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

MIST: Mothers and Infants Sober Together
Updated/reviewed May 2023

• Need: To address the needs of pregnant women who are using substances and infants born into drug-positive families.
• Intervention: The Mothers and Infants Sober Together (MIST) program assisted mothers who used substances get treatment and provide a safe, drug-free home for themselves and their newborn.
• Results: MIST has helped mothers find treatment and education and has helped children grow up in safe and healthy homes.

Recovery Kentucky
Added February 2023

• 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.

Addiction Recovery Mobile Outreach Team (ARMOT)
Updated/reviewed January 2023

• Need: To reduce the number of overdoses and overdose-related deaths from opioids in rural Pennsylvania.
• Intervention: ARMOT provides 1) case management and recovery support services to individuals with substance use disorders and 2) education and support to rural hospital staff, patients, and their loved ones.
• Results: Since 2015, ARMOT has received over 2,956 referrals.

ASPIN's Certified Recovery Specialist Program
Updated/reviewed September 2022

• Need: Improved approach in addressing the behavioral health and primary care disparities of Indiana's underserved rural counties.
• Intervention: A network was established that trained community health workers (CHWs) to be certified health insurance enrollment navigators and provide mental health services.
• Results: This year, ASPIN trained 230 CHWs, cross-trained 70 behavioral health case managers as CHWs, and 35 individuals in the Indiana Navigator Pre-certification Education.

Morrison County Accountable Community for Health
Updated/reviewed September 2022

• Need: To combat prescription drug misuse in rural Morrison County, Minnesota.
• Intervention: The Morrison County ACH brought together primary care, social services, law enforcement, and other partners to make sure that patients receive treatment and support.
• Results: One pharmacy saw a 40% reduction in the number of prescribed opioids, and the ACH was able to taper 684 patients off opioids completely.

Camp Mariposa
Updated/reviewed August 2022

• Need: To help children whose family members are struggling with substance misuse.
• Intervention: A year-round program provides mentoring as well as substance use prevention education.
• Results: In 2021, Camp Mariposa served a total of 76 youth in its three rural locations in Kentucky, Tennessee, and West Virginia.

Isanti County SafeCab Program
Updated/reviewed August 2022

• Need: To reduce the number of deaths and injuries caused by drunk driving in Isanti County.
• Intervention: The SafeCab program provides alternative transportation home for bar patrons who would otherwise drive impaired.
• Results: The program is credited with a significant decrease in DUI (Driving Under the Influence) arrests and the lower average corresponding BAC (Blood Alcohol Content) levels in Isanti County.

Staggered Sentencing for Repeat Drunk Driving Offenders
Updated/reviewed August 2022

• Need: To reduce the incidences of repeat drunk driving.
• Intervention: Repeat DWI (driving while intoxicated) offenders were given a staggered sentence, allowing them to serve their sentence in segments of time, typically separated by several months to a year. The offender was able to file a motion to request a waiver for the remaining sentence period(s), if able to show that he/she maintained sobriety.
• Results: The incidence of recidivism, or crime relapse, has been reduced among offenders given staggered sentences, by comparison to offenders given traditional DWI sentences. The program has also reduced the average cost of jail time that otherwise would have been served from a full sentence.

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.

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