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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.

Other Project Examples

Spit It Out-West Virginia
Updated/reviewed January 2022
  • Need: In the years prior to 2008, McDowell County, West Virginia, had high rates of tobacco use.
  • Intervention: The Spit It Out-West Virginia program (2008-2010) was created to increase access to tobacco cessation and prevention resources.
  • Results: Hundreds of people were provided with tobacco cessation efforts, 5 workplaces became tobacco free, and tobacco control efforts continue today.
funded by the Federal Office of Rural Health Policy funded by the Health Resources Services Administration Community Connections, Inc. Rural Health Opioid Program
Updated/reviewed December 2021
  • Need: To reduce deaths due to opioid overdose in rural southeast West Virginia.
  • Intervention: The Community Connections, Inc. Rural Health Opioid Program trained and certified first responders, healthcare staff, and laypeople in naloxone administration.
  • Results: From October 2018 to September 2021, the program provided direct education to 638 individuals, trained 821 providers, and distributed 4,023 Narcan kits.
Project VISION
Updated/reviewed December 2021
  • Need: To reduce opioid use and increase quality of life in Rutland, Vermont.
  • Intervention: Project VISION works to reduce opioid use through community engagement.
  • Results: Since 2012, Project VISION has collected and disposed of 550 pounds of unused medications, reduced thefts by over 32%, and had a 50% improvement on a neighborhood quality of life survey.
Coast to Forest: Mental Health Promotion in Rural Oregon
Added November 2021
  • Need: To promote mental health and prevent substance use disorders in Oregon.
  • Intervention: Coast to Forest strengthens local capacity through training and community education.
  • Results: In its first year, the project trained 195 individuals across Oregon in Mental Health First Aid and developed 36 county-level resource guides.
Nictotine Use Prevention and Control (NUPAC) 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: NUPAC 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.
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.
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 MaineGeneral Harm Reduction Program
Updated/reviewed December 2020
  • Need: To reduce deaths from opioid overdoses in rural Maine.
  • Intervention: The MaineGeneral Harm Reduction Program provides community education/training for healthcare staff, first responders, community agency staff, and community members in rural Kennebec and Somerset counties.
  • Results: MaineGeneral continues to train providers, provide stigma assessments, and distribute Narcan kits.
funded by the Federal Office of Rural Health Policy SLV N.E.E.D.: Naloxone Education Empowerment Distribution Program
Updated/reviewed August 2020
  • Need: Growing concern in rural Colorado communities regarding prescription and illegal opioid overdoses.
  • Intervention: Education efforts for health workers and the larger community, in addition to establishing a naloxone overdose reversal drug program.
  • Results: In addition to continuing to train nearly all first responders to administer naloxone, the organization provides harm reduction education in various community settings.

Last Updated: 1/10/2022