Substance Use and Misuse in Rural Areas – Models and Innovations
These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.
Updated/reviewed March 2021
- Need: A drug and alcohol prevention program for middle school students that is specific to rural culture in Pennsylvania and Ohio.
- Intervention: An adaptation of the evidence-based keepin' it REAL curriculum was customized for rural middle school students.
- Results: Students showed a reduction in all substance use and less personal acceptability of substance use.
Updated/reviewed June 2019
- Need: An approach to support sustained, quality delivery of evidence-based programs for youth and families in rural communities.
- Intervention: PROSPER, a program delivery system, guides communities in implementing evidence-based programs that build youth competencies, improve family functioning, and prevent risky behaviors, particularly substance use.
- Results: Youth in PROSPER communities reported delayed initiation of a variety of substances, lower levels of other behavioral problems, and improvements in family functioning and other life skills.
Updated/reviewed August 2020
- Need: Increase access to medication-assisted treatment for opioid use disorder in rural Vermont.
- Intervention: Statewide hub-and-spoke treatment access system.
- Results: Increased treatment capacity and care coordination.
Updated/reviewed May 2020
- Need: Reduction in the number of emergency department dental patients abusing opioid prescriptions in rural southeastern Maine.
- Intervention: Using a one-page opioid prescription guideline, opioid prescribing and emergency room visits for dental pain decreased.
- Results: The rate of opioid prescription dropped nearly 20% after implementation, and in comparing the 12-month period before and after implementation, dental pain emergency department visits decreased from 26 to 21 per 1,000.
Updated/reviewed January 2020
- Need: To connect low-income people in rural northwest Minnesota to dental care and support services in order to address barriers to care.
- Intervention: Partners work together to provide patient transportation, care coordination, and insurance navigation and enrollment.
- Results: Patients accessing support services are more likely to complete dental treatment. Over 1,000 people a year have been assisted with Medicaid enrollment, and reported use of the emergency department for dental pain has been reduced.
Updated/reviewed April 2019
- Need: There is a lack of interventions that addresses teenager behavioral problems, particularly for rural African American adolescents.
- Intervention: Rural, locally trained leaders administered five 2-hour meetings for teenagers and their primary caregivers. Trainings focused on reducing risks that prevent positive development, specifically sexual risk-taking that can lead to HIV and other STIs.
- Results: Teens reported reduced conduct problems, depressive symptoms, and substance abuse. Families were strengthened, and SAAF-T reduced unprotected intercourse and increased condom efficacy.
Updated/reviewed December 2018
- Need: More mental health and substance abuse prevention and treatment services in rural Texas.
- Intervention: A network was formed to bring counseling services through telehealth systems and community health workers to Brazos Valley, Texas.
- Results: The program improved health outcomes, increased general knowledge of the impact of substance abuse, and raised awareness of services among Hispanic residents.
Updated/reviewed January 2018
- Need: To reduce overdose-related deaths among prescription opioid users in rural Wilkes County, North Carolina
- Intervention: Education and tools are provided for prescribers, patients and community members to lessen drug supply and demand, and to reduce harm in prescription opioid use
- Results: Opioid overdose death rates have decreased in Wilkes County
Updated/reviewed November 2020
- Need: To properly address and treat patients who have concurrent substance use and chronic healthcare issues.
- Intervention: A referral system utilizes community health workers (CHWs) in a drug and alcohol treatment setting. A registered nurse helps with providers' medication-assisted treatment programs.
- Results: This program has reduced hospital emergency visits and hospital readmissions for patients since its inception.
Updated/reviewed October 2020
- Need: To reduce prescription opioid misuse and overdoses in North Carolina.
- Intervention: The ICPTTP standardizes and streamlines chronic pain management in primary care clinics.
- Results: The ICPTTP reduced patients' average morphine equivalent daily dose, and 29% of patients successfully tapered off chronic opioid therapy.
Last Updated: 3/2/2021