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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.

Promising Examples

funded by the Federal Office of Rural Health Policy Cross-Walk: Integrating Behavioral Health and Primary Care
Updated/reviewed October 2021
  • Need: To address and treat substance use disorder (SUD) and depression in the Upper Great Lakes region.
  • Intervention: Cross-Walk, a program that integrates behavioral healthcare into primary care services, was developed in Michigan's Marquette County.
  • Results: The collaborative efforts strengthened care management services in local healthcare facilities as primary care patients were referred to a behavioral health specialist.
funded by the Federal Office of Rural Health Policy Healthy Outcomes Integration Team
Updated/reviewed December 2019
  • Need: To provide integrated treatment planning and coordinated healthcare services to rural residents.
  • Intervention: The Healthy Outcomes Integration Team was designed to treat adults who have a serious mental health condition and those who have, or are at risk of developing, chronic health conditions.
  • Results: Clients received coordinated care, substance abuse treatment, crisis services, and wellness planning. Many also improved their physical health outcomes.
Communities that Care Coalition
Updated/reviewed May 2019
  • Need: A way to improve the health and well-being of young people by addressing substance abuse in rural areas of Massachusetts's Franklin County and the North Quabbin.
  • Intervention: A community-based prevention initiative was formed to reduce youth violence, delinquency, alcohol and tobacco use, and to promote proper nutrition and physical activity.
  • Results: CTC has seen significant reductions in substance abuse among local youth in the 30 rural towns they serve.

Other Project Examples

Seneca Strong's Certified Addiction Recovery Coaches
Updated/reviewed July 2022
  • Need: Like many Native American populations, the Seneca Nation of Indians has experienced disproportionate rates of opioid, alcohol, and substance misuse.
  • Intervention: The Seneca Nation Government and Executives founded Seneca Strong, a cultural recovery peer advocate program, with the goal of reducing substance misuse across the Nation.
  • Results: Seneca Strong has since grown in personnel and capacity to meet the needs of the Allegany and Cattaraugus territories of the Seneca Nation.
Mobile Health Units for Opioid Use Disorder Treatment
Updated/reviewed April 2022
  • Need: To bring medication-assisted treatment to rural and underserved areas in Colorado.
  • Intervention: Six mobile health units travel to 32 counties and offer services like telehealth sessions, counseling, naloxone, and referrals to wraparound services.
  • Results: The units traveled more than 100,000 miles from January 2020 to January 2021.
Spit It Out-West Virginia
Updated/reviewed January 2022
  • Need: In the years prior to 2008, McDowell County, West Virginia, had high rates of tobacco use.
  • Intervention: The Spit It Out-West Virginia program (2008-2010) was created to increase access to tobacco cessation and prevention resources.
  • Results: Hundreds of people were provided with tobacco cessation efforts, 5 workplaces became tobacco free, and tobacco control efforts continue today.
funded by the Federal Office of Rural Health Policy funded by the Health Resources Services Administration Community Connections, Inc. Rural Health Opioid Program
Updated/reviewed December 2021
  • Need: To reduce deaths due to opioid overdose in rural southeast West Virginia.
  • Intervention: The Community Connections, Inc. Rural Health Opioid Program trained and certified first responders, healthcare staff, and laypeople in naloxone administration.
  • Results: From October 2018 to September 2021, the program provided direct education to 638 individuals, trained 821 providers, and distributed 4,023 Narcan kits.
Project VISION
Updated/reviewed December 2021
  • Need: To reduce opioid use and increase quality of life in Rutland, Vermont.
  • Intervention: Project VISION works to reduce opioid use through community engagement.
  • Results: Since 2012, Project VISION has collected and disposed of 550 pounds of unused medications, reduced thefts by over 32%, and had a 50% improvement on a neighborhood quality of life survey.
Coast to Forest: Mental Health Promotion in Rural Oregon
Added November 2021
  • Need: To promote mental health and prevent substance use disorders in Oregon.
  • Intervention: Coast to Forest strengthens local capacity through training and community education.
  • Results: In its first year, the project trained 195 individuals across Oregon in Mental Health First Aid and developed 36 county-level resource guides.
Tobacco Use Prevention and Control (TUPAC) Program
Updated/reviewed October 2021
  • Need: To foster relationships with indigenous people in New Mexico to determine culturally appropriate practices in reducing nicotine addiction.
  • Intervention: TUPAC provides outreach, community programs, and cessation services.
  • Results: In fiscal year 2020, 1,938 QUIT NOW and DEJELO YA quit line enrollees stopped using tobacco, and over 4,520 tobacco users made progress on their path to quitting.

Last Updated: 7/18/2022