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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

Contingency Management Smoking Cessation in Appalachia
Updated/reviewed April 2020
  • Need: To reduce smoking rates of pregnant women and adolescents in Appalachian regions of Eastern Kentucky and Ohio.
  • Intervention: A web-based smoking cessation program that offered monetary incentives to reducing smoking.
  • Results: Participants significantly reduced smoking rates or quit altogether.
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

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.
Morrison County Accountable Community for Health
Updated/reviewed September 2021
  • Need: To combat prescription drug misuse in rural Morrison County, Minnesota.
  • Intervention: The Morrison County ACH brings 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.
funded by the Health Resources Services Administration New Horizons Substance Use Recovery Network
Updated/reviewed August 2021
  • Need: In northern Michigan, a need for an integrated approach to deliver medication-assisted treatment for established patients of Federally Qualified Health Centers with opioid use disorder.
  • Intervention: Collaboration between one FQHC across 3 sites, a local waivered prescriber group, and a behavioral health organization created an integrated treatment approach for opioid use disorder.
  • Results: Increased access to medication-assisted treatment and comprehensive substance use disorder services leading to increased retention in treatment and increased engagement in stable recovery from opioid and alcohol use disorders.
Mobile Health Units for Opioid Use Disorder Treatment
Added April 2021
  • 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.
Pathways Vermont Housing First Program
Updated/reviewed April 2021
  • Need: Ending a local Vermont population's homelessness experience.
  • Intervention: In 2010, Pathways Vermont implemented a first-of-its-kind, rural-focused Housing First program in order to provide housing and support services to those with mental health and substance use conditions experiencing homelessness.
  • Results: Since its initial start-up, Pathways Vermont has assisted over 560 Vermonters — about 70% from rural areas — experiencing homelessness using the Housing First model. The organization has collaborated with the state mental health department, corrections department, local healthcare systems and providers, and other organizations to end homelessness. In addition, programmatic work has expanded to reach other local populations, including veterans and at-risk families.
funded by the Federal Office of Rural Health Policy On the Move! Unlawful Narcotics Investigations, Treatment & Education (Operation UNITE)
Updated/reviewed February 2021
  • Need: To decrease illicit drug and alcohol use in the Central Appalachian region of Kentucky, where many schools had no type of prevention curriculum.
  • Intervention: Using engaging simulations and presentations, the project delivers substance use prevention education to middle school and high school students.
  • Results: Post-test surveys show that thousands of students are reached through the "On the Move!" project and gain positive knowledge on the dangers of substance use.
funded by the Federal Office of Rural Health Policy Addiction Recovery Mobile Outreach Team (ARMOT)
Updated/reviewed December 2020
  • 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: In the first 5 years of the program, ARMOT received over 1,950 referrals.

Last Updated: 10/7/2021