Substance Use and Misuse in Rural Areas – Resources
Selected recent or important resources focusing on Substance Use and Misuse in Rural Areas.
Geographic Disparities by Rural-Urban Status and Drive Time to Care in Tobacco Treatment for COPD
Explores the potential relationship between the drive-time to tobacco dependence treatment (TDT) services and the development of COPD among smokers. Details distances of rural smokers to TDT services. Draws from Veterans Affairs data and breaks down data by demographic characteristics, treatment type, and rural versus urban location, among other measures.
Author(s): Arianne K. Baldomero, Anne C. Melzer, Ken M. Kunisaki, et al.
Citation: JAMA Network Open, 8(8), e2528898
Date: 08/2025
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Explores the potential relationship between the drive-time to tobacco dependence treatment (TDT) services and the development of COPD among smokers. Details distances of rural smokers to TDT services. Draws from Veterans Affairs data and breaks down data by demographic characteristics, treatment type, and rural versus urban location, among other measures.
Author(s): Arianne K. Baldomero, Anne C. Melzer, Ken M. Kunisaki, et al.
Citation: JAMA Network Open, 8(8), e2528898
Date: 08/2025
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Tobacco Product Use or Nicotine Vaping in the Past Month
Report discusses rates of tobacco and nicotine vaping use detailed in the National Survey on Drug Use and Health (NSDUH) from 2022, 2023, and 2024. Features breakdowns by demographics, years and rurality, among other measures.
Date: 08/2025
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Report discusses rates of tobacco and nicotine vaping use detailed in the National Survey on Drug Use and Health (NSDUH) from 2022, 2023, and 2024. Features breakdowns by demographics, years and rurality, among other measures.
Date: 08/2025
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Tobacco Retailer Density and Rurality Across Four US States: California, Connecticut, North Carolina, and Ohio
Presents a study on the tobacco retailer density of rural areas. Compares density rates of rural tracts with metropolitan, micropolitan, and small towns. Draws examples from California, Ohio, Connecticut, and North Carolina.
Author(s): Emerson Webb, Peter F. Craigmile, Meghan E. Morean, et al.
Citation: Journal of Rural Health, 41(3), e70073
Date: 08/2025
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Presents a study on the tobacco retailer density of rural areas. Compares density rates of rural tracts with metropolitan, micropolitan, and small towns. Draws examples from California, Ohio, Connecticut, and North Carolina.
Author(s): Emerson Webb, Peter F. Craigmile, Meghan E. Morean, et al.
Citation: Journal of Rural Health, 41(3), e70073
Date: 08/2025
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Prescribed Medications for Patients with Amphetamine-Type Stimulant Use Disorder Seen in Rural-Serving Pacific Northwest Primary Care Clinics
Examines the frequency in which patients living in the rural Pacific Northwest with amphetamine-type stimulant use disorder (AT-StUD) received medications for AT-StUD in primary care clinics. Utilizes 2017-2021 electronic health record (EHR) data to analyze patients who have received prescriptions according to demographics, mental health status, and health behaviors.
Author(s): Megan J. Yerton, Connor J. McCabe, Matthew D. Iles-Shih, Judith I. Tsui, Kevin A. Hallgren
Citation: Addiction Science & Clinical Practice, 20, 67
Date: 08/2025
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Examines the frequency in which patients living in the rural Pacific Northwest with amphetamine-type stimulant use disorder (AT-StUD) received medications for AT-StUD in primary care clinics. Utilizes 2017-2021 electronic health record (EHR) data to analyze patients who have received prescriptions according to demographics, mental health status, and health behaviors.
Author(s): Megan J. Yerton, Connor J. McCabe, Matthew D. Iles-Shih, Judith I. Tsui, Kevin A. Hallgren
Citation: Addiction Science & Clinical Practice, 20, 67
Date: 08/2025
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Risk & Protective Factors for Rural Youth Substance Use: A Report for the Rural Network
Examines youth substance use in rural areas and various risk and protective factors. Utilizes data from Washington State's Rural Network members to analyze substance use and discusses school-based, family-based, and community-based preventive factors.
Author(s): Ellie Jackson
Date: 08/2025
Sponsoring organizations: Rural Network, WWAMI Rural Health Research Center
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Examines youth substance use in rural areas and various risk and protective factors. Utilizes data from Washington State's Rural Network members to analyze substance use and discusses school-based, family-based, and community-based preventive factors.
Author(s): Ellie Jackson
Date: 08/2025
Sponsoring organizations: Rural Network, WWAMI Rural Health Research Center
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NSDUH (National Survey on Drug Use and Health) Detailed Tables - 2024
Explores 2024 survey data on use of prescription and illicit drugs, alcohol, tobacco and nicotine products, trends in substance use disorder (SUD) and mental illness, and access to treatment for youth and adults. Features statistics for a variety of demographic and geographic characteristics, including rural versus urban status.
Date: 08/2025
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Explores 2024 survey data on use of prescription and illicit drugs, alcohol, tobacco and nicotine products, trends in substance use disorder (SUD) and mental illness, and access to treatment for youth and adults. Features statistics for a variety of demographic and geographic characteristics, including rural versus urban status.
Date: 08/2025
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Examining Geographic Disparities in Access to No-Cost Naloxone in North Carolina: A Cross-Sectional Survey of Naloxone Distribution Programs
Presents a study exploring the geographic distribution of no-cost naloxone in North Carolina. Bases findings on a survey of naloxone distributors in the state and breaks down data by user demographics and distributor type.
Author(s): Grace Marley, Caroline Shubel, Carolyn T. Thorpe, et al.
Citation: Journal of Rural Health, 41(3), e70069
Date: 08/2025
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Presents a study exploring the geographic distribution of no-cost naloxone in North Carolina. Bases findings on a survey of naloxone distributors in the state and breaks down data by user demographics and distributor type.
Author(s): Grace Marley, Caroline Shubel, Carolyn T. Thorpe, et al.
Citation: Journal of Rural Health, 41(3), e70069
Date: 08/2025
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Illegally Made Fentanyl Use in the United States: 2022 and 2023
Report highlights findings from the 2022 and 2023 National Survey on Drug Use and Health (NSDUH) on the use of illegally made fentanyl across the U.S. Explores co-usage with other drugs, emergency room visits/hospitalizations, and breaks down user characteristics by age, poverty level, and rurality, among other measures.
Citation: NSDUH Data Brief, 2(2)
Date: 07/2025
Sponsoring organizations: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration
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Report highlights findings from the 2022 and 2023 National Survey on Drug Use and Health (NSDUH) on the use of illegally made fentanyl across the U.S. Explores co-usage with other drugs, emergency room visits/hospitalizations, and breaks down user characteristics by age, poverty level, and rurality, among other measures.
Citation: NSDUH Data Brief, 2(2)
Date: 07/2025
Sponsoring organizations: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration
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A Comparison of Classifications for Geographic Location and their Associations with Tobacco Use among US Adults
Details a study on the differences in two different rural classification in rates of cigarette, e-cigarette, and smokeless tobacco usage. Compares U.S. Census Bureau's definition of urban and rural areas with the National Center for Education Statistics' urban/suburban/town/rural classification.
Author(s): Jenny E. Ozga, Andrea Milstred, Melissa D. Blank, et al.
Citation: Journal of Rural Health, 41(3), e70070
Date: 06/2025
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Details a study on the differences in two different rural classification in rates of cigarette, e-cigarette, and smokeless tobacco usage. Compares U.S. Census Bureau's definition of urban and rural areas with the National Center for Education Statistics' urban/suburban/town/rural classification.
Author(s): Jenny E. Ozga, Andrea Milstred, Melissa D. Blank, et al.
Citation: Journal of Rural Health, 41(3), e70070
Date: 06/2025
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Evaluation of the Maternal Opioid Misuse (MOM) Model: Fourth Annual Report (Implementation Year 3)
Provides an overview of the Maternal Opioid Misuse Model, which provides evidence-based integrated care and care coordination for pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD). Describes activities MOM Model awardees undertook during the MOM Model's second implementation year, July 1, 2023–June 30, 2024, and summarizes qualitative and beneficiary-level process data findings by state awardee. Discusses barriers pregnant and postpartum women with OUD face in accessing high-quality, continuous care, specifically in rural areas.
Additional links: Findings at a Glance
Date: 06/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, Westat
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Provides an overview of the Maternal Opioid Misuse Model, which provides evidence-based integrated care and care coordination for pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD). Describes activities MOM Model awardees undertook during the MOM Model's second implementation year, July 1, 2023–June 30, 2024, and summarizes qualitative and beneficiary-level process data findings by state awardee. Discusses barriers pregnant and postpartum women with OUD face in accessing high-quality, continuous care, specifically in rural areas.
Additional links: Findings at a Glance
Date: 06/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, Westat
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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: 9/30/2025

