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Rural Health Information Hub
Rural Health Information Hub

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.

Other Project Examples

Added February 2026

  • Need: To connect people with substance use, trauma, and other challenges to community and services in rural New York.
  • Intervention: The Recovery Café Camden offers shared meals, small-group discussions, hobby building, and connection to resources.
  • Results: Between January 13, 2025, and November 18, 2025, the Café recorded 370 participant engagements across Recovery Circles and 128 across School of Recovery classes.
funded by the Federal Office of Rural Health Policy

Updated/reviewed January 2026

  • 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.

Updated/reviewed January 2026

  • Need: To promote mental health and prevent substance use disorders in rural Oregon, Washington, Idaho, and Alaska.
  • Intervention: Coast to Forest strengthened local capacity through training, technical assistance, education, and community partnerships.
  • Results: Since the project's launch in 2020, it trained over 800 individuals across the Pacific Northwest in Mental Health First Aid, developed 100 county-level resource guides, organized a series of Community Conversations in five rural Oregon counties, and more.

Updated/reviewed December 2025

  • 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 2025, the podcast has 18 episodes.
funded by the Federal Office of Rural Health Policy

Updated/reviewed November 2025

  • Need: To help individuals and families impacted by substance use disorder 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 within a Rural Health Clinic.
  • Results: The program operates 5 days a week and sees 400 patients each month.
funded by the Federal Office of Rural Health Policy

Updated/reviewed November 2025

  • Need: To support pregnant and parenting women with a history of substance use, mental health, or co-occurring disorders in rural areas of Montana.
  • Intervention: One Health, a consortium of Federally Qualified Health Centers (FQHCs), developed a team of "recovery doulas" – individuals who are dual-certified as doulas and peer-support specialists. The One Health recovery doula program offers group and individual services to women and their partners from pregnancy through the first years of parenthood.
  • Results: A team of four recovery doulas (or doulas-in-training) employed by One Health offer services in 8 rural eastern Montana counties. One Health has also successfully trained and certified 35 Peer Recovery Doulas statewide through their Peer Recovery Doula certification curriculum.

Updated/reviewed April 2025

  • 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.

Added November 2024

  • Need: To reduce barriers to employment for people in substance use recovery in Marinette County, Wisconsin.
  • Intervention: An initiative in which community members in recovery train local employers in recovery friendly workplace guidelines and provide recovery coaching to employees.
  • Results: One business in Marinette County has been fully trained, and more than 50 people in recovery have been referred to the Wisconsin Department of Workforce Development's Worker Connection Program in the program's first year.

Updated/reviewed October 2024

  • Need: To reduce drug overdose deaths and the spread of infectious diseases in rural Colorado.
  • Intervention: This program provides harm reduction and peer support to people who use drugs and to their loved ones.
  • Results: This program provided Narcan training to 377 individuals and distributed 2,448 doses of naloxone and 3,539 fentanyl test strips in 2023.

Updated/reviewed August 2024

  • 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 2023, Camp Mariposa served a total of 113 youth in its four rural locations in Indiana, Kentucky, Tennessee, and West Virginia. In a study, 92% of participants reported no use of any substance to get high.
Last Reviewed: 6/28/2023