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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 June 2024

  • Need: To expand access to medications for opioid use disorder (MOUD) across the state of Pennsylvania.
  • Intervention: An initiative formed to provide technical assistance aimed at improving MOUD treatment capacity and quality at healthcare sites across urban and rural Pennsylvania.
  • Results: In 2023, 108 providers engaged with the program, treating a total of 5,185 individuals with MOUD. Currently, the program engages partners in 20 Pennsylvania counties – serving rural populations in Crawford, Schuylkill, Susquehanna, Butler, and Cambria counties.
funded by the Federal Office of Rural Health Policy

Added March 2024

  • Need: Enhanced support for people with substance use disorders leaving jail and reentering communities in rural northeastern Kentucky.
  • Intervention: A reentry program that uses peer support specialists to teach cognitive life skills, obtain essential identification documents, and help people create and follow personalized case plans before and after their release.
  • Results: More than 420 people have been served by First Day Forward, with recidivism rates significantly lower among people who successfully completed the program.
funded by the Federal Office of Rural Health Policy

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.

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.
funded by the Federal Office of Rural Health Policy

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 in getting treatment and provided 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.
funded by the Federal Office of Rural Health Policy funded by the Health Resources Services Administration

Updated/reviewed September 2022

  • Need: Improved approach in addressing the behavioral health and primary care disparities of Indiana's 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.

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.

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.

Updated/reviewed July 2022

  • Need: 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 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.

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.
Last Reviewed: 6/28/2023