Substance Use and Misuse in Rural Areas – Resources
Selected recent or important resources focusing on Substance Use and Misuse in Rural Areas.
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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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 2 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 2 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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The Opioid Epidemic in Rural Communities: Can Telehealth Increase Access to Medication for Opioid Use Disorder and Offset Barriers to Care?
Examines the impact of telehealth on access to medication for opioid use disorder (MOUD) and substance use disorder (SUD) and opioid use disorder (OUD) treatment. Utilizes data from the Rural Communities Opioid Response Program's (RCORP) consortia, the National Survey of Drug Use and Health (NSDUH), and the U.S. Census Bureau's American Community Survey (ACS) to analyze access to MOUD and rates of telehealth use for rural consortia. Discusses potential barriers and factors impacting telehealth implementation for SUD and OUD care.
Author(s): Kathleen Meyers, Shannon Herman, Heather Schuler, et al.
Citation: Drug and Alcohol Dependence, 271, 112628
Date: 06/2025
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Examines the impact of telehealth on access to medication for opioid use disorder (MOUD) and substance use disorder (SUD) and opioid use disorder (OUD) treatment. Utilizes data from the Rural Communities Opioid Response Program's (RCORP) consortia, the National Survey of Drug Use and Health (NSDUH), and the U.S. Census Bureau's American Community Survey (ACS) to analyze access to MOUD and rates of telehealth use for rural consortia. Discusses potential barriers and factors impacting telehealth implementation for SUD and OUD care.
Author(s): Kathleen Meyers, Shannon Herman, Heather Schuler, et al.
Citation: Drug and Alcohol Dependence, 271, 112628
Date: 06/2025
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Continuity of Pain Clinic Care among Rural and Urban Veterans
Presents a study exploring the differences in continuity of pain care through the Veterans Health Administration (VHA) for rural and urban veterans. Breaks down data by age, sex, pain severity, and behavioral health disorders, among other measures.
Author(s): Katherine Hadlandsmyth, Rena E. Courtney, Jenna L. Adamowicz, et al.
Citation: Journal of Rural Health, 41(2), e70031
Date: 05/2025
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Presents a study exploring the differences in continuity of pain care through the Veterans Health Administration (VHA) for rural and urban veterans. Breaks down data by age, sex, pain severity, and behavioral health disorders, among other measures.
Author(s): Katherine Hadlandsmyth, Rena E. Courtney, Jenna L. Adamowicz, et al.
Citation: Journal of Rural Health, 41(2), e70031
Date: 05/2025
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Federal and State Reimbursement for Youth Behavioral Health Services
Report details Medicaid and Children's Health Insurance Program (CHIP) coverage of behavioral health services for rural people under 21 years of age. Breaks down reimbursement eligibility for behavioral health providers in all 50 states and discusses barriers to access in rural areas.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Report details Medicaid and Children's Health Insurance Program (CHIP) coverage of behavioral health services for rural people under 21 years of age. Breaks down reimbursement eligibility for behavioral health providers in all 50 states and discusses barriers to access in rural areas.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Medicare Beneficiary Receipt of Methadone by Drive Time to Opioid Treatment Programs
Examines availability of methadone at opioid treatment programs for Medicare beneficiaries who have been diagnosed with an opioid use disorder. Utilizes data from 640,706 Medicare beneficiaries and analyzes their respective drive time to a treatment facility as well as receipt of methadone treatment. Includes U.S. map showing locations of opioid treatment programs and rural versus urban comparisons of patient drive times.
Author(s): Jonathan Cantor, Helin G. Hernandez, Aaron Kofner, et al.
Citation: JAMA Network Open, 8(4)
Date: 04/2025
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Examines availability of methadone at opioid treatment programs for Medicare beneficiaries who have been diagnosed with an opioid use disorder. Utilizes data from 640,706 Medicare beneficiaries and analyzes their respective drive time to a treatment facility as well as receipt of methadone treatment. Includes U.S. map showing locations of opioid treatment programs and rural versus urban comparisons of patient drive times.
Author(s): Jonathan Cantor, Helin G. Hernandez, Aaron Kofner, et al.
Citation: JAMA Network Open, 8(4)
Date: 04/2025
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Different Forms of Stigma and Rural Primary Care Professionals' Willingness to Prescribe Buprenorphine
Presents a study exploring the different types of stigma affecting buprenorphine and other medications for opioid use disorder (MOUD) prescribing rates in rural primary care settings. Details perceived stigmas around MOUD by providers, such as the fear of being harmed by patients, fear of their professional image being harmed, and the fear of the medications harming their patients.
Author(s): Berkeley Franz, Lindsay Y. Dhanani, Sean Bogart, et al.
Citation: Journal of Substance Use & Addiction Treatment, 171, 209633
Date: 04/2025
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Presents a study exploring the different types of stigma affecting buprenorphine and other medications for opioid use disorder (MOUD) prescribing rates in rural primary care settings. Details perceived stigmas around MOUD by providers, such as the fear of being harmed by patients, fear of their professional image being harmed, and the fear of the medications harming their patients.
Author(s): Berkeley Franz, Lindsay Y. Dhanani, Sean Bogart, et al.
Citation: Journal of Substance Use & Addiction Treatment, 171, 209633
Date: 04/2025
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Delivering Medications for Opioid Use Disorder in Primary Care: Environmental Scan
Report provides a literature review and interviews with key informants to outline the opioid use disorder (OUD) treatment environment and make policy recommendations. Discusses how changes to regulations have affected access to medications for opioid use disorder (MOUD), how the opioid use environment has changed, and what models and evidence-based tools exist to facilitate OUD treatment, among other issues.
Author(s): Collette Sosnowy, Danielle Durant, Garrett Moran, et al.
Date: 03/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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Report provides a literature review and interviews with key informants to outline the opioid use disorder (OUD) treatment environment and make policy recommendations. Discusses how changes to regulations have affected access to medications for opioid use disorder (MOUD), how the opioid use environment has changed, and what models and evidence-based tools exist to facilitate OUD treatment, among other issues.
Author(s): Collette Sosnowy, Danielle Durant, Garrett Moran, et al.
Date: 03/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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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: 2/17/2026