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

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

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.

Camp Mariposa

Updated/reviewed August 2023

• 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 2022, Camp Mariposa served a total of 123 youth in its four rural locations in Indiana, Kentucky, Tennessee, and West Virginia. In a study, 93% of participants reported no use of any substance to get high.

Mobile Health Units for Opioid Use Disorder Treatment

Updated/reviewed August 2023

• 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.

School-Based Drug Misuse Prevention Program

Updated/reviewed July 2023

• Need: School-based drug misuse prevention program in Appalachian Ohio, a need triggered by a high school student's overdose death.
• Intervention: Implementation of the HOPE curriculum, an age-appropriate K through 12th grade drug abuse prevention program.
• Results: No further drug overdose deaths after curriculum initiated.

MIST: Mothers and Infants Sober Together

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 get treatment and provide 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.

Addiction Recovery Mobile Outreach Team (ARMOT)

Updated/reviewed January 2023

• 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.

ASPIN's Certified Recovery Specialist Program

Updated/reviewed September 2022

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

Isanti County SafeCab Program

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.

Staggered Sentencing for Repeat Drunk Driving Offenders

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.

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