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Substance Use and Misuse in Rural Areas – Resources

Selected recent or important resources focusing on Substance Use and Misuse in Rural Areas.

Patient-Level and County-Level Trends in Nonfatal Opioid-Involved Overdose Emergency Medical Services Encounters — 491 Counties, United States, January 2018–March 2022
Reports on trends in rates of EMS encounters for nonfatal opioid-involved overdoses during January 2018–March 2022, based on data from 491 counties in 21 states. Includes trend data by quarter for rural and urban counties.
Author(s): Shannon M. Casillas, Cassandra M. Pickens, Erin K. Stokes, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 71(34), 1073-1080
Date: 08/2022
Sponsoring organization: Centers for Disease Control and Prevention
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Association of Methamphetamine and Opioid Use with Nonfatal Overdose in Rural Communities
Study examining the incidence of nonfatal overdoses for people using methamphetamine and opioids alone and together, drawing data from National Rural Opioid Initiative surveys of people who use drugs in rural areas of 10 states. Presents findings related to prevalence of methamphetamine and opioid use and implications of the findings for harm reduction programs and treatment programs.
Author(s): P. Todd Korthuis, Ryan R. Cook, Canyon A. Foot, et al.
Citation: JAMA Network Open, 5(8), e2226544
Date: 08/2022
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The Rural Opioid Initiative Consortium Description: Providing Evidence to Understand the Fourth Wave of the Opioid Crisis
Highlights an initiative aimed at developing interventions to address rural opioid use. Collects data from rural areas in 10 states via surveys of people who use drugs and explores overlapping issues, such as other drug use, homelessness, and lack of access to treatment, among others.
Author(s): Richard A. Jenkins, Bridget M. Whitney, Robin M. Nance, et al.
Citation: Addiction Science and Clinical Practice, 17, 38
Date: 07/2022
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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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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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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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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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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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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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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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