Substance Use and Misuse in Rural Areas – Resources

The Rural and Urban Supply of Clinicians With a DEA Waiver to Prescribe Buprenorphine in 2022 Prior to the Elimination of the Waiver Requirement
Report explores the differences in rates of clinicians with DEA waivers to prescribe buprenorphine in 2022 in rural versus urban counties. Highlights the rural gaps in access to buprenorphine to treat opioid use disorder prior to the elimination of the DEA waiver requirement in 2023. Provides rural, urban, and regional comparisons.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Ethics for Behavioral Health Professionals in Rural Areas
Webinar recording discusses ethics in behavioral health delivery in rural areas. Provides guidance for behavioral health professionals on shaping care through ethical decision-making models and highlights topics relevant to rural communities.
Date: 03/2025
Sponsoring organization: Addiction Technology Transfer Center Network
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Enhancing Rural Access to Medications for Opioid Use Disorder: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Opioid Use Among Rural Medicare Beneficiaries
Examines trends in prescription opioid use among Medicare beneficiaries in rural areas, utilizing 2010-2017 Medicare Current Beneficiary Survey (MCBS) data. Provides data on receipt of opioid prescriptions among community-dwelling and facility-dwelling beneficiaries, associations between prescribing and chronic overlapping pain conditions (COPCs), and prescriptions exceeding CDC guidelines. Includes rural-urban comparisons.
Author(s): Yvonne Jonk, Heidi O'Connor, Karen Pearson, et al.
Date: 01/2025
Sponsoring organization: Maine Rural Health Research Center
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Rural Recovery Innovations
Discusses disparities in behavioral health recovery support services in rural, frontier, and tribal communities. Highlights innovative and promising practices for addressing behavioral health disparities, such as addressing stigma, supporting peer workforce, and addressing social determinants of health, among other measures.
Date: 01/2025
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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2025 National Guidelines for a Behavioral Health Coordinated System of Crisis Care
Offers a framework for behavioral health crisis care systems to reduce the impact substance use and mental illness following 11 principles and 3 essential elements that are comprehensive, accessible, evidence-based, quality, responsive, and equitable. Discusses rural throughout. Includes guidance on developing a behavioral health coordinated system of crisis care.
Additional links: Model Definitions for Behavioral Health Emergency, Crisis, and Crisis-Related Services
Date: 01/2025
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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A Rural-Urban Analysis of Buprenorphine Therapy During and After Pregnancy Among the Commercially Insured
Explores the use of evidence-based buprenorphine treatment and adherence during the peri-pregnancy period among commercially insured individuals by rurality. Analyzes data on 1,331,040 people between 15 and 44 years-old with diagnosis codes for pregnancy and labor/delivery from January 1, 2015, to December 31, 2019.
Author(s): KariLynn Dowling-McClay, Bill Brooks, Daniel Krauss, et al.
Date: 01/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Implementation of Mobile Medication Units: Findings from a Qualitative Study
Provides a brief overview of the development of policy regarding the approval of mobile medication units (MMUs) operated by opioid treatment programs (OTPs). Presents findings from an environmental scan and key informant interviews regarding MMU implementation. Discusses barriers to establishing, sustaining, and expanding MMU services. Describes opportunities to increase access to methadone in underserved communities. Includes rural references throughout.
Date: 01/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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Youth Mental Health and Substance Use Task Force: Redesigning the Health Care Delivery System to Better Meet the Needs of Youth
Presents policy recommendations from 50 experts and thought leaders regarding how to maximize the potential of the U.S. healthcare system to better serve youth with behavioral health needs. Covers the behavioral health workforce, transparency and compliance with existing screening and treatment requirements, promoting integrated primary care and behavioral health services in pediatric settings, the needs of youth with the highest acuity behavioral health needs, and strengthening crisis and stabilization systems. Includes rural references and considerations throughout.
Date: 01/2025
Sponsoring organization: Bipartisan Policy Center
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Sexualized Drug Use Factors Among Rural Sexual Minority Men
Presents a study identifying factors that correspond to sexualized drug use, or substance use immediately before or during sex, for rural sexual minority men. Highlights risk factors of sexualized drug use, such as HIV infection, and details corresponding demographic and behavioral characteristics.
Author(s): Christopher Owens, Benjamin N. Montemayor
Citation: Journal of Rural Health, 41(1), e12917
Date: 2025
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