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Substance Abuse in Rural Areas Resources

Selected recent or important resources focusing on Substance Abuse in Rural Areas.

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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Rural Youth Fight for Tobacco-Free Communities
Highlights teen-led programs to prevent tobacco use in rural Kentucky, Vermont, and Montana. Discusses the impact youth can have on local and state policy related to tobacco, and well as the effectiveness youth have in reaching their peers on this issue.
Author(s): Allee Mead
Location: Rural Monitor
Date: 11/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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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.
Date: 10/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas — United States
Reports on trends in illicit drug use, illicit drug use disorders, and overdose deaths in large metropolitan, small metropolitan, and nonmetropolitan areas, based on 2003–2014 National Survey on Drug Use and Health (NSDUH) data and 1999–2015 National Vital Statistics System Mortality (NVSS-M) data. Includes metro/nonmetro illicit drug use data by sex, age group, race/ethnicity, and household income. Includes data on metro/nonmetro drug overdose deaths by sex, race/ethnicity, intent (unintentional, homicide, suicide, undetermined), and age group.
Author(s): Karin A. Mack, Christopher M. Jones, Michael F. Ballesteros
Location: MMWR Surveillance Summaries, 66(19), 1-12
Date: 10/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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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: 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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Full Committee Hearing: The Federal Response to the Opioid Crisis
Presents the U.S. Senate Committee on Health, Education, Labor, and Pensions meeting 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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In Focus: Expanding Access to Addiction Treatment Through Primary Care
Discusses the lack of access to treatment for drug addiction and presents models for implementing medication-assisted treatment (MAT) for addiction, including one in a rural community health center. Looks at barriers to expanding MAT in primary care, as well as methods for overcoming those barriers.
Author(s): Martha Hostetter, Sarah Klein
Location: Transforming Care: Reporting on Health System Improvement
Date: 09/2017
Type: Document
Sponsoring organization: Commonwealth Fund
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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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Rural Older Adults Hit Hard by Opioid Epidemic
Describes the scarcity of overdose-related medical resources in rural areas, despite the relatively high rate of hospitalizations and death among rural opioid users ages 45 and older. Explores causes of increased opioid prescribing, health risks, associated elder abuse, barriers to care, and possible solutions.
Author(s): William F. Benson, Nancy Aldrich
Date: 09/2017
Type: Document
Sponsoring organization: American Society on Aging
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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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Rural Tobacco Control and Prevention
Webinar recording presents the Rural Tobacco Control and Prevention Toolkit developed by NORC Walsh Center for Rural Health Analysis. Features examples of successful programs from the Vermont Department of Health and the West Virginia University Extension Service - McDowell County.
Additional links: Audio Recording, PowerPoint Handout, Webinar Transcript
Date: 09/2017
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Results from the 2016 National Survey on Drug Use and Health: Detailed Tables
Provides data on use of illicit drugs, alcohol, and tobacco, trends in substance use disorder and mental health, and access to treatment for youth 12-17 and adults. Features statistics for a variety of demographic and geographic characteristics.
Date: 09/2017
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Annual Surveillance Report of Drug-Related Risks and Outcomes--United States, 2017
Summarizes latest information on opioid prescribing from 2006-2016; drug use, misuse, and substance use disorder from 2014-2015; nonfatal overdose hospitalizations and emergency department visits from 2014; and drug overdose mortality from 1999-2015. Features statistics with breakdowns by large metropolitan, small metropolitan, non-metropolitan urbanized, non-metropolitan less urbanized, and completely rural.
Date: 08/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Spit It Out-West Virginia
Video highlighting the Spit it Out program, which serves six West Virginia Coal Country counties. Describes how the Southern Coalfields Tobacco Prevention Coalition Network partnered with mining companies to reduce tobacco use, particularly smokeless tobacco use.
Date: 08/2017
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Trends in Opioid-Related Hospitalizations
Presents state-by-state data on opioid-related hospitalizations throughout the U.S. Details the change in hospitalization rate in each state from 2009-2014. Identifies the geographic areas in each state with the highest rates.
Date: 08/2017
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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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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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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Tobacco Control and Cessation in Rural Areas Rural Health Chat
Summary of a July 2017 Twitter chat focused on rural tobacco control and cessation. Documents a conversation among rural health experts addressing a range of topics, including tobacco use in rural areas, challenges rural residents face in quitting, the impact of tobacco use, innovative solutions, and resources to support rural tobacco control and cessation.
Date: 07/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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Use of the Emergency Department for Mental Health and Substance Abuse among Women
Fact sheet identifying trends among urban and rural women who utilize the emergency department (ED) for treatment of substance abuse (SA) and/or mental health (MH) issues. Research seeks to help communities understand who is using the ED for MH and SA so they can provide more effective, less costly care.
Author(s): Shawnda Schroeder, Mandi-Leigh Peterson, Jordan Jaeger
Date: 07/2017
Type: Document
Sponsoring organization: Rural Health Reform Policy Research Center
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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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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 rurally located physicians with DEA waivers.
Author(s): C. Holly A. Andrilla, Cynthia Coulthard, Eric H. Larson
Location: Annals of Family Medicine, 15(4), 359-362
Date: 07/2017
Type: Document
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Rural and Urban Utilization of the Emergency Department for Mental Health and Substance Abuse
Details a report on the use of emergency services in treating mental health and substance abuse (MH/SA) in both rural and urban settings. Discusses healthcare needs of MH/SA patients, as well as the increasing demands on emergency departments. Breaks down data by urban, large rural, small rural, and isolated rural emergency departments, as well as by age and primary payer of patients.
Author(s): Shawnda Schroeder, Mandi Leigh-Peterson
Date: 06/2017
Type: Document
Sponsoring organization: Rural Health Reform 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, Webinar 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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Traffic Safety Facts, 2015 Data: Rural/Urban Comparison of Traffic Fatalities
Contains statistics on motor vehicle fatal crashes based on data from the Fatality Analysis Reporting System (FARS). Provides a rural/urban comparison of statistics regarding various factors, such as time of day, speeding, alcohol use, and rollover crashes, among others.
Date: 04/2017
Type: Document
Sponsoring organization: National Highway Traffic Safety Administration
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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. Background on each of the 18 original grant recipients and their programs is provided.
Date: 04/2017
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Deaths of Despair: Drug, Alcohol, and Suicide Mortality in Small City and Rural America
Recording of an April 26, 2017 webinar focused on trends in drug, alcohol, and suicide mortality in the U.S. Discusses potential explanations for increased deaths from these causes over the past twenty years and examines regional variations in these deaths. Discusses strategies to combat these deaths of despair.
Author(s): Shannon Monnat
Date: 04/2017
Type: Video/Multimedia
Sponsoring organization: University of Wisconsin Institute for Research on Poverty
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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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Prevention of Drug Use and Treatment of Drug Use Disorders in Rural Areas
Discusses the role and potential benefits of engaging rural communities in the treatment and prevention of substance use disorders. Seeks to raise awareness among policymakers, public health officials, local authorities, and other stakeholders, and provide guidance to help these stakeholders plan and implement rural-specific strategies. Includes a discussion of substance use problems in the rural context, and provides examples of useful tools and evidence-based strategies. Also provides a list of additional resources, and a self-assessment tool designed to help identify needs, capacities, and strategies in your community.
Date: 03/2017
Type: Document
Sponsoring organization: United Nations Office on Drugs and Crime
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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.
Location: Transforming Care: Reporting on Health System Improvement
Date: 03/2017
Type: Document
Sponsoring organization: Commonwealth Fund
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Vermont Care Network Advocates for Behavioral Health and Developmental Disability Agencies
Highlights the work of the Vermont Care Network, which supports 16 non-profit agencies that provide behavioral health and developmental disability services in the state. Discusses cross-sector collaboration and integration of mental health, substance use, and developmental disability services with primary care.
Author(s): Jenn Lukens
Location: Rural Monitor
Date: 03/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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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. Also presents key opportunities 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
Policy brief discussing primary care's role in identifying, managing, and treating substance use disorders. Explores state-level options that can be used to strengthen primary care systems such as payment and delivery reform, provider education and training, prescription drug monitoring programs, and medication-assisted treatment. Also 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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Bowling Alone, Dying Together: The Role of Social Capital in Mitigating the Drug Overdose Epidemic in the United States
Highlights a study on community fragility and decline in civic engagement as factors contributing to opioid overdose mortality over the past 15 years. Compares measures of community factors, such as social capital, poverty, and rurality, among others.
Author(s): Michael J. Zoorob, Jason L. Salemi
Location: Drug and Alcohol Dependence, 173, 1-9
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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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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A Socioecological Approach to Addressing Tobacco-Related Health Disparities
Presents a sociological approach to reducing tobacco use. Focuses on addressing tobacco use in minority groups where usage is still prevalent. Analyzes factors that predispose various groups to tobacco use and discusses methods for prevention and cessation.
Additional links: Executive Summary
Date: 2017
Type: Document
Sponsoring organization: National Cancer Institute
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Protecting Our Infants Act: Report to Congress
Summary of the U.S. Department of Health and Human Services response to the Protecting Our Infants Act (2015), including background information about prenatal exposure to opioids; neonatal abstinence syndrome (NAS); evidence-based treatment and prevention programs; and suggestions to bridge the gap in barriers to care. Includes examples of successful rural programs and recommended guidelines for the prevention and treatment of opioid use disorder among reproductive age women.
Additional links: Protecting Our Infants Act: Final Strategy
Date: 2017
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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Behavioral Health Barometer: United States, Volume 4
Provides a broad overview of behavior health in metropolitan and nonmetropolitan areas of the U.S. with an emphasis on illicit drug, alcohol, and tobacco use, as well as the estimated percentage of people living with serious mental illness. Includes special focus on the misuse of prescription pain relievers, heroin use, and medication-assisted therapy (MAT) for opioid addiction. Data is from the 2015 National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services.
Date: 2017
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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White Paper: Opioid Use, Misuse, and Overdose in Women
White paper discussing 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. Includes information about how rural location affects use and treatment, particularly lack of access to care and overdose remedies.
Additional links: Final Report
Date: 12/2016
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services Office on Women's Health
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Vital Signs: Trends in HIV Diagnoses, Risk Behaviors, and Prevention Among Persons Who Inject Drugs — United States
Reports on trends in HIV diagnoses among people who inject drugs. Figure 1 shows data for urban and rural whites, African Americans, and Hispanics from 2008-2014.
Author(s): Cyprian Wejnert, Kristen L. Hess, H. Irene Hall, et al.
Location: MMWR (Morbidity and Mortality Weekly Report), 65(47), 1336-1342
Date: 12/2016
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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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
Location: Rural Monitor
Date: 11/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Vital Signs: Disparities in Tobacco-Related Cancer Incidence and Mortality — United States, 2004–2013
Reports on trends and disparities in incidence and death rates for cancers related to cigarette smoking during 2004–2013. Includes data for urban and rural counties.
Author(s): S. Jane Henley, Cheryll C. Thomas, Saida R. Sharapova, et al.
Location: MMWR (Morbidity and Mortality Weekly Report), 65(44),1212-1218
Date: 11/2016
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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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. 60 minutes.
Additional links: Transcript
Date: 09/2016
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Supply and Distribution of the Behavioral Health Workforce in Rural America
Discusses and compares the provider to population ratios of the behavioral health workforce in metropolitan and nonmetro (micropolitan and non-core) U.S. counties. A state-level analysis of the study is also available with information for all states.
Author(s): Eric H. Larson, Davis G. Patterson, Lisa A. Garberson, C. Holly A. Andrilla
Date: 09/2016
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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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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Results from the 2015 National Survey on Drug Use and Health: Detailed Tables
Provides data on illicit drug, alcohol, tobacco use, substance abuse disorder, and access to substance abuse treatment for youths 12 – 17 and adults 18 or older. Topics include measures on mental health illness, services utilization, depression, and the co-occurrence of mental disorders with substance abuse. Data is provided in a variety of demographic and geographic characteristics.
Date: 09/2016
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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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
Location: 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
Location: Rural Monitor
Date: 08/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Madison Outreach and Services through Telehealth (MOST) Network
Video featuring the Madison Outreach Services through Telehealth (MOST) Network, which serves the Hispanic/Latino population of Brazos Valley, Texas. Highlights their partnership with Texas A&M’s Telehealth Counseling Clinic, where doctoral-level students and promotoras connect with patients in remote clinics to offer mental health and substance abuse counseling.
Date: 07/2016
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Families in Crisis: The Human Service Implications of Rural Opioid Misuse (Policy Brief)
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.
Location: 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
Location: Rural Monitor
Date: 06/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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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.
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
Location: Rural Monitor
Date: 05/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Rural Communities in Crisis: Strategies to Address the Opioid Crisis
An overview on the effects of the opioid and heroin crisis occurring in rural areas, and the challenges to rural healthcare organizations combating this issue. 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, Robin Rose, et al.
Date: 04/2016
Type: Document
Sponsoring organization: National Rural Health Association
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Sobriety and Alcohol Use Among Rural Alaska Native Elders
Reports findings from descriptive and correlational data gathered during a needs assessment regarding alcohol use among Inupiat and Yup'ik Eskimo elders residing in remote, rural villages in Northwest region of Alaska.
Author(s): Monica C. Skewes, Jordan P. Lewis
Location: International Journal of Circumpolar Health, 75
Date: 02/2016
Type: Document
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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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SAMHSA Opioid Overdose Prevention Toolkit
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: 01/2016
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Increases in Acute Hepatitis B Virus Infections - Kentucky, Tennessee, and West Virginia, 2006-2013
Reports on increased rates of hepatitis B infections in three Appalachian states, particularly among injection drug users and in non-urban areas.
Author(s): Aaron M. Harris, Kashif Iqbal, Sarah Schillie, et al.
Location: MMWR (Morbidity and Mortality Weekly Report), 65(3), 47-50
Date: 01/2016
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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In Brief: Rural Behavioral Health: Telehealth Challenges and Opportunities
Reports on the role of telehealth in transcending the barriers to access of mental and substance use disorder treatment in rural communities. Addresses barriers to telehealth implementation, utilization, and access.
Date: 2016
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Violent Victimization and Substance Dependency: Comparing Rural Incarcerated Heterosexual and Sexual Minority Women
Reports findings from a study of rural Appalachian women prisoners that looked at sexual identity and violent victimization experiences as they relate to alcohol and drug use.
Author(s): Melanie D. Otis, Carrie B. Oser, Michele Staton-Tindall
Location: Journal of Social Work Practice in the Addictions, 16(1-2), 176-201
Date: 2016
Type: Document
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Illicit Drug Abuse in Rural Communities
Summary of a study of the use of illicit drugs (specifically, marijuana and cocaine) as well as alcohol and tobacco in rural communities for people 12 and older. Focuses on contributing socio-economic factors that may predict abuse of these substances. Includes data and statistics for rural-urban difference.
Author(s): Yoon G. Lee
Location: Rural Connections, 10(1), 17-20
Date: 2016
Type: Document
Sponsoring organization: Western Rural Development Center
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Rural Behavioral Health: Telehealth Challenges and Opportunities
Reviews the barriers to mental and substance use disorder treatment and services in rural communities, presents ways telehealth can address these barriers, and discusses the challenges in implementing telehealth services in rural areas.
Author(s): Christina Currier, Suzanne Wise, Candi Byrne
Location: SAMHSA In Brief, 9(2)
Date: 2016
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Alcohol Use Patterns Among Urban and Rural Residents: Demographic and Social Influences
Analyzes the rates of alcohol use and alcohol use disorder (AUD) in urban and rural areas, and addresses the impact and the consequences of alcohol use on rural populations.
Author(s): Mark A. Dixon, Karen G. Chartier
Location: Alcohol Research: Current Reviews, 38(1), 69–77
Date: 2016
Type: Document
Sponsoring organization: National Institute on Alcohol Abuse and Alcoholism
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Father Involvement and Young, Rural African American Men's Engagement in Substance Misuse and Multiple Sexual Partnerships
Reports on a study to analyze the association of biological father and social father involvement with their male children with predicted development or engagement in risk behaviors of young rural men living in the South.
Author(s): Allen W. Barton, Steven M. Kogan, Junhan Cho, Geoffrey L. Brown
Location: American Journal of Community Psychology.; 56(3-4) 241–251
Date: 12/2015
Type: Document
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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.
Location: 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,
Location: Preventive Medicine, 80, 18–22
Date: 11/2015
Type: Document
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Perceived Ease of Access to Alcohol, Tobacco and Other Substances in Rural and Urban US Students
Examines differences in perceived ease of access to both legal and illegal substances for adolescents in rural and urban areas of Georgia. Provides statistics with breakdowns by substance, rural/urban, and middle versus high school students.
Author(s): Jacob Warren, K. Bryant Smalley, K. Nikki Barefoot
Location: Rural and Remote Health, 15, 3397
Date: 10/2015
Type: Document
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Implications of Rural Residence and Single Mother Status for Maternal Smoking Behaviors
Reports on a study using survey data to analyze and compare smoking behaviors of rural and urban mothers, both single and married, to determine if there is a relationship between prevalence of smoking, rurality, and single mother status.
Author(s): Jean A. Talbot, Donald Szlosek, Erika C. Ziller
Date: 10/2015
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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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 narcotic 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.
Location: The Milbank Quarterly, 93(3), 561-583
Date: 09/2015
Type: Document
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Prevention Paradigm for Native Americans
Video describing a new model of suicide prevention for Native Americans that focuses on the strengths and resilience of the people, as presented by Doreen Bird, program specialist at the Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center. Discusses how Native people should be involved in the development of suicide prevention programs in order to embolden the community, and create programs that are more effective at reducing suicide.
Date: 08/2015
Type: Video/Multimedia
Sponsoring organization: Suicide Prevention Resource Center
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Drug Use, Hepatitis C, and Service Availability: Perspectives of Incarcerated Rural Women
A fact-finding look at drug use and the health consequences of drug use, hepatitis C, and health service availability among a high-risk sample of women serving time in jail for drug use. Data was collected from a sample of 22 female offenders incarcerated in 3 jail facilities located in rural Appalachia.
Author(s): Michele Staton-Tindall, J. Matthew Webster, Carrie B. Oser, et al.
Location: Journal of Health & Social Policy, 30(4) 385–396
Date: 07/2015
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.
Location: American Journal of Public Health, 105(Suppl), 26-32
Date: 07/2015
Type: Document
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Attitudes and Beliefs of Primary Care Providers in New Mexico About Lung Cancer Screening Using Low-Dose Computed Tomography
Reports on a study to determine the awareness and attitudes of rural and urban primary healthcare providers in New Mexico (8 practicing in FQHCs) who use low-dose computed tomography (LDCT) when screening high risk underserved minority populations for lung cancer.
Author(s): Richard M. Hoffman, Andrew L. Sussman, Christina M. Getrich, et al.
Location: Preventing Chronic Disease, 12
Date: 07/2015
Type: Document
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Neonatal and Maternal Hospital Stays Related to Substance Use, 2006-2012
Examines newborn and maternal inpatient hospital stays associated with substance use, based on data from 38 states. Table 2 provides data by location of patient residence, for rural and urban locations.
Author(s): Kathryn R. Fingar, Carol Stocks, Audrey J. Weiss, Pamela L. Owens
Date: 07/2015
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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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
Location: New England Journal of Medicine, 373(5), 397-399
Date: 07/2015
Type: Document
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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
Location: 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.
Location: 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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A Rural Appalachian Faith-Placed Smoking Cessation Intervention
Describes a faith-oriented smoking cessation program comprising 590 smokers in 26 churches located in rural Appalachia. Discusses 3 themes identified by the participant’s evaluation of the program including the program’s ability to leverage social connections, be conveniently orientated, and to provide financial support for smoking cessation.
Author(s): Nancy E. Schoenberg, Henry E. Bundy, Jordan A. Baeker Bispo, et al.
Location: Journal of Religion and Health, 54(2), 598-611
Date: 04/2015
Type: Document
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The Future of Rural Behavioral Health
Policy paper discussing the unique challenges of providing behavioral healthcare services in rural areas. Includes policy recommendations and interventions related to workforce development, reimbursement and financing, integration of care, and the use of technology in delivering behavioral healthcare.
Author(s): Will Wilson, Angela Bangs, Tammy Hatting
Date: 02/2015
Type: Document
Sponsoring organization: National Rural Health Association
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Rural Substance Use Treatment Centers in the United States: An Assessment of Treatment Quality by Location
Investigates the differences in treatment quality in rural and urban substance abuse treatment centers to determine if these differences are a result of structural characteristics and rurality.
Author(s): Mary Bond Edmond, Lydia Aletraris, Paul M. Roman
Location: American Journal of Drug and Alcohol Abuse, 41(5), 449-457
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
Location: Annals of Family Medicine, 13(1), 23-26
Date: 2015
Type: Document
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Behavioral Health Equity Barometer: United States, 2014
Reports on differences in prevalence of behavioral health disorders, perceptions of risk, and access to treatment for different populations. Includes information for metropolitan and non-metropolitan residents, as well as by race/ethnicity, income level, and health insurance status.
Date: 2015
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Facilitators of Health Systems Change for Tobacco Dependence Treatment: A Qualitative Study of Stakeholders' Perceptions
An evaluation of tobacco treatment programs in rural and urban health systems in Minnesota that demonstrates they can implement extensive changes in a short time period to enhance the treatment of tobacco dependence. Emphasizes the use of electronic health records and healthcare quality measures to improve the healthcare environment for tobacco dependence.
Author(s): Amanda L Jansen, Traci R Capesius, Randi Lachter, et al.
Location: BMC Health Services Research, 14, 575
Date: 11/2014
Type: Document
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Building the Evaluation Capacity of Local Programs Serving American Indian/Alaska Native Populations: Lessons Learned
Describes technical assistance provided to help tribal communities develop their evaluation capacity so they could show that the substance abuse prevention programs they were undertaking were effective. Includes discussion of facilitators and challenges related to building evaluation capacity.
Date: 10/2014
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings
Presents summary results of the 2013 survey on the use of illicit drugs, alcohol, and tobacco by youth and adults. Includes data for metropolitan and non-metropolitan areas.
Additional links: Detailed Tables
Date: 09/2014
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Predictors of Heavy Episodic Drinking and Weekly Drunkenness among Immigrant Latinos in North Carolina
Analyzes the elements linked with excessive drinking among the rural immigrant Latino male population in North Carolina.
Author(s): J. Daniel-Ulloa, B.A. Reboussin, P.A. Gilbert, et al.
Location: American Journal of Men's Health, 8(4), 339-348
Date: 07/2014
Type: Document
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Gender Differences in the Use of Drug Resistance Strategies: An Analysis of Rural Asian/Pacific Islander Youth
Examines the differences between multi-ethnic male and female youth from the Island of Hawaii regarding their use of drug resistance strategies, and the implications for health promotion and drug prevention policies.
Author(s): Scott K. Okamoto, Suzanne Pel, Susana Helm, Jessica K. Valdez
Location: Health Promotion Practice, 15((4), 568-574
Date: 07/2014
Type: Document
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Barriers to Substance Abuse Treatment in Rural and Urban Communities: A Counselor Perspective
Compares rural and urban substance abuse counselors’ perceptions of barriers to providing substance abuse treatment by analyzing data collected from 28 counselors in Kentucky.
Author(s): Erin Pullen, Carrie Oser
Location: Substance Use & Misuse, 49(7), 891-901
Date: 06/2014
Type: Document
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A Comparison of Mental Health, Substance Use, and Sexual Risk Behaviors Between Rural and Non-Rural Transgender Persons
Evaluates the mental health, substance use, and sexual risk behaviors of transgender persons in both rural and non-rural areas to determine the need for mental and physical health services.
Author(s): Keith J. Horvath, Alex Iantaffi, Rebecca Swinburne-Romine, Walter Bockting
Location: Journal of Homosexuality, 61(8), 1117-1130
Date: 06/2014
Type: Document
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Suicide Among Young Alaska Native Men: Community Risk Factors and Alcohol Control
Discusses a study examining the variation in suicide rates among rural Alaskan Native men.
Author(s): Matthew Berman
Location: American Journal of Public Health, 104(Suppl 3), S329-S335
Date: 06/2014
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.
Location: Preventive Medicine, 62, 71-77
Date: 05/2014
Type: Document
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Trust in Physicians Among Rural Medicaid-Enrolled Smokers
Reports on a study of rural Medicaid-enrolled adult smokers participating in a tobacco cessation program to assess their level of trust in their physicians and the relationship between trust and patient characteristics and physician performance.
Author(s): Emory Nelms, Ling Wang, Michael Pennell, et al.
Location: Journal of Rural Health, 30(2), 214–220
Date: 04/2014
Type: Document
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'It's about the Smoke, Not the Smoker': Messages That Motivate Rural Communities to Support Smoke-free Policies
Discusses the results of a series of focus groups and surveys with community activists in three rural Kentucky counties regarding the use of promotional materials used to endorse smoke-free policies.
Author(s): Ganna Kostygina, Ellen J. Hahn, Mary Kay
Location: Health Education Research, 29(1), 58-71
Date: 02/2014
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
Location: American Journal of Public Health, 102(2)
Date: 02/2014
Type: Document
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Gender Differences in Circumstances Surrounding First Injection Experience of Rural Injection Drug Users in the United States
Discusses the gender differences between first time drug injection users in Appalachian Kentucky who primarily use prescription opioids.
Author(s): April M. Young, Nika Larian, Jennifer R. Havens
Location: Drug and Alcohol Dependence, 134, 401-405
Date: 01/2014
Type: Document
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Religiosity and Sexual Risk Behaviors Among African American Cocaine Users in the Rural South
Reports on a study investigating the association between religious behavior and sexual behavior among African Americans who use cocaine living in rural Arkansas.
Author(s): Brooke E.E. Montgomery, Katharine E. Stewart, Karen H.K. Yeary, et al.
Location: Journal of Rural Health, 30(3), 284-291
Date: 2014
Type: Document
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Drug Offers as a Context for Violence Perpetration and Victimization
Analyzes the connection of drug use by rural Native Hawaiian youth with aggressive behavior and violence.
Author(s): Susana Helm, Scott Okamoto, Alexis Kaliades, et al.
Date: 2014
Type: Document
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Extreme Binge Drinking Among 12th-Grade Students in the U.S.: Prevalence and Predictors
Analyzes the frequency and predictors of binge drinking and extreme binge drinking by 12th graders in rural and urban areas of the U.S.
Author(s): Megan E. Patrick, John E. Schulenberg, Meghan E. Martz, et al.
Location: JAMA Pediatrics, 167(11), 1019-25
Date: 11/2013
Type: Document
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Risky Sex in Rural America: Longitudinal Changes in a Community-Based Cohort of Methamphetamine and Cocaine Users
Analyzes the relationship between stimulant use and sexual behavior in a community-based study of rural users.
Author(s): Tyrone F. Borders, Katharine E. Stewart, Patricia B. Wright
Date: 11/2013
Type: Document
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Usefulness of a Survey on Underage Drinking in a Rural American Indian Community Health Clinic
Discusses how a survey of predominantly American Indian/Alaska Native youth on underage drinking can be helpful to a community health center when developing education and prevention efforts.
Author(s): David A. Gilder, Juan A. Luna, Jennifer Roberts, et al.
Location: American Indian and Alaska Native Mental Health Research Journal, 20(2), 1-26
Date: 10/2013
Type: Document
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Cost-Effectiveness of the Strong African American Families - Teen Program: 1-Year Follow-Up
A study to determine the cost-effectiveness of the Strong African American Families – Teen Program (SAAF-T) in the prevention of alcohol use and binge drinking by rural African American youth.
Author(s): Justin B. Ingels, Phaedra S. Corso, Steve M. Kogan, Gene H. Brody
Location: Drug and Alcohol Dependence, 133(2), 556-561
Date: 08/2013
Type: Document
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Comparing Teen Substance Use in Northern New Hampshire to Rural Use Nationwide
Using data administered in 2011 from the Carsey Institute’s Coös Youth Study and the National Survey on Drug Use and Health, this brief compares teen substance use patterns in New Hampshire’s most rural county to patterns among rural youth nationwide.
Author(s): Karen T. Van Gundy
Date: 07/2013
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Addressing the Specific Behavioral Health Needs of Men
Addresses the specific treatment needs of adult men with substance use disorders. Reviews gender-specific research and best practices, such as common patterns of initiation of substance use among men and specific treatment issues and strategies. Includes some discussion of how these issues impact rural men.
Date: 05/2013
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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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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Individual and Network Factors Associated With Prevalent Hepatitis C Infection Among Rural Appalachian Injection Drug Users
Examines the connection between injection drug users and Hepatitis C infections in rural Kentucky. Features statistics with breakdowns including sex, age, race, ethnicity, and various risk behaviors.
Author(s): Jennifer R. Havens, Michelle R. Lofwall, Simon D. W. Frost, et al.
Location: American Journal of Public Health, 103(1), 44-52
Date: 01/2013
Type: Document
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Qualitative Analysis of Provider Barriers and Solutions to HIV Testing for Substance Users in a Small, Largely Rural Southern State
Reports on a study, completed in Arkansas, to recognize any challenges to integrating HIV testing with substance abuse treatment for rural drug users from the perceptions of the service providers.
Author(s): Patricia B. Wright, Geoffrey M. Curran, Katharine E. Stewart, Brenda M. Booth
Location: Journal of Rural Health, 29(4), 2013
Date: 2013
Type: Document
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Medicaid Handbook: Interface with Behavioral Health Services
Provides a basic understanding of the Medicaid program, specifically emphasizing the interplay between Medicaid principles and the provision of behavioral health services in both rural and urban settings.
Date: 2013
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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A Comparison of Rural and Urban Substance Abuse Treatment Admissions
Compares rural and urban data in terms of substance abuse treatment admissions by age, gender, race and ethnicity, education level, employment status, income source, health insurance status, substance, and source of treatment referral.
Date: 07/2012
Type: Document
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Preventing Suicide: A Toolkit for High Schools
Helps high schools, school districts, and their partners design and implement strategies to prevent suicide and promote behavioral health among students with a special focus on American Indian students and other minority student populations in rural and urban areas.
Date: 06/2012
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Physical Victimization of Rural Methamphetamine and Cocaine Users
Evaluates the association between stimulant use of cocaine and/or methamphetamines and violence occurring among rural substance abuse users.
Author(s): Teresa L. Kramer, Tyrone F. Borders, Shanti Tripathi, et al.
Location: Violence and Victims, 27(1), 109-124
Date: 05/2012
Type: Document
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Stimulant Use Trajectories and the Longitudinal Risk of Heavy Drinking: Findings From a Rural Population-Based Study
Examines the longitudinal relationships between heavy drinking days and dormant sequences of powder cocaine, crack cocaine, and methamphetamine use among rural residents.
Author(s): Tyrone F. Borders, Brenda M. Booth
Location: Addictive Behaviors, 37(3), 269-272
Date: 03/2012
Type: Document
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An Evidence-Based Cessation Strategy Using Rural Smokers' Experiences With Tobacco
A study to identify the most effective population-based strategies to reach rural smokers and motivate them to quit. Describes the personal narratives of current and former smokers living in an economically distressed, rural area of Appalachian Kentucky.
Author(s): K.M. Butler, S. Hedgecock, R.A. Record, et al.
Location: Nursing Clinics of North America, 47(1), 31-43
Date: 03/2012
Type: Document
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Adolescent Alcohol Use: Do Risk and Protective Factors Explain Rural-Urban Differences?
Examines alcohol use among rural and urban adolescents between the ages of 12 and 17. After controlling for a broad range of key risk and protective factors, it is clear that an unexplained rural effect persists with rural adolescents still exhibiting higher alcohol use than their urban counterparts.
Additional links: Policy Brief
Author(s): John A. Gale, Jennifer D. Lenardson, David Lambert, David Hartley
Date: 03/2012
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Cutting Tobacco's Rural Roots: Tobacco Use in Rural Communities
The fifth report in the American Lung Association’s Disparities in Lung Health Series. Examines the prevalence of tobacco addiction and exposure to secondhand smoke in rural communities nationwide, particularly among rural youth.
Date: 2012
Type: Document
Sponsoring organization: American Lung Association
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Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General
Addresses the prevalence, causes, effects, and implications of tobacco use by young people in rural and urban areas. Describes factors that lead youth and young adults to start using tobacco and the impact their choice has on the nation, communities, families, and individuals. Identifies proven, effective strategies that have potential to reduce tobacco use.
Date: 2012
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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Smoke-Free Policies at Home, Church, and Work: Smoking Levels and Recent Quit Attempts Among a Southeastern Rural Population, 2007
Examines the effect of smoke-free policies and social support for quitting smoking in the home, at church and at work for rural African Americans and whites in 4 Georgia counties.
Author(s): Carla Berg, Deanne W. Swan, Michelle C. Kegler, George Fredrick, Sandra Daniel
Location: Preventing Chronic Disease, 9
Date: 12/2011
Type: Document
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Prescription Painkiller Overdoses in the US
Discusses the increase in overdose deaths from prescription painkillers in the last decade. 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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Assessment of Awareness of Connectedness as a Culturally-Based Protective Factor for Alaska Native Youth
A quantitative assessment of connectedness within Native American communities as a culturally based protective factor against substance abuse and suicide.
Author(s): Nathaniel V. Mohatt, Carlotta C. Ting Fok, Rebekah Burket, David Henry, James Allen
Location: Cultural Diversity and Ethnic Minority Psychology, 17(4), 444–455
Date: 10/2011
Type: Document
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Methamphetamine: The National Summit to Promote Public Health, Partnerships, and Safety for Critically Affected Populations
Identifies three critically affected populations of methamphetamine: incarcerated populations, LGBT individuals, and women of childbearing years. Describes funding issues and unique challenges they face, including those related to living in rural and frontier areas.
Date: 07/2011
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Rural Drug Users: Factors Associated with Substance Abuse Treatment Utilization
Reports on a study that compares rural drug users’ substance abuse history and substance abuse treatment utilization patterns to determine if there is an association between substance abuse treatment, or the underutilization of treatment, and other health problems.
Author(s): Carrie B. Oser, Carl G. Leukefeld, Michele Staton-Tindall, et al.
Location: International Journal of Offender Therapy and Comparative Criminology, 55(4), 567-586
Date: 06/2011
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
Location: JAMA Pediatrics, 165(3), 250-255
Date: 03/2011
Type: Document
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Northwest Tribal Substance Abuse Action Plan: A Five-Year Strategic Plan for the Tribes of Idaho, Oregon, and Washington, 2011-2015
An action plan developed to provide substance abuse prevention and treatment intervention strategies responsive to the existing capacity and needs of 43 federally-recognized tribes in Idaho, Oregon and Washington.
Date: 2010
Type: Document
Sponsoring organization: Northwest Portland Area Indian Health Board
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Availability, Characteristics, and Role of Detoxification Services in Rural Areas
Reports on rural detoxification (detox) providers, including their characteristics, access issues, and geographic distribution. Based on data from a national inventory of facilities providing substance abuse treatment services.
Additional links: Policy Brief: Few and Far Away: Detoxification Services in Rural Areas
Author(s): Jennifer D. Lenardson, Melanie M. Race, John A. Gale
Date: 12/2009
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Prescription Opiate Misuse among Rural Stimulant Users in a Multistate Community-based Study
Reports on an analysis investigating the reasons associated with prescription opiate misuse among users from rural counties in Arkansas, Kentucky, and Ohio.
Author(s): Jennifer R. Havens, William W. Stoops, Carl G. Leukefeld, et al.
Location: American Journal of Drug and Alcohol Abuse, 35(1), 18-23
Date: 2009
Type: Document
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Opioid Overdose: U.S. Prescribing Rate Maps
A collection of maps showing retail opioid prescription rates from 2006-2016 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 Tobacco Control and Prevention Toolkit
Resources and best practices to help rural communities develop tobacco control and prevention 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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Rural Prevention and Treatment of Substance Abuse Toolkit
Resources and best practices to help rural communities develop substance abuse 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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Drug Poisoning Mortality: United States, 1999-2015
Collection of data visualizations showing drug poisoning deaths at the national, state, and county levels. County-level data is available as a series of heat maps by year for 1999 through 2015.
Type: Website
Sponsoring organization: National Center for Health Statistics
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Turn the Tide Rx
Provides resources to guide healthcare providers when treating patients with chronic pain safely and effectively with and without opioid drugs. Identifies and discusses pain treatment options, substance use disorder screening tools, and opioid use disorder and overdose treatment options.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Health Equity Change Makers: Elk's Story
A video describing the Northern Arapaho Horse Culture class, a suicide and substance abuse prevention program that uses Native American culture and horsemanship to encourage youth to work through challenges and build resiliency. The program is part of the Northern Arapaho Suicide Prevention Program on the Wind River Reservation in Wyoming funded by the Indian Health Service. Length: 2:25
Type: Video/Multimedia
Sponsoring organization: U.S. Department of Health and Human Services Office of Minority Health
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Drug Poisoning Mortality: United States, 1999 - 2014
Includes charts, graphs, and maps depicting drug poisoning mortality data by national, state, and county level for the years 1999-2014. Part of the CDC's National Center for Health Statistics Data Visualization Gallery.
Type: Website
Sponsoring organization: National Center for Health Statistics
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Medicare Part D Opioid Drug 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.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
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Child Health USA 2014
A collection of data on the physical, mental, and emotional health of the Nation’s children. Addresses poverty, education, child care, and health service utilization and financing. Includes selected data by rural and urban residence.
Type: Website
Sponsoring organization: Maternal and Child Health Bureau
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SAMHSA’s Tribal Training and Technical Assistance Center
Provides culturally relevant and evidence-based training and technical assistance on mental health and substance use disorders, and suicide prevention to federally recognized tribes, other American Indian/Alaska Native (AI/AN) communities, SAMHSA tribal grantees and other organizations that serve Indian Country.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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National Survey on Drug Use and Health (NSDUH)
Provides access to results for this annual survey focused on substance abuse and mental health issues. Includes information on prevalence and services. Rural-specific data is available in detailed tables that list "geographic characteristics." Data is also made available by state and for regions within states.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Mental Health First Aid
Details a public education program to assist the public in identifying, understanding, and responding to signs of mental illnesses and substance use disorders. Provides a "Find a Course" link to access mental health first aid instructors who will train residents in rural areas.
Type: Website
Sponsoring organization: National Council for Behavioral Health
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Keep it Sacred: National Native Network
Provides a forum for tribes and tribal organizations to obtain and disseminate evidence-based and culturally appropriate information in order to identify and eliminate health disparities related to commercial tobacco abuse.
Type: Website
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SAMHSA-HRSA Center for Integrated Health Solutions
Promotes the development of integrated primary and behavioral health services to better address the needs of individuals with mental health and substance use conditions, whether seen in specialty behavioral health or primary care provider settings. Includes resources to address integrated care in rural settings.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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2-1-1 Information & Referral Service
2-1-1 provides free and confidential information and referral for help with employment, food, housing, health care, addiction prevention programs, and counseling.
Type: Hotline
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PubMed Search: Substance Abuse in Rural Areas
Searches PubMed's collection of journal article citations on substance-related disorders and treatment in rural areas.
Type: Literature Search
Sponsoring organization: National Library of Medicine
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Resources on Substance Abuse and Mental Health for Military Families
Offers information to returning veterans on accessing mental health and substance abuse services and for military families on coping with trauma.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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National Registry of Evidence-based Programs and Practices (NREPP)
Searchable database of interventions for the prevention and treatment of mental and substance use disorders. Includes option to focus on interventions used in a rural/frontier or tribal setting.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Partners for Recovery
Offers technical support and information to those who deliver services to people with substance use and co-occurring mental health conditions. Includes information on recovery, cross-systems collaboration, stigma reduction, workforce and leadership development.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Behavioral Health Treatment Services Locator
Locate treatment facilities addressing substance abuse, addiction, and mental health problems by zip code or city and state.
Type: Directory
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 11/17/2017