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Rural Health Information Hub

Substance Use and Misuse in Rural Areas – Resources

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

Improving Behavioral Health Services for Individuals with SMI in Rural and Remote Communities
Discusses behavioral health workforce shortages in rural and remote areas and the effect this has on healthcare access for people with serious mental illness (SMI). Highlights strategies for reducing barriers to access and improve workforce retention. Provides examples of programs to improve access in various states.
Date: 08/2021
Sponsoring organizations: American Psychiatric Association, SMI Adviser, Substance Abuse and Mental Health Services Administration
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Barriers for Implementing the Hub and Spoke Model to Expand Medication for Opioid Use Disorder: A Case Study of Montana
Highlights a study of the barriers to the implementation of hub and spoke programs to provide treatment for opioid use disorder in rural Montana. Features data based on interviews with 65 programs that provide medication for opioid use disorder in Montana and discusses the barriers to their efforts.
Author(s): Brandn Green, Danielle Christine Rhubart, Matthew R Filteau
Citation: Substance Abuse: Research and Treatment, 15
Date: 08/2021
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Prevention, Treatment, and Recovery Innovations in Native American Communities
Report highlights the efforts of tribal programs to address opioid use disorder in their communities. Presents success stories of programs providing culturally competent treatment, prevention, and recovery for American Indian and Alaska Native communities in several states.
Date: 08/2021
Sponsoring organization: National American Indian and Alaska Native Addiction Technology Transfer Center
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Multilevel Modeling of County-level Excessive Alcohol Use, Rurality, and COVID-19 Case Fatality Rates in the US
Presents a study on the relationship between COVID-19 outcomes and elevated alcohol use in rural counties. Looks at levels of alcohol use and misuse in rural counties prior to the pandemic and compares it with COVID-19 mortality data. Breaks down data by rurality and alcohol use while controlling for other comorbidities such as obesity, smoking, and being over the age of 65.
Author(s): George Pro, Paul A. Gilbert, Julie A. Baldwin, et al.
Citation: PLOS ONE, 16(6), e0253466
Date: 06/2021
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Rural-Urban Differences in Changes and Effects of Tobacco 21 in Youth E-cigarette Use
Highlights a study on youth e-cigarette use across rural and urban communities in light of the increase in Tobacco 21 (T21) policies. Compares under 21 e-cigarette use in rural and urban areas and in T21 and non-T21 areas. Breaks down data by year (2018-2019), sex, and grade in school, among other measures.
Author(s): Hongying Dai, Lisa Chaney, Edward Ellerbeck, et al.
Citation: Pediatrics, 147(5), e2020020651
Date: 05/2021
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Mental Health and Substance Use Treatment Services Utilization
Summarizes the results of a poll conducted between April 29-May 2, 2021, regarding patients' experiences receiving mental health and substance use treatment services, including telehealth services, during the COVID-19 pandemic. Examines the utilization of these services and barriers to treatment by sex, age, education, income, ethnicity, and urban-rural status. Explores the preferences of individuals seeking mental health or substance abuse treatment.
Date: 05/2021
Sponsoring organizations: Bipartisan Policy Center, Morning Consult
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State and Community Efforts to Address Stimulant Use
Explores state and community-based efforts to address stimulant misuse. Summarizes common themes and key findings that emerged from discussions with a diverse group of stakeholders. Covers program activities, funding sources, facilitators, and barriers to implementing programs to respond to stimulant use. Identifies policy options for community, state, and federal stakeholders. Includes rural references throughout.
Author(s): Rebecca L. Haffajee, Sara Heins
Date: 05/2021
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Escalating Alcohol-Involved Death Rates: Trends and Variation across the Nation and in the States from 2006 to 2019
Examines alcohol-involved deaths by state and at the national level, discussing Centers for Disease Control and Prevention vital statistics data. Explores death rate changes, trends, and variation, comparing state rates to U.S. rates and comparing rates across demographic and age groups, by sex, and by urban/rural location. Offers a map with links to infographics for each state.
Additional links: Issue Brief
Date: 04/2021
Sponsoring organization: State Health Access Data Assistance Center
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Guide for Future Directions for the Addiction and OUD Treatment Ecosystem
Details strategies for addressing the opioid use epidemic and improving the current addiction treatment ecosystem. Breaks down the strategies by capacity, competency, consistency, and compensation. Discusses some of the barriers to treating opioid use disorder in rural areas.
Author(s): R. Corey Waller, Kelly J. Clark, Alex Woodruff, et al.
Date: 04/2021
Sponsoring organization: National Academy of Medicine
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Addressing Opioid-Related Outcomes Among Individuals With Co-Occurring Behavioral Health Conditions: An Environmental Scan of Quality Measures
Presents the results of an environmental scan of healthcare quality measures relevant to addressing polysubstance use among individuals with co-occurring behavioral health conditions. Includes information on access to buprenorphine providers in rural communities.
Date: 04/2021
Sponsoring organization: National Quality Forum
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Last Updated: 9/8/2025