug Enforcement Administration prescription waiver. Breaks down data by physician specialty, practice type, and waiver type, among other factors.
Author(s): Holly A. Andrilla, Cynthia Coulthard, Davis G. Patterson
Citation: American Journal of Preventive Medicine, 54(6) S3, S208-S214
Date: 06/2018
Type: Document
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Promising Practice: Summits Tackle Opioid Misuse and Treatment in Rural Illinois
Describes the Opioid Crisis Next Door summits, a series of conferences sponsored by the Illinois Center for Rural Health (ICRH) to increase the awareness of the opioid and heroin crisis in rural communities, and to identify ways for these communities to effectively respond to their misuse.
Author(s): Beth Blevins
Date: 05/2018
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Running the Numbers: County Level Dynamics of Heroin Mortality in North Carolina
Presents a study on opioid overdose mortality in North Carolina. Compares counties that have higher rates of overdose mortality with those with lower rates and aims to identify the factors that contribute to those rates.
Author(s): Alexander H Gunn, Bryce Bartlett, Grace Feng, et al.
Citation: North Carolina Medical Journal, 79(3), 195-200
Date: 05/2018
Type: Document
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Access to Syringe Services Programs — Kentucky, North Carolina, and West Virginia, 2013–2017
Overview of the role of syringe services programs (SSPs) in reducing hepatitis C transmission related to injection drug use. Describes the expansion of SSPs in Kentucky, North Carolina, and West Virginia from 2013 through August 1, 2017. Discusses the opportunity to improve access to care through SSPs, including access to related services such as medication-assisted treatment, which can be included in comprehensive SSPs.
Author(s): Danae Bixler, Greg Corby-Lee, Scott Proescholdbell, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 67(18), 529-532
Date: 05/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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2017 Colorado Opioid Safety Pilot Results Report
Describes an opioid safety pilot study that implemented the ALTO, or alternative to opioid, approach for pain treatment in 7 urban and 3 rural hospital emergency departments in Colorado. Discusses ALTO's multifaceted treatment approach for pain management, data collection and analysis, and lessons learned.
Additional links: Pre-Launch Checklist: Using Alternatives to Opioids (ALTOs) in Hospital Emergency Departments
Date: 05/2018
Type: Document
Sponsoring organization: Colorado Hospital Association
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Opioid White Paper: Analysis of Responses to Committee Request for Information
Details an analysis of the information received by the U.S. House of Representatives Ways and Means Committee regarding the opioid crisis. Discusses the current state of the crisis and the measures currently in place regarding prevention and treatment.
Date: 04/2018
Type: Document
Sponsoring organization: House Ways and Means Committee
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The Opioid Crisis Response Act of 2018
Presents the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) hearing on the Opioid Crisis Response Act of 2018. Features testimony from representatives of the Delaware Office of the Child Advocate, the National Association of State Alcohol and Drug Abuse Directors, and the Addiction Policy Forum.
Date: 04/2018
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Moving Away from the Tip of the Pyramid: Screening and Brief Intervention for Risky Alcohol and Opioid Use in Underserved Patients
Summarizes the findings of an online survey of a practice-based research network of 126 medical providers serving Hispanic/Latino and Native American patients in rural and urban settings in New Mexico. Discusses clinician perspectives on the need to address substance use in primary care, current screening and treatment practices, and their willingness to adapt practices to meet the needs of the patient populations.
Author(s): Kamilla L. Venner, Victoria Sánchez, Jacqueline Garcia, et al.
Citation: Journal of the American Board of Family Medicine, 31(2), 243-251
Date: 03/2018
Type: Document
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Understanding the Science of Pain and Opioids
An overview of how opioids impact the brain and of the brain disease model of opioid use disorder. Includes a list of risk factors related to drug misuse.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Information Hub
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The "M" of MAT: Medications for Opioid Use Disorder
A brief overview of medications used to treat opioid use disorder, as part of whole-patient treatment which includes counseling and behavioral therapies.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Information Hub
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Combating the Opioid Crisis: Prevention and Public Health Solutions
Presents the U.S. House of Representatives Energy and Commerce Committee hearing on preventative measures and the role of public health in combating the opioid crisis. Features testimony from representatives of the Food and Drug Administration, Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services, the National Association of County and City Health Officials, and the National Indian Health Board, among others.
Additional links: Michael E. Kilkenny Testimony, Stacy Bohlen Testimony
Date: 03/2018
Type: Video/Multimedia
Sponsoring organization: House Energy and Commerce Committee, Subcommittee on Health
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The Geographic Variation in the Cost of the Opioid Crisis
Presents a study on the economic costs of the opioid crisis across the nation. Features state-by-state and county-level data on the monetary burden of opioid abuse on communities.
Author(s): Alex Brill, Scott Ganz
Date: 03/2018
Type: Document
Sponsoring organization: American Enterprise Institute
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Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants — United States, 2015–2016
Examines age-adjusted death rates for overdoses involving all opioids, cocaine, and psychostimulants with abuse potential. Includes data by opioid subcategory for prescription opioids, heroin, and synthetic opioids. Provides data by urbanization level for metropolitan, micropolitan, and noncore counties, as well as data by decedent demographics.
Author(s): Puja Seth, Lawrence Scholl, Rose A. Rudd, Sarah Bacon
Citation: MMWR (Morbidity and Mortality Weekly Report), 67(12), 349-358
Date: 03/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Integrating Infectious Disease Considerations with Response to the Opioid Epidemic: A Workshop
Presentation recordings discusses the link between the opioid crisis and infectious diseases, such as HIV and HCV. Features state-by-state, county-level, and rural information, particularly in southern states.
Additional links: Jody Rich: Correctional Health, Nickolas Zaller: Challenges and Opportunities in Rural America
Date: 03/2018
Type: Video/Multimedia
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Infectious Diseases and Opioid Use Disorder (OUD) Policy Issues and Recommendations
Report details policy recommendations regarding infectious diseases, such as HIV and HCV, linked to injection drug use (IDU). Recommendations look at prevention as well as treatment. Features several important policy considerations for rural communities.
Date: 03/2018
Type: Document
Sponsoring organizations: HIV Medicine Association, Infectious Disease Society of America, Pediatric Infectious Disease Society
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Preventing Opioid Overdoses Among Rural Americans
Policy brief focused on preventing rural opioid overdoses and reducing overdose deaths in rural areas. Identifies policy options and strategies including evidence-based prescribing methods, medication-assisted treatment (MAT), and overdose reversing medication. Includes three brief case studies.
Date: 03/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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What's MAT Got to Do with It? Medication-Assisted Treatment for Opioid Use Disorder in Rural America
Provides an overview of medication-assisted treatment (MAT), an evidence-based treatment for opioid use disorder, with information on the science behind the disorder and how three MAT medications work. Highlights rural health organizations providing MAT treatment.
Author(s): Kay Miller Temple
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Information Hub
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The Opioid Epidemic: Definitions, Data, Solutions
Fact sheet presents data on opioids and overdose deaths among American Indians/Alaska Native populations. Details several policy based solutions for Native American communities.
Date: 03/2018
Type: Document
Sponsoring organization: National Congress of American Indians Policy Research Center
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Oversight Hearing on Opioids in Indian Country: Beyond the Crisis to Healing the Community
Presents the U.S. Senate Committee on Indian Affairs hearing on the opioid crisis in Indian Country. Features testimony from representatives of the U.S. Department of Justice, the Substance Abuse and Mental Health Administration, the Indian Health Service, the Port Gamble S'Klallam Tribe, and the National Indian Health Board.
Date: 03/2018
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Indian Affairs
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Opioid Overdoses Treated in Emergency Departments
Describes trends in opioid overdose emergency department (ED) visits and discusses what the federal government, health departments, EDs, and healthcare providers can do. Includes links to related CDC resources.
Additional links: Fact Sheet, Transcript for VitalSigns Teleconference
Date: 03/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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The Opioid Crisis: Leadership and Innovation in the States
Presents the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) hearing on state policy approaches to combating the opioid crisis. Features testimony from the governors of Maryland and Oregon detailing the opioid interventions implemented in their states.
Date: 03/2018
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses — United States, July 2016-September 2017
Reports on changes in opioid overdoses seen in emergency departments (EDs) by region, state, and urbanization level. Addresses the need for real-time data to coordinate responses to outbreaks and the role ED data can play. Discusses how ED physicians and staff can help address future overdoses among ED patients. Figure 2 shows quarterly suspected opioid overdose data for metropolitan, micropolitan, and noncore counties.
Author(s): Alana M. Vivolo-Kantor, Puja Seth, R. Matthew Gladden, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 67(9), 279-285
Date: 03/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Pain in the Nation Update: Deaths from Alcohol, Drugs and Suicide Reach the Highest Level Ever Recorded
Report details deaths related to alcohol, drugs, and suicide across the nation. Highlights rates for non-metro areas, as well as by race, gender, and by age groups, among others.
Date: 02/2018
Type: Document
Sponsoring organization: Trust for America's Health
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The Opioid Crisis: The Role of Technology and Data in Preventing and Treating Addiction
Highlights the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) hearing on the use of data and technology interventions in combating the opioid epidemic. Features testimony from representatives of Express Scripts, the National Alliance for Model State Drug Laws, the Santa Clara University Public Health Program, and the University of Illinois at Chicago.
Date: 02/2018
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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The Opioid Crisis: Impact on Children and Families
Presents the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) hearing on the opioid crisis's effect on children and families. Features testimony from representatives of the 525 Foundation, Casey Family Programs, and Vanderbilt University Medical Center.
Date: 02/2018
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Hearing on the Opioid Crisis: Removing Barriers to Prevent and Treat Opioid Abuse and Dependence in Medicare
Presents a U.S. House of Representatives Committee on Ways and Means Health Subcommittee hearing on the opioid crisis. Focuses specifically on addiction treatment and prevention efforts to protect older Americans who rely on Medicare.
Date: 02/2018
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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Scaling-Up HCV Prevention and Treatment Interventions in Rural United States-Model Projections for Tackling an Increasing Epidemic
Examines how combining annual hepatitis C virus (HCV) treatments with syringe service programs and medication assisted treatment (MAT) can reduce HCV chronic prevalence or incidence given increasing drug injection use due to the opioid epidemic. Models different program combinations needed to reduce HCV rates 90% by 2025 and 2030 based on data from rural Scott County, Indiana. Examines the portion of required annual HCV treatments both with and without scaling up other programs.
Author(s): Hannah Fraser, Jon Zibbell, Thomas Hoerger, et al.
Citation: Addiction, 113(1), 173-182
Date: 01/2018
Type: Document
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The Role of Rural Hospitals in Addressing Opioid and Other Substance Use Problems
Provides slides from the January 2018 Small Rural Hospital Transition HELP Webinar on strategies for rural hospitals to engage in opioid and substance use issues. Addresses drivers of substance use disorders, barriers to treatment, prevention strategies, community coalitions, and more. Includes program examples for prevention, screening, and treatment.
Author(s): John Gale
Date: 01/2018
Type: Presentation Slides
Sponsoring organization: Maine Rural Health Research Center
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Rapid Review of Rural Health Research: Resources for the Five Leading Causes of Death
Prepared to accompany the December 12-13, 2017 workshop What Works for Rural: From Research to Reality. Compiles research and resources gathered online from October 2013 to December 2017 on the topics of cancer, chronic lower respiratory disease, heart disease, stroke, and unintentional injury, which includes a subsection on drug overdoses and opioids.
Date: 01/2018
Type: Document
Sponsoring organizations: Centers for Disease Control and Prevention, Federal Office of Rural Health Policy, Georgia Health Policy Center, National Network of Public Health Institutes
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Strategies to Combat Opioid Use in Rural Communities
Webinar discussing evidence-based, cost-effective prevention, treatment, and recovery programs successfully used in rural settings to combat opioid problems. Described community organizing strategies to engage local stakeholders. Presented by John Gale from the Maine Rural Health Research Center.
Additional links: Presentation Slides, Transcript, Webinar Recording
Date: 01/2018
Type: Video/Multimedia
Sponsoring organization: Rural Health Research Gateway
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Substance Abuse Among Older Adults: Opioid Issues and Trends in Rural America
Webinar recording discusses the opioid crisis and its effect on elderly people in rural areas. Features presentations by representatives from the National Advisory Committee on Rural Health and Human Services (NACRHHS) and Health Benefits ABCs.
Additional links: Webinar Slides
Author(s): Paul Moore, William Benson
Date: 01/2018
Type: Video/Multimedia
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Rural Health Research Recap: Opioid Use and Treatment Availability
Summarizes key findings from the Rural Health Research Centers' most recent research on opioid use and treatment. Focuses on research related to opioid use in rural communities, treatment for opioid use disorder, perceived need and use of treatment, and rural community response. Provides links to each of the referenced source documents.
Date: 01/2018
Type: Document
Sponsoring organization: Rural Health Research Gateway
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Communicating about Opioids in Appalachia: Challenges, Opportunities, and Best Practices
Describes how opioids are affecting Appalachia and offers suggestions on how community-based organizations can promote prevention and treatment, and eliminate the stigma of addiction.
Date: 01/2018
Type: Document
Sponsoring organizations: Appalachian Regional Commission, Oak Ridge Associated Universities
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The Opioid Crisis: An Examination of How We Got Here and How We Move Forward
Presents the full U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) hearing on the opioid crisis, featuring a testimony from Sam Quinones, journalist and author of Dreamland: The True Tale of America's Opioid Epidemic.
Additional links: Written Testimony
Date: 01/2018
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Perceived Treatment Need and Utilization for Illicit Drug and Opioid Use Disorders in Non-Metropolitan Areas
Gives estimates of perceived need and use of treatment for illicit drug and prescription pain reliever use disorders in 2008-2010, 2011-2013, and 2014-2015 among people ages 18-64. Includes statistics with breakdowns by urban or rural locations and by opioid, heroin, prescription drug, or any drug use disorder.
Author(s): Tyrone F. Borders, Hefei Wen
Date: 01/2018
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Illicit Drug and Opioid Use Disorders among Non-Metropolitan Residents
Provides estimates of metropolitan and non-metropolitan past year drug use disorder rates among people ages 18-64 and temporal changes in past year drug use disorder prevalence rates. Includes statistics with metropolitan and non-metropolitan breakdowns for any drug, opioid, heroin, and prescription pain reliever use disorder.
Author(s): Tyrone F. Borders, Hefei Wen
Date: 01/2018
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Evidence-Based Strategies for Preventing Opioid Overdose: What's Working in the United States
A guide for community leaders, public health, law enforcement, and others working to address the opioid crisis in their community. Identifies evidence-based practices that have been successfully implemented in the U.S. and are effective in reducing rates of opioid overdose. Includes strategies focused on naloxone distribution, medication-assisted treatment (MAT), addressing opioid use in criminal justice settings, syringe services, and more.
Author(s): Jennifer J. Carroll, Traci C. Green, Rita K. Noonan
Date: 2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Quality Improvement and Care Coordination: Implementing the CDC Guideline for Prescribing Opioids for Chronic Pain
A guide to help primary care providers, practices, and healthcare systems manage patients who are on long-term opioid therapy. Provides an evidence-based prescribing guideline, quality improvement measures, and practice-level care coordination strategies. Appendix F provides examples of comprehensive management approaches, including discussion of telehealth approaches that could be used in rural communities.
Date: 2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Child Welfare and Substance Use
Discusses a study on the relationship between substance use, specifically opioid misuse, and child welfare caseloads. Explores reports of child abuse and foster care entries along with drug mortality rates and retail opioid sales. Features rural information in the second and third reports.
Date: 2018
Type: Website
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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The Opioid Crisis in Rural and Small Town America
Provides data on opioid mortality rates in 2016 and changes in opioid mortality from 1999 through 2016 for metropolitan and nonmetro counties. Also provides metro/nonmetro data on drug overdoses by type of opioid - heroin, prescription opioids, synthetic opioids, and unspecified opioids - from 1999 through 2016. Discusses challenges rural areas face in addressing the opioid crisis.
Author(s): Shannon M. Monnat, Khary K. Rigg
Date: 2018
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Leading a Faith-Based Charge Against Opioid Abuse: How a Minnesota Rural Health Organization Became a National Leader
Describes prescription drug abuse treatment efforts of CHI St. Gabriel's Health, a multifacility rural health organization in Little Falls, Minnesota.
Author(s): Patrick Rioux
Citation: Health Progress, 99(2), 29-32
Date: 2018
Type: Document
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Examining Substance Use Disorder Treatment Demand and Provider Capacity in a Changing Health Care System: Final Report
Assesses demand and capacity for substance use disorder treatment, with comparisons between years 2013 and 2016. Features statistics including numbers of clients, staff hours, percentage of facilities offering pharmacotherapies and accepting various insurance types, and distribution of specialty treatments, with breakdowns by urban and rural locations.
Additional links: In Focus Brief, May 2018
Author(s): Ellen Bouchery
Date: 12/2017
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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Vermont Hub-and-Spoke Model of Care for Opioid Use Disorders: An Evaluation
Details an evaluation of Vermont's hub-and-spoke model of medication-assisted treatment (MAT) for opioid addiction. Discusses the system's successes and areas that need focus and improvement.
Additional links: Summary Brief
Author(s): Richard A. Rawson
Date: 12/2017
Type: Document
Sponsoring organization: Vermont Center on Behavior & Health
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Behavioral, Mental, and Physical Health Characteristics and Opioid Medication Misuse among Community Pharmacy Patients: A Latent Class Analysis
Study of opioid misuse risk factors based on mental, behavioral, and physical health characteristics for patients in 2 rural and 2 urban Pennsylvania counties. Uses latent class analysis methodology to identify combinations of indicators that may be visible to pharmacists and that may suggest increased risk of opioid misuse, including age, employment, whether a pharmacy is in a rural area, and education level.
Author(s): Gerald Cochran, Valerie Hruschak, Jennifer L. Bacci, Kenneth C. Hohmeier, Ralph Tarter
Citation: Research in Social and Administrative Pharmacy, 13(6), 1055-1061
Date: 11/2017
Type: Document
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Pain in the Nation: The Drug, Alcohol and Suicide Crises and the Need for a National Resilience Strategy
Examines current trends, causes, costs, and potential solutions to the drug, alcohol, and suicide crises in the U.S. Includes rural data and discussion of rural-specific issues.
Author(s): Laura M. Segal, Anne De Biasi, Jennifer L. Mueller, Kendra May, Molly Warren
Date: 11/2017
Type: Document
Sponsoring organization: Trust for America's Health
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The Front Lines of the Opioid Crisis: Perspectives from States, Communities, and Providers
Video recording details the Senate Health, Education, Labor, and Pensions (HELP) Committee hearing on the opioid epidemic. Features testimony detailing efforts to combat opioid addiction from representatives of the Virginia Commonwealth University School of Dentistry; the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals; the Wisconsin Prescription Drug Monitoring Program; and the Kentucky Justice and Public Safety Cabinet.
Date: 11/2017
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Rural America in Crisis: The Changing Opioid Overdose Epidemic
Discusses the history of the opioid epidemic and its effect on rural communities, as well as key functions of public health programs that can help prevent opioid overdoses. Lists several resources regarding opioids and overdose prevention.
Author(s): Rita Noonan
Date: 11/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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The President's Commission on Combating Drug Addiction and the Opioid Crisis
Includes recommendations set forth by the President's Commission on Combating Drug Addiction and the Opioid Crisis to combat the opioid epidemic. Details plans for federal funding, prevention, treatment, education, and research. Discusses the role of the Department of Health and Human Services and the Department of Justice in facilitating the proposed course of action.
Date: 11/2017
Type: Document
Sponsoring organization: The President's Commission on Combating Drug Addiction and the Opioid Crisis
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Silence Surrounding Hepatitis C Status in Risk Relationships among Rural People Who Use Drugs
Highlights a study on hepatitis C (HCV) status among rural people who use drugs by injection (PWIDs). Discusses the rates at which HCV-positive PWIDs disclosed their diagnosis to their partners, close friends, and family.
Author(s): Megan G. Hofmeister, Jennifer R. Havens, April M. Young
Citation: The Journal of Primary Prevention, 38(5), 481-494
Date: 10/2017
Type: Document
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Prescription Opioid Misuse among Rural Community Pharmacy Patients: Pilot Study for Screening and Implications for Future Practice and Research
Examines rural and urban community pharmacy patients in Pennsylvania to describe and compare patterns of opioid medication misuse. Identifies demographic and risk factors associated with rural and urban opioid medication misuse. Includes demographic statistics by rural and urban areas, such as education, employment status, and misuse behaviors. Offers recommendations to address opioid medication misuse.
Author(s): Gerald T. Cochran, Rafael J. Engel, Valerie J. Hruschak, Ralph E. Tarter
Citation: Journal of Pharmacy Practice, 30(5), 498-505
Date: 10/2017
Type: Document
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The Opioid Epidemic and Federal Efforts to Address It: Frequently Asked Questions
Provides an overview of America's opioid problem, including information on abuse and supply, and discusses federal agencies and programs that address opioid abuse. Also discusses recent federal legislation and state-level policies that seek to combat the opioid problem.
Date: 10/2017
Type: Document
Sponsoring organization: Congressional Research Service
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Preventing Drug Abuse: Low Participation by Pharmacies and Other Entities as Voluntary Collectors of Unused Prescription Drugs
Report to Congress documenting low participation rates among pharmacies and other eligible entities in the Drug Enforcement Administration's (DEA) unused controlled substance collection and disposal program. Includes an outline of program requirements, a state-by-state overview of currently eligible and enrolled entities, and information about participation rates by rural and urban location.
Additional links: Full Report
Date: 10/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Opioid Use Disorders: HHS Needs Measures to Assess the Effectiveness of Efforts to Expand Access to Medication-Assisted Treatment
Reviews U.S. Department of Health and Human Services' (HHS) efforts to expand access to and the use of medication assisted treatment (MAT) for treating opioid use disorders. Includes a discussion of rural-specific programs and makes recommendations for improving future efforts and overall program evaluation.
Additional links: Full Report
Date: 10/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Implementing Medication-Assisted Treatment for Opioid Use Disorder in Rural Primary Care: Environmental Scan Volume 1
Details challenges and barriers to implementing medication-assisted treatment (MAT) for opioid use disorder (OUD) in a primary care setting, such as healthcare policy, workforce, and financing, among others. Includes 250 tools and resources to help overcome barriers and support implementation MAT in rural areas.
Additional links: Volume 2: Tools and Resources
Author(s): Garrett E. Moran, Caroline M. Snyder, Rebecca F. Noftsinger, Joshua K. Noda
Date: 10/2017
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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The Federal Response to the Opioid Crisis
Presents the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) hearing on the government's response on the opioid crisis. Includes testimonies from SAMHSA, CDC, NIH, and the FDA regarding current efforts to increase access to treatment for opioid addiction and promote preventative measures across the U.S.
Additional links: Written Testimony
Date: 10/2017
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Using Telehealth to Identify and Manage Health and Substance Use Disorder Conditions in Rural Areas
Reports on an environmental scan, discussions with providers and stakeholders, and site visits regarding how telehealth supports behavioral health and substance use disorder treatment. Addresses how telehealth is used, implementation, services offered, financing and sustainability. Focuses on the implications for treating opioid use disorders in rural areas, in particular, using medication-assisted treatment (MAT) with support from telehealth. Appendix B includes site briefs from the 9 states included in the study.
Date: 09/2017
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Tackling the Opioid Crisis in a Rural Community
Discusses a partnership between a rural hospital physician and the director of a community counseling center to establish a medication-assisted treatment (MAT) for opioid addiction in rural Maine. Presents the program's support structure, as well as the advantages of having an integrated treatment approach.
Date: 09/2017
Type: Document
Sponsoring organization: American Hospital Association
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Opioid Use in Rural Areas Rural Health Chat
Summary of a September 2017 Twitter chat focused on the opioid epidemic. Documents a conversation among rural health experts addressing a range of topics, including the impact of opioids on rural communities, programs and services needed to address opioid misuse, barriers to accessing treatment, and innovative solutions.
Date: 09/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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Raising Awareness and Seeking Solutions to the Opioid Epidemic's Impact on Rural Older Adults
Examines opioid misuse by older rural people, discusses prevention and treatment programs, and identifies areas for further research. Includes information on Project Lazarus, a public health model based on the premise that overdose deaths are preventable and communities are responsible for their own health.
Author(s): William F. Benson, Nancy Aldrich
Date: 08/2017
Type: Document
Sponsoring organization: Grantmakers In Aging
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Overdose Deaths Related to Fentanyl and Its Analogs — Ohio, January-February 2017
Reports findings from a study of 281 unintentional overdose fatalities in 25 Ohio counties from January-February 2017, checking for the presence of fentanyl analogs, opioids, and other drugs. Includes demographic and drug data by type of county, including data for rural and Appalachian counties.
Additional links: Errata
Author(s): Raminta Daniulaityte, Matthew P. Juhascik, Kraig E. Strayer, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 66(34), 904-908
Date: 08/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Heartache, Pain, and Hope: Rural Communities, Older People, and the Opioid Crisis: An Introduction for Funders
Provides an overview of the opioid crisis and its impact on the lives of older adults. Addresses both opioid use by older adults and addiction within older adults' families. Identifies solutions being implemented by governments, communities, healthcare providers, and funders to address these concerns. Includes policy recommendations.
Date: 08/2017
Type: Document
Sponsoring organization: Grantmakers In Aging
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A Guide to Establishing Syringe Services Programs in Rural, At-Risk Areas
Intended to explain basics of syringe services programs, to identify the need for them in at-risk rural communities, and to provide guidance on considerations when establishing programs. Includes examples of programs in Kentucky, West Virginia, Indiana, and North Carolina and information about syringe services-related regulations and laws in select locations.
Author(s): Regina La Belle
Date: 07/2017
Type: Document
Sponsoring organization: Comer Family Foundation
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Patient Residence Characteristics of Opioid-Related Inpatient Stays and Emergency Department Visits Nationally and by State, 2014
Provides data on opioid-related hospital inpatient stays and emergency department (ED) visits from 2005 to 2014. Includes data by location of patient residence for metropolitan and rural areas. Identifies states where the highest rates of opioid-related inpatient stays and ED visits are in rural areas. Also provides data by community-level income.
Author(s): Audrey J. Weiss, Molly K. Bailey, Lauren O'Malley, et al.
Date: 07/2017
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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SLV N.E.E.D. (Naloxone - Education - Empowerment - Distribution)
Video featuring the San Luis Valley N.E.E.D. (Naloxone - Education - Empowerment - Distribution) program, which provides opioid-related education to healthcare providers and the community, as well as a naloxone distribution program and naloxone training for first responders in six rural Colorado counties.
Date: 07/2017
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use
Report looks at the current opioid epidemic in the U.S. Explores options for balancing chronic pain management while reducing the occurrence of addiction and misuse. Presents recommendations for treating overdoses and reducing demand for prescription, as well as illicit, opioids.
Additional links: Read Online
Author(s): Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse
Date: 07/2017
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Barriers Rural Physicians Face Prescribing Buprenorphine for Opioid Use Disorder
Examines the barriers rural physicians who hold Drug Enforcement Agency (DEA) waivers to prescribe buprenorphine face. Seeks to explain why some rural physicians who hold a DEA waiver choose not to prescribe buprenorphine or treat a fewer number of patients than their waiver allows. Data was collected through a 2016 survey of all physicians with DEA waivers in rural areas.
Author(s): C. Holly A. Andrilla, Cynthia Coulthard, Eric H. Larson
Citation: Annals of Family Medicine, 15(4), 359-362
Date: 07/2017
Type: Document
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Opioid Prescribing - Where You Live Matters
Presents county-by-county data on opioid prescriptions throughout the nation. Includes a guide for providers on how to decrease the amount of opioids prescribed, as well as what states, health insurers, and individuals can do to limit opioid use.
Date: 07/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015
Reports on opioid prescribing in the United States from 2006 to 2015. Includes data for metropolitan, micropolitan, and noncore (rural) counties. Also offers maps showing county-level prescriptions per capita in 2015 and changes in prescriptions per capita from 2010 to 2015.
Author(s): Gery P. Guy Jr., Kun Zhang, Michele K. Bohm, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 66(26), 697-704
Date: 07/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Final Report: Opioid Use, Misuse, and Overdose in Women
Discusses the need for prevention, treatment and recovery programs for women who have opioid use disorders. Focuses on the increase in opioid use among the female population and ways to help manage and respond to the impact of overuse and overdose. Provides a summary of the September 2016 national meeting focus on opioid use in women. Includes information about how rural location affects use and treatment, particularly lack of access to care and overdose remedies.
Additional links: White Paper, December 2016
Date: 07/2017
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services Office on Women's Health
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Reducing Rural Opioid Overdoses Webinar Recording
Webinar recording discusses the National Organization of State Offices of Rural Health (NOSORH) Report on Lessons from Rural Opioid Overdose Reversal Grant Recipients. Features presentations by FORHP Rural Opioid Overdose Reversal (ROOR) grantees: MaineGeneral Medical Center in Maine and Project Renew in West Virginia.
Additional links: MaineGeneral Webinar Slides, Project Renew Webinar Slides
Date: 06/2017
Type: Video/Multimedia
Sponsoring organization: National Organization of State Offices of Rural Health
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Responding to the Opioid Crisis: An Update for Tribal Leaders
Details the impact of the opioid crisis on American Indians and Alaska Natives. Discusses options for tribal leaders to respond within their communities.
Date: 06/2017
Type: Document
Sponsoring organization: National Congress of American Indians Policy Research Center
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Prevention and Treatment of Substance Abuse in Rural Communities
Webinar recording discusses the challenges and strategies in stemming the rate of substance abuse in rural communities. Introduces the Rural Prevention and Treatment of Substance Abuse Toolkit, designed to help communities implement substance abuse programs. Presents several examples of state level programs focused on increasing access to naloxone and training for first responders to recognize and prevent overdoses.
Additional links: Audio Recording, PowerPoint Handout, Transcript
Date: 05/2017
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Changes in the Supply of Physicians with a DEA DATA Waiver to Prescribe Buprenorphine for Opioid Use Disorder
Data brief describing changes in access to waivered physicians from 2012 to 2016. Features a county-level map and statistics with breakdowns by urban areas and three levels of rural areas.
Author(s): C. Holly A. Andrilla, Cynthia Coulthard, Eric H. Larson
Date: 05/2017
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Promising Practice: Virginia SORH Taking Aim at Opioid Overdose
Illustrates how the Virginia State Office of Rural Health (VA SORH) and its partners are focusing their attention on the opioid epidemic in rural areas of the state by expanding treatment, and training lay rescuers to recognize and respond to an opioid overdose and administer naloxone when necessary.
Author(s): Beth Blevins
Date: 04/2017
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Report on Lessons Learned from Rural Opioid Overdose Reversal Grant Recipients
Presents lessons learned from the recipients of the Rural Opioid Overdose Reversal (ROOR) Program grants. The ROOR Program was piloted by the Federal Office of Rural Health Policy (FORHP) in 2015 and seeks to combat the opioid crisis at the local level. Report also shares resources designed to assist other rural organizations and documents the impact of the pilot year program. Provides background information on each of the 18 original grant recipients and their programs.
Date: 04/2017
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Rural Opioid Prevention and Treatment Strategies: The Experience in Four States
Study examining strategies for dealing with the rural opioid crisis, including prevention, treatment, and recovery services. Uses data from interviews with key stakeholders in Indiana, North Carolina, Vermont, and Washington.
Additional links: Research and Policy Brief
Author(s): John A. Gale, Anush Y. Hansen, Martha Elbaum Williamson
Date: 04/2017
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Combatting the Opioid Epidemic with Provider and Public Education
Highlights from a conversation with Fred Wells Brason II, discussing community-based efforts to reduce opioid misuse and abuse in rural communities. Brason helped found Project Lazarus in Wilkes County, North Carolina, which reduced the overdose rate in Wilkes County by 72 percent over three years. The Project Lazarus model has since spread to more than 20 states and focuses on cross-sector collaboration, public and provider education, and increasing access to treatment.
Citation: Transforming Care: Reporting on Health System Improvement
Date: 03/2017
Type: Document
Sponsoring organization: Commonwealth Fund
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Treating the Rural Opioid Epidemic
Policy brief reviewing the barriers to implementing effective, high-quality treatment for mental health and substance abuse issues in rural areas. Includes policy recommendations for addressing these issues, focusing on access to medication assisted treatment (MAT) and funding for rural mental health infrastructure.
Author(s): Christine Hancock, Heidi Mennenga, Nikki King, et al.
Date: 02/2017
Type: Document
Sponsoring organization: National Rural Health Association
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Integrating Substance Use Disorder Treatment and Primary Care
Discusses the role of primary care providers in improving access to substance use treatment, particularly for alcohol and opioid use disorders. Explores state-level options, such as Medicaid payments, continuing medical education (CME) requirements, and prescription drug monitoring programs. Examines the Screening, Brief Intervention, and Referral to Treatment (SBIRT) approach, and how access barriers may affect SBIRT implementation in rural areas.
Author(s): Charles Townley, Hannah Dorr
Date: 02/2017
Type: Document
Sponsoring organization: National Academy for State Health Policy
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Prescription Opioid Poisoning Across Urban and Rural Areas: Identifying Vulnerable Groups and Geographic Areas
Examines hospital discharge rates for prescription opioid poisoning for rural and urban areas using data from 2001-2011 in California. Identifies hot-spot locations for opioid poisoning and environmental features related to opioid poisoning using a zip code level of analysis. Discusses the implications for policymakers and public health officials.
Author(s): Magdalena Cerda, Andrew Gaidus, Katherine M. Keyes, et al.
Citation: Addiction, 112(1), 103-112
Date: 01/2017
Type: Document
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A Community Partnership to Respond to the Heroin and Opioid Abuse Epidemic
Discusses the community response to heroin and opioid abuse in rural Carlton County, Minnesota. Details the county's collaboration with the Fond du Lac Band of Lake Superior Chippewa and St. Louis County to form the Carlton County Drug Abuse Task Force.
Author(s): Laura C. Palombi, Joe Vargo, Laura Bennett, et al.
Citation: Journal of Rural Health, 33(1), 110-113
Date: 01/2017
Type: Document
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Addiction Recovery Mobile Outreach Team (ARMOT)
Video featuring the Addition Recovery Mobile Outreach Team (ARMOT), a rural Pennsylvania program that helps people access substance abuse treatment. ARMOT staff meet with patients to discuss treatment options and with patients' families to provide education and support.
Date: 01/2017
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Alaska Opioid Policy Task Force: Final Recommendations
Provides recommendations supporting comprehensive public health prevention strategies to prevent and reduce opioid use, misuse, and abuse in rural and urban Alaska.
Date: 01/2017
Type: Document
Sponsoring organization: Alaska Department of Health and Social Services
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Combatting the Opioid Epidemic through Rural Coalitions
Presentation slide deck highlighting prevention activities and events rural coalitions can offer to address the opioid epidemic.
Author(s): Laura Palombi, Amy LaRue, Laura Bennett, Brent Thompson
Date: 2017
Type: Presentation Slides
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Stem the Tide: Addressing the Opioid Epidemic
Presents a report on various methods hospitals and health systems can use to address the opioid epidemic. Discusses non-opioid pain management, prescribing practices, and treatment for substance use disorders, among other topics. Highlights several rural programs in the Case Examples sections.
Date: 2017
Type: Document
Sponsoring organization: American Hospital Association
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Medication-Assisted Treatment Models of Care for Opioid Use Disorder in Primary Care Settings
Report details 12 promising medication-assisted treatment (MAT) models for treatment of opioid use disorder in a primary care setting. Discusses rural issues in several models.
Date: 12/2016
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Opioid Overdose Experience, Risk Behaviors, and Knowledge in Drug Users from a Rural Versus an Urban Setting
Highlights a study on the overdose knowledge of opioid users from both rural and urban areas. Details participants' experience with overdosing and their responses to the Brief Opioid Overdose Knowledge (BOOK) questionnaire.
Author(s): Kelly E. Dunn, Frederick S. Barrett, Claudia Yepez-Laubach, et al.
Citation: Journal of Substance Abuse and Treatment, 71, 1-7
Date: 12/2016
Type: Document
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Pennsylvania Mobile Team Addresses Substance Use Disorders
Features the Addiction Recovery Mobile Outreach Team (ARMOT) program, which supports patients in the recovery process and educates medical staff on addiction and recovery. ARMOT is a collaboration of three hospitals, two substance abuse providers, and the Armstrong-Indiana-Clarion Drug and Alcohol Commission.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 11/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Rural Opioid Use Disorder Treatment Depends on Family Physicians
Brief description of a study examining distribution of physicians approved to prescribe buprenorphine for opioid use disorder, by specialty and rurality. Features breakdowns by family medicine, emergency medicine, internal medicine, psychiatry, and all other specialties, and by urban or rural location.
Author(s): Peter Wingrove, Brian Park, Andrew Bazemore
Citation: American Family Physician, 94(7), 546
Date: 10/2016
Type: Document
Sponsoring organization: Robert Graham Center
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Opioid Addiction: Laws, Regulations, and Other Factors Can Affect Medication-Assisted Treatment Access
Examines current federal laws and regulations related to the medication-assisted treatment (MAT) of opioid dependency, and discusses how these laws affect access to treatment, including in rural areas. Also explores other factors that affect access to treatment such as cost, insurance coverage, practitioner availability, and perceived value. Provides detailed descriptions about the uses and concerns of the three medications currently approved by the FDA for use in opioid MAT - methadone, buprenorphine, and naltrexone.
Additional links: Full Report
Date: 09/2016
Type: Document
Sponsoring organization: Government Accountability Office
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NACRHHS Policy Briefs on Emergency Care Models and Rural Opioid Misuse Implications
September 2016 webinar discussion of two policy briefs sent to the Secretary of the U.S. Department of Health and Human Services (HHS) regarding alternative provision for emergency care due to rural hospital closures and the impact of opioid misuse in rural communities. Presented by members of the National Advisory Committee on Rural Health and Human Services including Former Governor Ronnie Musgrove, Committee Chair; Kelly Evans, Chief Executive Officer for Beartooth Billings Clinic, Red Lodge, MT; and Paul Moore, Executive Secretary.
Additional links: Audio Recording, PowerPoint Handout, Transcript
Date: 09/2016
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Intervention, Treatment, and Prevention Strategies to Address Opioid Use Disorders in Rural Areas: A Primer on Opportunities for Medicaid-Safety Net Collaboration
A guide designed to assist state Medicaid directors, healthcare providers, and other stakeholders who work to reduce opioid addiction. Includes descriptions of successful state initiatives implemented to reduce deaths due to overdose, and improve access to quality care for rural, low-income individuals experiencing opioid addiction. Provides an infographic displaying the prevalence and increase of substance abuse disorder in the U.S.
Additional links: Rural Opioid Infographic
Author(s): Chiara Corso, Charles Townley
Date: 09/2016
Type: Document
Sponsoring organization: National Academy for State Health Policy
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Fentanyl Law Enforcement Submissions and Increases in Synthetic Opioid-Involved Overdose Deaths - 27 States, 2013-2014
Reports on drugs testing positive for fentanyl. Provides information on synthetic opioid-involved deaths other than methadone, including fentanyl deaths. For 27 states with death certificate reporting of drugs involved in overdoses, provides data for metropolitan, micropolitan, and noncore areas.
Author(s): R. Matthew Gladden, Pedro Martinez, Puja Seth
Citation: MMWR (Morbidity and Mortality Weekly Report), 65(33), 837-843
Date: 08/2016
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Talking Rural Opioid Use at the United Nations: Q&A with Holly Andrilla
An interview with rural health researcher Holly Andrilla of the WWAMI Rural Health Research Center, recounting her experience presenting to the United Nations Office of Drugs and Crime in Vienna, Austria. Provides an international perspective on substance abuse prevention and treatment.
Author(s): Zachary Toliver
Citation: Rural Monitor
Date: 08/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Remedy for the Rural Opioid Epidemic: Leaders Discuss Medication-Assisted Addiction Treatment in Primary Care
Summarizes a meeting focused on understanding the opioid challenges in rural Northern California and identifying potential solutions. Provides maps highlighting opioid overdose death rates by county and the availability of licensed narcotic treatment programs.
Date: 07/2016
Type: Document
Sponsoring organization: California Health Care Foundation
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Families in Crisis: The Human Service Implications of Rural Opioid Misuse
Presents findings and policy recommendations from the National Advisory Committee on Rural Health and Human Services' 2016 meeting with rural residents, healthcare providers, and stakeholders regarding the impact and effects of opioid use disorders on rural families. Topics addressed include drug overdose and death, conflict with partners and children, emotional disturbance, adverse health risks, and related impacts on employment and economic sustainability.
Date: 07/2016
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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On Pills and Needles: Counties Fight the Opioid Drug Crisis
Special issue focused on how counties are responding to the opioid crisis. Includes an interview with Michael Botticelli, director of the White House Office of National Drug Control Policy, focused on the federal response to rural opioid abuse.
Citation: County News
Date: 07/2016
Type: Document
Sponsoring organization: National Association of Counties
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The Opioid Epidemic: Rural Organizations Fight Back
Highlights programs across the country, such as the ANGEL Program, the Police Assisted Addiction and Recovery Initiative (PARRI) and the Second Chance Drug Initiative, in which police departments and treatment facilities work together to fight addiction and move drug users toward treatment rather than incarceration. Also discusses the use and availability of Naloxone, an opioid overdose reversal drug.
Author(s): Zachary Toliver
Citation: Rural Monitor
Date: 06/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Prescription Opioid Use: Patient Characteristics and Misuse in Community Pharmacy
Highlights a study on prescription opioid use in both rural and urban communities in southwestern Pennsylvania. Analyzes data from an anonymous survey about opioid usage by type of drug and participant characteristics, such as age, gender, and education, among others.
Author(s): Gerald Cochran, Jennifer L. Bacci, Thomas Ylioja, et al.
Citation: Journal of the American Pharmacists Association, 56(3), 248-256
Date: 05/2016
Type: Document
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The Communities That Care Coalition Model for Improving Community Health through Clinical-Community Partnerships: A Population Health Case Report
Discussion paper featuring a community coalition in rural western Massachusetts focused on supporting youth well-being and reducing youth substance abuse. Describes the initiative and the partners involved, including clinicians and public health. Discusses how the Communities That Care Coalition works within a network of local coalitions, including acting as the prevention arm of the region's Opioid Task Force.
Author(s): Jeanette Voas, Katherine Allen, Ruth Potee
Date: 05/2016
Type: Document
Sponsoring organization: National Academy of Medicine
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The Opioid Epidemic: Testing the Limits of Rural Healthcare
Discusses the factors that make rural communities vulnerable to the ongoing opioid epidemic and efforts needed in rural areas to address this crisis, including the role of rural first responders.
Author(s): Zachary Toliver
Citation: Rural Monitor
Date: 05/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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National Advisory Committee on Rural Health and Human Services Meeting Minutes, Beaufort, South Carolina, April 18-20, 2016
Provides a summary of the 79th meeting of the National Advisory Committee on Rural Health and Human Services (NACRHHS), which was held in Beaufort, South Carolina. The meeting focused on two main topics: alternative models to preserving access to emergency care in rural areas in the face of hospital closures and the abuse of prescription painkillers and opioids.
Date: 04/2016
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Rural Communities in Crisis: Strategies to Address the Opioid Crisis
Policy brief describing the effects of the opioid and heroin crisis occurring in rural areas. Covers challenges to rural healthcare organizations combating this issue, and identifies and discusses policy recommendations addressing the opioid and heroin crisis in rural communities and in rural healthcare systems.
Author(s): John A. Gale, Dave Schmitz, Michael Meit, et al.
Date: 04/2016
Type: Document
Sponsoring organization: National Rural Health Association
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Rural Opioid Abuse: Prevalence and User Characteristics
Compares non-medical use of opioids, opiates, and heroin in rural and urban areas and assesses socioeconomic characteristics associated with their use.
Author(s): Jennifer D. Lenardson, John A. Gale, Erika C. Ziller
Date: 02/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Syringe Service Programs for Persons Who Inject Drugs in Urban, Suburban, and Rural Areas - United States, 2013
Describes characteristics of syringe service programs in urban, suburban, and rural areas. Includes information on program size, number of syringes exchanged, total funding, and whether public funding supports the program. Discusses the increase in opiate overdoses and prescription opiate use in rural areas and concerns related to the availability of syringe exchange programs in these areas.
Author(s): Don C. Des Jarlais, Ann Nugent, Alisa Solberg, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 64(48), 1337-41
Date: 12/2015
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Caring for Pregnant Opioid Abusers in Vermont: A Potential Model for Non-Urban Areas
Provides an overview of the challenges managed and the approach used for the development of a comprehensive program for the treatment of opioid dependence during pregnancy in rural Vermont.
Author(s): Marjorie Meyer, Julie Phillips
Citation: Preventive Medicine, 80, 18-22
Date: 11/2015
Type: Document
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Rural Adolescents Are More Likely Than Their Urban Peers to Abuse Prescription Painkillers
Provides an overview of the growing epidemic of prescription drug abuse by adolescents in small towns and in rural areas of the U.S., and emphasizes the urgency with which this epidemic should be addressed.
Author(s): Shannon M. Monnat, Khary K. Rigg
Date: 10/2015
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Where Is Buprenorphine Dispensed to Treat Opioid Use Disorders? The Role of Private Offices, Opioid Treatment Programs, and Substance Abuse Treatment Facilities in Urban and Rural Counties
Examines the impact of 2006 federal legislation allowing waivered physicians to prescribe and expand FDA approved buprenorphine as a treatment for opioid use disorder to a maximum of 100 patients. Discusses buprenorphine distribution by both urban and rural waivered physicians, opioid treatment programs, and treatment facilities for substance abuse.
Author(s): Bradley D. Stein, Rosalie L. Pacula, Adam J. Gordon, et al.
Citation: The Milbank Quarterly, 93(3), 561-583
Date: 09/2015
Type: Document
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Disparity in Naloxone Administration by Emergency Medical Service Providers and the Burden of Drug Overdose in US Rural Communities
Examines the factors that influence the administration of naloxone by emergency medical technicians (EMTs) in drug overdoses occurring in rural, suburban, and urban areas, using data from the National Emergency Medical Services Information System.
Author(s): Mark Faul, Michael W. Dailey, David E. Sugerman, et al.
Citation: American Journal of Public Health, 105(Suppl), e26-e32
Date: 07/2015
Type: Document
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Threading the Needle - How to Stop the HIV Outbreak in Rural Indiana
Perspective piece describing an outbreak of HIV in rural Indiana linked to prescription-opioid injection and the steps taken to address that outbreak. Identifies actions that physicians and states can take to prevent HIV outbreaks among injection-drug users.
Author(s): Steffanie A. Strathdee, Chris Beyrer
Citation: New England Journal of Medicine, 373(5), 397-399
Date: 07/2015
Type: Document
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Prevalence of Opioids and the Workforce to Provide Treatment in Rural and Urban Settings
Webinar presented on June 25, 2015, featuring Holly Andrilla, John Gale, and Jennifer Lenardson, in which they discuss their research on opioid use, prescribing of opioids by the medical workforce, and availability of treatment. Features statistics with breakdowns by urban and rural locations.
Additional links: Presentation Slides, Transcript, Webinar Recording
Date: 06/2015
Type: Video/Multimedia
Sponsoring organization: Rural Health Research Gateway
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Urban vs. Rural Differences in Prescription Opioid Misuse among Adults in the United States: Informing Region Specific Drug Policies and Interventions
A study analyzing data from the 2011 and 2012 National Survey on Drug Use and Health discussing the rural/urban differences in prescription opioid misuse.
Author(s): Khary K. Rigg, Shannon M. Monnat
Citation: International Journal of Drug Policy, 26(5), 484–491
Date: 05/2015
Type: Document
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Increases in Hepatitis C Virus Infection Related to Injection Drug Use Among Persons Aged ≤30 Years - Kentucky, Tennessee, Virginia, and West Virginia, 2006-2012
Discusses opioid abuse, drug injecting, and hepatitis C virus (HCV) infection in central Appalachia, with data on HCV infection rates for four states. Includes data for rural and urban areas by gender and race/ethnicity.
Author(s): Jon E. Zibbell, Kashif Iqbal, Rajiv C. Patel, Anil Suryaprasad, Kathy J. Sanders, Loretta Moore-Moravian, Jamie Serrecchia, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 64(17), 453-458
Date: 05/2015
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Federal Guidelines for Opioid Treatment Programs
Highlights guidelines for planning and implementing an opioid treatment program. Features information on the use of telemedicine, as well as exemptions for serving rural areas.
Date: 01/2015
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Screening Community Pharmacy Patients for Risk of Prescription Opioid Misuse
Examines the feasibility of screening patients for risks of opioid prescription misuse when filling prescriptions at rural and urban community pharmacies. Evaluates patients' behavioral, mental, and physical health to determine risk level. Includes rural versus urban data on gender, age, education, employment, and behavioral, mental, physical, and general health.
Author(s): Gerald Cochran, Jessica Rubinstein, Jennifer L. Bacci, Thomas Ylioja, Ralph Tarter
Citation: Journal of Addiction Medicine, 9(5), 411-416
Date: 2015
Type: Document
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Geographic and Specialty Distribution of US Physicians Trained to Treat Opioid Use Disorder
Illustrates the geographic distribution (rural-urban status) and the availability of physicians who receive waivers from the Drug Enforcement Administration (DEA) to prescribe medication and to treat patients with opioid use disorder.
Author(s): Roger A. Rosenblatt, C. Holly A. Andrilla, Mary Catlin, Eric H. Larson
Citation: Annals of Family Medicine, 13(1), 23-26
Date: 2015
Type: Document
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Risk Factors for HCV Infection Among Young Adults in Rural New York Who Inject Prescription Opioid Analgesics
Details a study of hepatitis C virus (HCV) prevalence among people who inject drugs and those who misuse prescription opioid analgesics in rural New York. Analyzes cohort by age, gender, age at first injection, and use of a syringe exchange program, among others.
Author(s): Jon E. Zibbell, Rachel Hart-Malloy, John Barry, Lillian Fan, Colleen Flanigan
Citation: American Journal of Public Health, 104(11), 2226-2232
Date: 11/2014
Type: Document
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Healthcare Use and Prescription of Opioids in Rural Residents with Pain
Researches the factors affecting healthcare use and prescription of opioids in low-income individuals living in rural areas. Examines the relationship between rural residency, low socioeconomic status, and self-reported pain levels, along with the disparities caused by greater need and limited access. Findings are based on information collected from rural, low-income individuals with chronic pain receiving treatment at Federally Qualified Health Centers.
Author(s): Shweta Kapoor, Beverly E. Thorn
Citation: Rural and Remote Health, 14(3), 2879
Date: 09/2014
Type: Document
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Can We Build an Efficient Response to the Prescription Drug Abuse Epidemic? Assessing the Cost Effectiveness of Universal Prevention in the PROSPER Trial
Reports on a study evaluating the effectiveness and the cost-effectiveness of 4 universal evidence-based-preventive-interventions (EBPIs) in reducing nonmedical prescription opioid use. Sample population included 6th grade school children from 28 rural public school districts, evenly divided between Iowa and Pennsylvania. Families were offered a single family-based intervention program in 6th grade, and 1 of 3 school-based intervention programs in 7th grade.
Author(s): D. Max Crowley, Damon E. Jones, et al.
Citation: Preventive Medicine, 62, 71-77
Date: 05/2014
Type: Document
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Barriers to Primary Care Physicians Prescribing Buprenorphine
Reports on a study of physicians in the State of Washington who participated in a Rural Opioid Addiction Management Project on the use of buprenorphine-naloxone in the treatment of opioid use disorders. Study determined the percentage of physicians who prescribed this treatment, the characteristics associated with the prescribing physicians, the number of patients treated, and the barriers found when integrating this treatment into their outreach practice.
Author(s): Eliza Hutchinson, Mary Catlin, C. Holly A. Andrilla, et al.
Citation: Annals of Family Medicine, 12(2), 128-133
Date: 03/2014
Type: Document
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Understanding the Rural–Urban Differences in Nonmedical Prescription Opioid Use and Abuse in the United States
This report analyzes the risk factors, including availability and access, that drive nonmedical prescription opioid drug misuse and abuse in U.S. states with large rural populations.
Author(s): Katherine M. Keyes, Magdalena Cerdá, Joanne E. Brady, Jennifer R. Havens, Sandro Galea
Citation: American Journal of Public Health, 102(2)
Date: 02/2014
Type: Document
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Nonmedical Use of Prescription-Type Drugs, by County Type
Provides tables and charts identifying the nonmedical use of prescription-type drugs by county in the U.S. Includes demographic characteristics of population surveyed and compares rural with metropolitan and non-metropolitan counties.
Date: 04/2013
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Prescription Painkiller Overdoses in the US
Discusses the increase in overdose deaths from prescription painkillers from 1999-2010. Reports that those living in rural counties are twice as likely to overdose on prescription painkillers compared to those living in urban.
Date: 11/2011
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Individual and Network Factors Associated with Non-fatal Overdose among Rural Appalachian Drug Users
Presents a study on the prevalence of non-fatal prescription drug overdoses in rural Appalachian Kentucky. Breaks down data by whether the overdose was experienced or witnessed, injection drug use, and lifetime drug use, among other factors.
Author(s): Jennifer R. Havens, Carrie B. Oser, Hannah K. Knudsen, et al.
Citation: Drug and Alcohol Dependence, 115(1-2), 107-112
Date: 05/2011
Type: Document
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Nonmedical Prescription Drug Use in a Nationally Representative Sample of Adolescents: Evidence of Greater Use Among Rural Adolescents
Analyzes a sample of adolescents aged 12 to 17 to determine if rural residence is linked with nonmedical prescription drug use and the factors related to nonmedical prescription drug use.
Author(s): Jennifer R. Havens, April M. Young, Christopher E. Havens
Citation: JAMA Pediatrics, 165(3), 250-255
Date: 03/2011
Type: Document
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Distance Traveled and Cross-state Commuting to Opioid Treatment Programs in the United States
Presents a study on commuting distance of patients in opioid treatment programs (OTP). Analyzes data collected from 23,141 methadone patients enrolled in 84 OTP centers across the U.S. from 2005-2009.
Author(s): Andrew Rosenblum, Charles M. Cleland, Chunki Fong, et al.
Citation: Journal of Environmental and Public Health, 2011, 948789
Date: 2011
Type: Document
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Prescription Opiate Misuse among Rural Stimulant Users in a Multistate Community-based Study
Investigates factors associated with prescription opiate misuse among a stimulant-using (methamphetamine and/or cocaine) population from rural counties in Arkansas, Kentucky, and Ohio. Factors examined include anxiety, chronic pain, other health issues, and other substance use.
Author(s): Jennifer R. Havens, William W. Stoops, Carl G. Leukefeld, et al.
Citation: American Journal of Drug and Alcohol Abuse, 35(1), 18-23
Date: 2009
Type: Document
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HRSA Center of Excellence for Behavioral Health Technical Assistance
Provides training and technical assistance for HRSA-funded grantees working to integrate behavioral healthcare into primary care settings. Features information and resources on models and best practices for behavioral healthcare integration.
Type: Website
Sponsoring organization: Health Resources and Services Administration
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Substance Use Warmline
Free, confidential teleconsultation service for clinicians, providing expert recommendations on substance use disorder treatment. Provides peer-to-peer consultation to support primary care providers in managing complex patients with addiction, chronic pain, and behavioral health issues.
Type: Hotline
Sponsoring organization: National Clinician Consultation Center
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Tribal Opioid Response Resource Toolkit
Offers a variety of materials, tools, resources and links to support tribes in their efforts to combat the opioid epidemic within their tribal communities.
Type: Website
Sponsoring organization: National Indian Health Board
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University of Rochester Medicine Recovery Center of Excellence (RCOE)
Provides resources and support to help rural communities identify and implement evidenced based practices to reduce morbidity and mortality from substance use disorder (SUD) and synthetic opioid use. Provides technical assistance to 20 high-needs rural Appalachian counties in Kentucky, New York, Ohio, and West Virginia.
Type: Website
Sponsoring organization: University of Rochester Medical Center
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Fletcher Group Rural Center of Excellence (RCOE)
Works to create and expand recovery housing services, evidenced-based treatment and prevention programs, and peer support services in over 100 counties highly impacted by substance use disorders (SUD) in Kentucky, Ohio, West Virginia, Georgia, Tennessee, Mississippi, Washington, Oregon, Montana, and Idaho.
Type: Website
Sponsoring organization: Fletcher Group
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University of Vermont Center on Rural Addiction
Works to support and build evidence-based practices for addiction treatment and prevention for substance use disorder (SUD), including opioid use disorder (OUD), in rural communities throughout Maine, New Hampshire, and Vermont. Offers education and outreach, examples of best practices, training, access to a clinician advisory board, and epidemiologic and evaluation services to identify existing and future addiction treatment needs and barriers.
Type: Website
Sponsoring organization: University of Vermont
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CLOUD (Curated Library about Opioid Use for Decision-makers)
Searchable library of curated, evidence-based resources on opioids and the opioid crisis. Includes documents and reports, legislation, videos, and websites on topics such as addiction treatment, harm reduction, prevention, recovery, and pain management. Provides information targeted to policymakers and community leaders; payers and providers; and patients and caregivers.
Type: Website
Sponsoring organization: Center for Evidence-based Policy
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FindTreatment.gov
Tool allows users to find mental health providers and treatment for substance use disorder by zip code. Features treatment options, payment information, and information about addiction and mental health.
Type: Directory
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Neonatal Abstinence Syndrome (NAS) Among Newborn Hospitalizations: Rate by Patient Location
Chart showing the rate of neonatal abstinence syndrome (NAS) per 1,000 newborn hospitalizations by patient location. Includes four metropolitan levels and rural areas, with national and state-level data available for 2009-2017.
Type: Chart/Graph
Sponsoring organization: Agency for Healthcare Research and Quality
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Preventing Substance Misuse in Rural Settings
A guide to delivering substance misuse prevention programming in rural communities. Identifies challenges and strategies specific to rural areas.
Type: Document
Sponsoring organization: Education Development Center
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Wisconsin Opioids: Data Direct
Provides access to interactive county-level data on opioid deaths and hospitalizations in Wisconsin. Includes data by age, sex, opioid type, and race/ethnicity. Select a county by clicking the map. Provides information on adult and youth opioid use. Highlights how populations are using opioids, reasons for obtaining opioid prescriptions, and trends for medication misuse.
Type: Website
Sponsoring organization: Wisconsin Department of Health Services
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Rural Communities Opioid Response Program
Details the multi-year initiative to overcome barriers to access of prevention, treatment, and recovery for substance use disorder (SUD).
Type: Website
Sponsoring organization: Health Resources and Services Administration
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Opioid Overdose Epidemic Toolkit for Local Health Departments
Toolkit offering resources, data, and other information at the local, state, and national level related to the opioid epidemic and substance use issues. Focuses on five response efforts: monitoring and surveillance; prevention; harm reduction and response; linkage to care; and stakeholder engagement and community partnerships.
Type: Website
Sponsoring organization: National Association of County and City Health Officials
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HHS.gov/Opioids: Help and Resources, National Opioids Crisis
Highlights the U.S. Department of Health and Human Services strategy to combating the opioid crisis. Presents resources and information for prevention, treatment, and recovery.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Rural Communities in Crisis: A Critical Count to Save Lives During the Opioid Epidemic
A method rural communities can use to estimate the size and characteristics of the population who inject drugs. Includes a toolkit describing the approach and an online calculation tool that can be used to estimate service needs in a community related to the opioid crisis.
Additional links: Calculation Tool, Toolkit: Applying Population Estimation Methods in Rural America
Type: Tool
Sponsoring organization: Johns Hopkins Bloomberg School of Public Health
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Maternal Opioid Misuse (MOM) Model
Overview of a CMS initiative focused on the care of pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD) through state-driven transformation of the delivery system. Supports coordination of clinical care and integration of other services critical for health, well-being, and recovery.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Drug Overdose Deaths in the United States
Interactive map highlights drug overdose deaths in the United States by county. Features demographic information such as race/ethnicity, educational attainment, and disability status, as well as economic factors such as poverty rate, unemployment rate, and accident-prone employment, among others.
Type: Map/Mapping System
Sponsoring organizations: NORC at the University of Chicago, U.S. Department of Agriculture
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Opioid Mapping Initiative
Presents a mapping system that allows users to locate distributors of naloxone and prescription drug drop off locations. Aims to provide open data sets to local health departments, law enforcement agencies, and communities.
Additional links: National Drug Drop-off Locations Map, National Naloxone Map
Type: Map/Mapping System
Sponsoring organization: New America
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Six Building Blocks: A Team-Based Approach to Improving Opioid Management in Primary Care
Offers a structured approach primary care providers can follow to improve management of patients on chronic opioid therapy. Includes a self-assessment, implementation guide, and links to additional resources.
Type: Website
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Opioid Epidemic Practical Toolkit: Helping Faith and Community Leaders Bring Hope and Healing to Our Communities
Provides practical steps that community and faith-based organizations can take to help address the opioid crisis. Includes information on awareness, prevention, and recovery support. Also covers community capacity building, collaboration, and federal resources.
Type: Website
Sponsoring organization: HHS Center for Faith-based and Neighborhood Partnerships (The Partnership Center)
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Indian Health Service - Opioid Use Disorder and Pain
Discusses the use of prescription opioids and outlines proper pain management for Indian Health Services (IHS) patients and providers. Features resources for providers and tribal communities in the areas of crisis data and response, medication assisted treatment (MAT) and Tele-MAT, a Naloxone training toolkit, prevention, maternal/child health, pain management, supplemental opioid funding for IHS facilities, and more.
Type: Website
Sponsoring organization: Indian Health Service
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Pain Management
Details the Indian Health Service guidelines on pain management. Features information on chronic pain, patient assessment, opioids, and other factors pertaining to the treatment of pain.
Type: Document
Sponsoring organization: Indian Health Service
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Rural Opioid Educational Resources
A comprehensive list of National Organization of State Offices of Rural Health resources addressing the opioid crisis. Includes reports, webinar recordings, promising practices, training materials, and medication-assisted treatment (MAT) resources. Also offers customizable posters, flyers, brochures, and more.
Type: Website
Sponsoring organization: National Organization of State Offices of Rural Health
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Opioid Misuse Resource Map
Presents a map of the U.S. which details the opioid resources available by state. Features programs providing emergency services, treatment, and prevention.
Type: Website
Sponsoring organization: U.S. Department of Agriculture
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Rural Opioid Overdose Reversal Program
Presents a report on the lessons learned from grant recipients of the Rural Opioid Overdose Reversal (ROOR) Program grant. Features related resources, such as a webinar, training, data, and outreach materials.
Type: Website
Sponsoring organization: National Organization of State Offices of Rural Health
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HRSA: Opioid Crisis
Features information, resources, and opportunities related to addressing the opioid crisis. Details HRSA's efforts to help combat opioid abuse, including the sharing of best practices, increasing education and training, and expanding access through health centers and the use of telehealth, among other interventions.
Type: Website
Sponsoring organization: Health Resources and Services Administration
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Drug Overdose Deaths in Appalachia
Interactive map highlights drug overdose deaths in Appalachia by county. Features demographic information such as race/ethnicity, educational attainment, and disability status, as well as economic factors such as poverty rate, unemployment rate, and accident-prone employment, among others.
Type: Map/Mapping System
Sponsoring organizations: Appalachian Regional Commission, NORC at the University of Chicago
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Opioid Misuse in Rural America
Features information and resources pertaining to opioid misuse in rural communities. Includes USDA programs and examples of best practices.
Type: Website
Sponsoring organization: U.S. Department of Agriculture
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Farm Town Strong
Website details information and resources to support agricultural communities affected by the opioid epidemic. Presents crisis hotlines, links to treatment centers, prevention resources, and prescription drug disposal for rural agricultural communities.
Type: Website
Sponsoring organizations: American Farm Bureau Federation, National Farmers Union
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Trends in Opioid-Related Hospitalizations
Presents data on opioid-related hospitalizations for 2009-2014 and 2016. Includes national and state-level data by patient location for metropolitan and rural areas.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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Opioid Overdose: U.S. Prescribing Rate Maps
A collection of maps showing retail opioid prescription rates from 2006-2018 at the county and state level.
Type: Map/Mapping System
Sponsoring organization: Centers for Disease Control and Prevention
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HCUP Fast Stats - Opioid-Related Hospital Use
Provides access to data on opioid-related inpatient stays and emergency department visits for rural and urban areas over a range of years. Data is available at the national and state level.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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Rural Prevention and Treatment of Substance Use Disorders Toolkit
Resources and best practices to help rural communities develop substance use disorder prevention and treatment programs. Identifies program models and examples, and discusses implementation, evaluation, sustainability, and dissemination of program results.
Type: Website
Sponsoring organization: Rural Health Information Hub
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Medicare Part D Opioid Prescribing Mapping Tool
Interactive mapping tool identifies opioid prescription rates at the state, county, and zip code level for de-identified Medicare Part D claims from 2013-2016. Also offers rural/urban opioid prescribing data.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
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Uniform Data System (UDS) Mapper
Illustrates the geographic reach, penetration, and growth of the Section 330-funded Health Center Program (HCP) and its relationship to other federally-linked health resources. Provides data on health centers and their service areas, as well as population indicators. Includes access to Mapping Areas of Priority for Medication-Assisted Treatment (MAP for MAT), with data identifying areas of high need and services available related to the opioid epidemic. Free, but registration is required.
Type: Map/Mapping System
Sponsoring organizations: American Academy of Family Physicians, Robert Graham Center
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Last Updated: 10/20/2020