Substance Use and Misuse in Rural Areas – Resources
Selected recent or important resources focusing on Substance Use and Misuse in Rural Areas.
Pharmacy-Related Syringe Access Barriers: An Audit of Oregon Community Pharmacies
Examines barriers to purchasing over-the-counter (OTC) syringes in Oregon pharmacies. Utilizes a telephone audit (secret shopper) methodology to examine 425 pharmacies' willingness to sell OTC syringes by pharmacy type, syringe services program (SSP) availability, overdose rates, and rural versus urban county type.
Author(s): Victor Abreu, Marissa McGinnis, Savannah Justen, et al.
Citation: Harm Reduction Journal, 22, 37
Date: 03/2025
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Examines barriers to purchasing over-the-counter (OTC) syringes in Oregon pharmacies. Utilizes a telephone audit (secret shopper) methodology to examine 425 pharmacies' willingness to sell OTC syringes by pharmacy type, syringe services program (SSP) availability, overdose rates, and rural versus urban county type.
Author(s): Victor Abreu, Marissa McGinnis, Savannah Justen, et al.
Citation: Harm Reduction Journal, 22, 37
Date: 03/2025
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Beliefs of US Chiefs of Police about Substance Use Disorder, Fentanyl Exposure, Overdose Response, and Use of Discretion: Results from a National Survey
Examines police chief perceptions regarding substance use. Focuses on issues such as discretion when making arrests, overdose response, risks of fentanyl exposure, de-escalation practices, harmful drugs in their communities, and buprenorphine obtained via illicit means. Analyzes survey data from 276 police chiefs regarding their knowledge and attitudes on addiction and policing, with breakdowns according to their region, urbanicity, and experience.
Author(s): Amelia Bailey, Barbara Andraka-Christou, Saba Rouhani, et al.
Citation: Health & Justice, 13, 13
Date: 03/2025
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Examines police chief perceptions regarding substance use. Focuses on issues such as discretion when making arrests, overdose response, risks of fentanyl exposure, de-escalation practices, harmful drugs in their communities, and buprenorphine obtained via illicit means. Analyzes survey data from 276 police chiefs regarding their knowledge and attitudes on addiction and policing, with breakdowns according to their region, urbanicity, and experience.
Author(s): Amelia Bailey, Barbara Andraka-Christou, Saba Rouhani, et al.
Citation: Health & Justice, 13, 13
Date: 03/2025
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Exposure to Firearm Injury and Suicide in a Rural Pennsylvania County: Implications for Mental and Behavioral Health
Presents a study exploring the relationship gun violence exposure and behavioral health indicators among a rural population. Bases findings on a survey of 630 residents of a rural county in Pennsylvania. Breaks down data by behavioral health indicator, level of exposure, and demographic information, such as age, sex, and economic situation, among other measures.
Author(s): Richard Stansfield, Daniel C. Semenza, Devon Ziminski
Citation: Journal of Behavioral Medicine, 48(1), 188-198
Date: 02/2025
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Presents a study exploring the relationship gun violence exposure and behavioral health indicators among a rural population. Bases findings on a survey of 630 residents of a rural county in Pennsylvania. Breaks down data by behavioral health indicator, level of exposure, and demographic information, such as age, sex, and economic situation, among other measures.
Author(s): Richard Stansfield, Daniel C. Semenza, Devon Ziminski
Citation: Journal of Behavioral Medicine, 48(1), 188-198
Date: 02/2025
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Disparities in Substance Use Disorder Telehealth Services
Results of a study examining telehealth's association with changes in disparities in substance use disorder telehealth utilization across payers and rurality, from 2019-2023. Features statistics including breakdowns by urban and rural areas.
Author(s): Lauryn Saxe Walker, Manying Cui, Jonathan Cantor, et al.
Citation: JAMA Network Open, 8(2), e2459606
Date: 02/2025
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Results of a study examining telehealth's association with changes in disparities in substance use disorder telehealth utilization across payers and rurality, from 2019-2023. Features statistics including breakdowns by urban and rural areas.
Author(s): Lauryn Saxe Walker, Manying Cui, Jonathan Cantor, et al.
Citation: JAMA Network Open, 8(2), e2459606
Date: 02/2025
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Enhancing Rural Access to Medications for Opioid Use Disorder: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Opioid Use Among Rural Medicare Beneficiaries
Examines trends in prescription opioid use among Medicare beneficiaries in rural areas, utilizing 2010-2017 Medicare Current Beneficiary Survey (MCBS) data. Provides data on receipt of opioid prescriptions among community-dwelling and facility-dwelling beneficiaries, associations between prescribing and chronic overlapping pain conditions (COPCs), and prescriptions exceeding CDC guidelines. Includes rural-urban comparisons.
Author(s): Yvonne Jonk, Heidi O'Connor, Karen Pearson, et al.
Date: 01/2025
Sponsoring organization: Maine Rural Health Research Center
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Examines trends in prescription opioid use among Medicare beneficiaries in rural areas, utilizing 2010-2017 Medicare Current Beneficiary Survey (MCBS) data. Provides data on receipt of opioid prescriptions among community-dwelling and facility-dwelling beneficiaries, associations between prescribing and chronic overlapping pain conditions (COPCs), and prescriptions exceeding CDC guidelines. Includes rural-urban comparisons.
Author(s): Yvonne Jonk, Heidi O'Connor, Karen Pearson, et al.
Date: 01/2025
Sponsoring organization: Maine Rural Health Research Center
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Rural Recovery Innovations
Discusses disparities in behavioral health recovery support services in rural, frontier, and tribal communities. Highlights innovative and promising practices for addressing behavioral health disparities, such as addressing stigma, supporting peer workforce, and addressing social determinants of health, among other measures.
Date: 01/2025
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Discusses disparities in behavioral health recovery support services in rural, frontier, and tribal communities. Highlights innovative and promising practices for addressing behavioral health disparities, such as addressing stigma, supporting peer workforce, and addressing social determinants of health, among other measures.
Date: 01/2025
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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A Rural-Urban Analysis of Buprenorphine Therapy During and After Pregnancy Among the Commercially Insured
Explores the use of evidence-based buprenorphine treatment and adherence during the peri-pregnancy period among commercially insured individuals by rurality. Analyzes data on 1,331,040 people between 15 and 44 years-old with diagnosis codes for pregnancy and labor/delivery from January 1, 2015, to December 31, 2019.
Author(s): KariLynn Dowling-McClay, Bill Brooks, Daniel Krauss, et al.
Date: 01/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Explores the use of evidence-based buprenorphine treatment and adherence during the peri-pregnancy period among commercially insured individuals by rurality. Analyzes data on 1,331,040 people between 15 and 44 years-old with diagnosis codes for pregnancy and labor/delivery from January 1, 2015, to December 31, 2019.
Author(s): KariLynn Dowling-McClay, Bill Brooks, Daniel Krauss, et al.
Date: 01/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Implementation of Mobile Medication Units: Findings from a Qualitative Study
Provides a brief overview of the development of policy regarding the approval of mobile medication units (MMUs) operated by opioid treatment programs (OTPs). Presents findings from an environmental scan and key informant interviews regarding MMU implementation. Discusses barriers to establishing, sustaining, and expanding MMU services. Describes opportunities to increase access to methadone in underserved communities. Includes rural references throughout.
Date: 01/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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Provides a brief overview of the development of policy regarding the approval of mobile medication units (MMUs) operated by opioid treatment programs (OTPs). Presents findings from an environmental scan and key informant interviews regarding MMU implementation. Discusses barriers to establishing, sustaining, and expanding MMU services. Describes opportunities to increase access to methadone in underserved communities. Includes rural references throughout.
Date: 01/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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Youth Mental Health and Substance Use Task Force: Redesigning the Health Care Delivery System to Better Meet the Needs of Youth
Presents policy recommendations from 50 experts and thought leaders regarding how to maximize the potential of the U.S. healthcare system to better serve youth with behavioral health needs. Covers the behavioral health workforce, transparency and compliance with existing screening and treatment requirements, promoting integrated primary care and behavioral health services in pediatric settings, the needs of youth with the highest acuity behavioral health needs, and strengthening crisis and stabilization systems. Includes rural references and considerations throughout.
Date: 01/2025
Sponsoring organization: Bipartisan Policy Center
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Presents policy recommendations from 50 experts and thought leaders regarding how to maximize the potential of the U.S. healthcare system to better serve youth with behavioral health needs. Covers the behavioral health workforce, transparency and compliance with existing screening and treatment requirements, promoting integrated primary care and behavioral health services in pediatric settings, the needs of youth with the highest acuity behavioral health needs, and strengthening crisis and stabilization systems. Includes rural references and considerations throughout.
Date: 01/2025
Sponsoring organization: Bipartisan Policy Center
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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: 4/25/2025