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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.

Promising Examples

Cross-Walk: Integrating Behavioral Health and Primary Care

funded by the Federal Office of Rural Health Policy

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

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.

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

funded by the Federal Office of Rural Health Policy funded by the Health Resources Services Administration

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

funded by the Federal Office of Rural Health Policy

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.

High Rockies Harm Reduction

Added October 2023

  • 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 distributed 3,125 doses of naloxone and 4,760 fentanyl test strips in 2022.

One Health Recovery Doulas

funded by the Federal Office of Rural Health Policy funded by the Health Resources Services Administration

Added October 2023

  • 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 nine recovery doulas (or doulas-in-training) employed by One Health offer services in ten rural Montana counties. Recovery doulas have provided essential support to women with substance use disorder, survivors of sexual abuse, unhoused individuals, and individuals facing other complex challenges.

Last Updated: 2/13/2024