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

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.

Other Project Examples

First Day Forward

Added March 2024

• Need: Enhanced support for people with substance use disorders leaving jail and reentering communities in rural northeastern Kentucky.
• Intervention: A reentry program that uses peer support specialists to teach cognitive life skills, obtain essential identification documents, and help people create and follow personalized case plans before and after their release.
• Results: More than 420 people have been served by First Day Forward, with recidivism rates significantly lower among people who successfully completed the program.

Moms Do Care EMPOWER (MDC-E)

Added February 2024

• Need: To support pregnant or new parents in rural Massachusetts affected by substance use or on medication for opioid use.
• Intervention: This program offers a medical and behavioral health home, providing trauma-informed support before, during, and after childbirth.
• Results: Six months after enrollment, there was a 20% increase in the number of participants who felt socially connected and a 5% increase in abstinence from all substances.

Recovery Kentucky

Updated/reviewed February 2024

• Need: To provide housing and recovery services for rural Kentuckians dealing with substance use.
• Intervention: Recovery Kentucky has 8 rural locations and provides apartments within a congregate living environment and an opportunity to begin recovery from substance use disorder in a structured, peer-led 12-step environment.
• Results: The rural and urban centers serve up to 2,200 people annually. An independent university-led resident outcome evaluation showed significant improvements in clients' drug and alcohol use, housing and employment status, decrease in criminal justice improvement, and improved health and mental health.

Coast to Forest: Mental Health Promotion in Rural Oregon and Beyond

Updated/reviewed January 2024

• Need: To promote mental health and prevent substance use disorders in rural Oregon, Washington, Idaho, and Alaska.
• Intervention: Coast to Forest strengthens local capacity through training, education, and community partnerships.
• Results: In its three years of operation, the project has trained over 500 individuals across the Pacific Northwest in Mental Health First Aid, developed 36 county-level resource guides, organized a series of Community Conversations in three rural Oregon counties, and more.

Nicotine Use Prevention and Control (NUPAC) Program

Updated/reviewed January 2024

• Need: To foster relationships with American Indian people in New Mexico to determine culturally appropriate practices in reducing nicotine addiction.
• Intervention: NUPAC provides outreach, community programs, and cessation services.
• Results: In fiscal year 2023, 1,333 QUIT NOW and DEJELO YA quit line enrollees stopped using tobacco.

Arukah Institute's Living Room Program

Added December 2023

• Need: To address high rates of substance use in Princeton, Illinois and the surrounding area.
• Intervention: The Arukah Institute, a local nonprofit organization providing mental health services, adapted a statewide model to provide support and a safe space for people in need of substance use resources.
• Results: The Living Room program had 1,485 visits in its first year, with 100% of clients served by recovery support specialists.

Riverfront Talks: Substance Matters Podcast

Added December 2023

• Need: To reduce stigma around mental illness and substance use in North Carolina.
• Intervention: The Beaufort County Behavioral Health Task Force created the Riverfront Talks: Substance Matters podcast to interview people with lived experience.
• Results: As of December 2023, the podcast has 10 episodes.

CMH Addiction Recovery Program

Added November 2023

• Need: To help people who use drugs and their families access treatment and counseling in rural Missouri.
• Intervention: The CMH Addiction Recovery Program provides medication-assisted treatment, counseling, peer and family support, and other related services through a Rural Health Clinic.
• Results: The program operates 5 days a week and sees 400 patients each month.

Richmond Substance Use and Mental Health Mobile Integrated Health Program

Added November 2023

• Need: To reduce the number of overdose deaths in Richmond, Indiana and connect people in need of mental health treatment to community resources.
• Intervention: A mobile integrated healthcare (MIH) program that connects social workers with people who have just experienced a mental health crisis or overdose.
• Results: More than 320 people have been referred to Richmond's MIH programs since June 2022.

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