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.
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.
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.
Need: Due to the opioid crisis, Austin, Indiana has seen the largest concentrated outbreak of HIV in rural America's recent history. Since 2015, over 200 residents have been diagnosed with the virus.
Intervention: Foundations Family Medicine began offering testing and treatment services for HIV, hepatitis C, and opioid/substance use disorder. Education, care coordination and behavioral health services were also offered as an integrated part of their primary care clinic.
Results: Although the virus continues to spread throughout Scott County, the rate has significantly decreased, outdoing national suppression rates by a large margin (76% compared to national average of 49%).