Substance Use and Misuse in Rural Areas – Resources
Selected recent or important resources focusing on Substance Use and Misuse in Rural Areas.
Geographic Trends in Opioid Overdoses in the US From 1999 to 2020
Results of a study examining trends in opioid-involved overdose death (OOD) rates in urban and rural counties. Explores OODs due to overprescription of opioids, use of heroin and illicit synthetic opioids such as fentanyl, and stimulants in combination with synthetic opioids. Features statistics with breakdowns by 6 levels of population density.
Author(s): Lori Ann Post, Alexander Lundberg, Charles B. Moss, et al.
Citation: JAMA Network Open, 5(7)
Date: 07/2022
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Results of a study examining trends in opioid-involved overdose death (OOD) rates in urban and rural counties. Explores OODs due to overprescription of opioids, use of heroin and illicit synthetic opioids such as fentanyl, and stimulants in combination with synthetic opioids. Features statistics with breakdowns by 6 levels of population density.
Author(s): Lori Ann Post, Alexander Lundberg, Charles B. Moss, et al.
Citation: JAMA Network Open, 5(7)
Date: 07/2022
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Barriers to Medications for Opioid Use Disorder in the Court System: Provider Availability, Provider "Trustworthiness," and Cost
Examines perceptions of medications for opioid use disorder (MOUD) availability, provider trustworthiness, and MOUD affordability based on a survey of 151 court team members in Florida. Discusses rates of court referral to MOUD treatment in cases involving opioid use disorder (OUD) and notes rural-specific barriers to MOUD referral.
Author(s): Fatema Z. Ahmed, Barbara Andraka-Christou, M.H. Clark, et al.
Citation: Health & Justice, 10, 24
Date: 07/2022
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Examines perceptions of medications for opioid use disorder (MOUD) availability, provider trustworthiness, and MOUD affordability based on a survey of 151 court team members in Florida. Discusses rates of court referral to MOUD treatment in cases involving opioid use disorder (OUD) and notes rural-specific barriers to MOUD referral.
Author(s): Fatema Z. Ahmed, Barbara Andraka-Christou, M.H. Clark, et al.
Citation: Health & Justice, 10, 24
Date: 07/2022
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Identifying Unique Barriers to Implementing Rural Emergency Department-Based Peer Services for Opioid Use Disorder Through Qualitative Comparison with Urban Sites
Study examining the implementation of emergency department-based interventions for opioid use disorder (OUD) in rural and urban areas based on interviews with programs in Indiana's Recovery Coach and Peer Support Initiative. Describes barriers to implementation for rural programs, including issues related to intervention characteristics, logistical challenges, and staffing issues.
Author(s): Dennis P. Watson, Monte D. Staton, Nicole Gastala
Citation: Addiction Science & Clinical Practice, 17, 41
Date: 07/2022
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Study examining the implementation of emergency department-based interventions for opioid use disorder (OUD) in rural and urban areas based on interviews with programs in Indiana's Recovery Coach and Peer Support Initiative. Describes barriers to implementation for rural programs, including issues related to intervention characteristics, logistical challenges, and staffing issues.
Author(s): Dennis P. Watson, Monte D. Staton, Nicole Gastala
Citation: Addiction Science & Clinical Practice, 17, 41
Date: 07/2022
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Fighting Fentanyl: The Federal Response to a Growing Crisis
Presents the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) hearing on the government's response to the fentanyl crisis. Includes testimonies from the Substance Abuse and Mental Health Administration (SAMHSA), National Center for Injury Prevention and Control, Health Resources and Services Administration (HRSA), and the Office of National Drug Control Policy regarding current efforts to address the expanding use of fentanyl across the U.S.
Additional links: Carole Johnson Testimony, Christopher Jones Testimony, Kemp Chester Testimony, Miriam E. Delphin-Rittmon Testimony
Date: 07/2022
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Presents the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) hearing on the government's response to the fentanyl crisis. Includes testimonies from the Substance Abuse and Mental Health Administration (SAMHSA), National Center for Injury Prevention and Control, Health Resources and Services Administration (HRSA), and the Office of National Drug Control Policy regarding current efforts to address the expanding use of fentanyl across the U.S.
Additional links: Carole Johnson Testimony, Christopher Jones Testimony, Kemp Chester Testimony, Miriam E. Delphin-Rittmon Testimony
Date: 07/2022
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Urban–Rural Differences in Drug Overdose Death Rates, 2020
Examines 2020 drug overdose deaths by sex and type of drug, among other factors, with data broken down by rural versus urban county status. Includes a U.S. map that depicts if overall urban or rural counties in a state have a higher rate of age-adjusted overdose death.
Author(s): Merianne Rose Spencer, Matthew F. Garnett, Arialdi M. Miniño
Date: 07/2022
Sponsoring organization: National Center for Health Statistics
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Examines 2020 drug overdose deaths by sex and type of drug, among other factors, with data broken down by rural versus urban county status. Includes a U.S. map that depicts if overall urban or rural counties in a state have a higher rate of age-adjusted overdose death.
Author(s): Merianne Rose Spencer, Matthew F. Garnett, Arialdi M. Miniño
Date: 07/2022
Sponsoring organization: National Center for Health Statistics
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Barriers and Facilitators Associated with Establishment of Emergency Department-Initiated Buprenorphine for Opioid Use Disorder in Rural Maine
Presents a study on the barriers and facilitators for implementing programs that initiate buprenorphine treatment for patients with opioid use disorder (OUD) seeking care in Critical Access Hospital (CAH) emergency departments (EDs) in rural Maine. Highlights findings of a survey of CAH ED directors on the challenges of implementing buprenorphine initiation programs.
Author(s): Noah K. Rosenberg, Alexander B. Hill, Lily Johnsky, et al.
Citation: Journal of Rural Health, 38(3), 612-619
Date: 06/2022
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Presents a study on the barriers and facilitators for implementing programs that initiate buprenorphine treatment for patients with opioid use disorder (OUD) seeking care in Critical Access Hospital (CAH) emergency departments (EDs) in rural Maine. Highlights findings of a survey of CAH ED directors on the challenges of implementing buprenorphine initiation programs.
Author(s): Noah K. Rosenberg, Alexander B. Hill, Lily Johnsky, et al.
Citation: Journal of Rural Health, 38(3), 612-619
Date: 06/2022
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Behavioral Health and Primary Care Integration in Rural Health Facilities: Policy Brief and Recommendations to the Secretary
Provides an overview of the prevalence of mental illness and substance use disorders in rural areas. Discusses the role of rural primary care providers in treating these conditions. Outlines federal programs and resources to support behavioral health and primary care integration. Offers policy recommendations related to access to care; workforce recruitment and retention; telehealth, technology, and broadband; and reimbursement and sustainable revenue.
Date: 06/2022
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of the prevalence of mental illness and substance use disorders in rural areas. Discusses the role of rural primary care providers in treating these conditions. Outlines federal programs and resources to support behavioral health and primary care integration. Offers policy recommendations related to access to care; workforce recruitment and retention; telehealth, technology, and broadband; and reimbursement and sustainable revenue.
Date: 06/2022
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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On the Farm
Documentary miniseries explores mental health and substance misuse on the American farm. Discusses the factors that contribute to psychological stress and substance use in farm families. Features interviews with experts as well as farmers and their families.
Additional links: Film Website
Date: 06/2022
Sponsoring organization: Mississippi State University
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Documentary miniseries explores mental health and substance misuse on the American farm. Discusses the factors that contribute to psychological stress and substance use in farm families. Features interviews with experts as well as farmers and their families.
Additional links: Film Website
Date: 06/2022
Sponsoring organization: Mississippi State University
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Rural Disparities in Adolescent Smoking Prevalence
Analyzes surveys of 299,435 12th grade students between 1998 and 2018 to compare smoking prevalence among urban and rural youth. Discusses potential reasons for disparate rates and gaps in the literature regarding e-cigarette use.
Author(s): Sooyong Kim, Arielle Selya
Citation: Journal of Rural Health, 38(2), 360-363
Date: 03/2022
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Analyzes surveys of 299,435 12th grade students between 1998 and 2018 to compare smoking prevalence among urban and rural youth. Discusses potential reasons for disparate rates and gaps in the literature regarding e-cigarette use.
Author(s): Sooyong Kim, Arielle Selya
Citation: Journal of Rural Health, 38(2), 360-363
Date: 03/2022
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Strengthening Federal Mental Health and Substance Use Disorder Programs: Opportunities, Challenges, and Emerging Issues
Presents a full committee hearing of the U.S. Senate Committee on Health, Education, Labor, and Pensions discussing the current state of federal mental health and substance use disorder programs. Features testimonies from representatives of the Heath Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the National Institute of Mental Health, and the National Institute on Drug Abuse.
Additional links: Carole Johnson Testimony, Joshua A. Gordon Testimony, Miriam E. Delphin-Rittmon Testimony, Nora D. Volkow Testimony
Date: 03/2022
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Presents a full committee hearing of the U.S. Senate Committee on Health, Education, Labor, and Pensions discussing the current state of federal mental health and substance use disorder programs. Features testimonies from representatives of the Heath Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the National Institute of Mental Health, and the National Institute on Drug Abuse.
Additional links: Carole Johnson Testimony, Joshua A. Gordon Testimony, Miriam E. Delphin-Rittmon Testimony, Nora D. Volkow Testimony
Date: 03/2022
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Additional resources are available related to this guide. See the full list of resources by topic for:
- Alcohol use
- Behavioral health
- Behavioral health workforce
- Illicit drug use
- Prescription drug misuse
- Substance use and misuse
- Tobacco use
Last Updated: 10/30/2025