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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.

Behavioral Health Conditions Reach Crisis Levels: Counties Urge Stronger Intergovernmental Partnerships and Outcomes
Features a number of counties throughout the nation and details their behavioral health needs and access challenges. Presents each county as a case study. Describes the policy priorities for each county and the barriers to access. Several of the featured counties are rural.
Additional links: Executive Summary
Date: 05/2023
Sponsoring organization: National Association of Counties
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Rural and Urban Differences in Factors Associated with Inpatient Hospital Stays for Substance Use Disorder
Provides information on inpatient hospital stays for patients with substance use disorder (SUD) by rural and urban location. Utilizes 2018 Healthcare Cost and Utilization Project (HCUP) data to examine 81,857 inpatient hospital stays, with rural versus urban data further broken down by age, sex, type of SUD diagnosis, secondary conditions and comorbidities, admission type and source, Health Professional Shortage Area (HPSA) status, payer type, hospital characteristics, and more.
Author(s): Craig Holden, Curt Mueller, Shena Popat, Alana Knudson
Date: 04/2023
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Factors Associated with Lengths-of-Stay for Inpatients with Substance Use Disorders
Policy brief identifying factors associated with inpatient length-of-stay (LOS) for the treatment of substance use disorders (SUDs) and exploring whether there are systematic differences in LOS for rural and urban residents. Includes statistics on characteristics of stays for a primary SUD diagnosis in Kentucky, North Carolina, Vermont, and Washington in 2018, with breakdowns by Mental Health Professional Shortage Area and rural or urban location, and selected factors on LOS for an SUD diagnosis, with breakdowns by mental diagnoses, chronic conditions, and sociodemographic measures.
Author(s): Curt Mueller, Craig Holden, Shena Popat, Alana Knudson
Date: 04/2023
Sponsoring organization: ETSU/NORC Rural Health Research Center
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The Rural Behavioral Health Crisis Continuum: Considerations and Emerging State Strategies
Presents examples of state strategies for bolstering the rural behavioral health crisis care continuum at each level of care.
Author(s): Miriam Pearsall, Sandra Wilkniss
Date: 04/2023
Sponsoring organization: National Academy for State Health Policy
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The State Perspective on Rural Behavioral Health Crisis Services
Provides an overview of a 12-month State Policy Academy on Rural Mental Health Crisis Services to help 5 states - Montana, South Carolina, South Dakota, Texas, and Wisconsin - work to improve rural behavioral health crisis services. Summarizes lessons learned, successes, and next steps. Covers data-informed strategies, cross-state and stakeholder partnerships, financing and funding approaches, the behavioral health workforce, and telehealth.
Author(s): Miriam Pearsall, Sandra Wilkniss
Date: 04/2023
Sponsoring organization: National Academy for State Health Policy
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Teens Linked to Care Toolkit
Toolkit from the Centers for Disease Control and Prevention (CDC) for developing prevention programs addressing substance use and sexual risk for youth in rural communities. Includes information on program planning, implementation, evaluation, and sustainability as well as 2 case studies from the pilot program using either a school-based or community-based model.
Date: 03/2023
Sponsoring organization: Centers for Disease Control and Prevention
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Review of Four CARA Programs and Preparing for Future Evaluations
Report highlights a review of 4 programs funded through the Comprehensive Addiction and Recovery Act (CARA) aimed at expanding access to overdose prevention and treatment of opioid use disorder. Explores the impact of the programs on their communities and makes recommendations for policy makers. Discusses challenges and program adaptations for rural communities.
Additional links: Read Online, Report Highlights
Author(s): Board on Population Health and Public Health Practice
Date: 03/2023
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Improving Access - NAM Action Collaborative on Countering the U.S. Opioid Epidemic Telehealth and Virtual Care Meeting Series
Highlights the proceedings of a meeting discussing the use of telehealth and virtual care to treat substance use disorder (SUD). Explores the effect the COVID-19 pandemic on telehealth regulation and reimbursement. Features considerations for rural communities.
Date: 03/2023
Sponsoring organization: National Academy of Medicine
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Spatiotemporal Trends in Three Smoothed Overdose Death Rates in US Counties, 2012–2020
Provides county-level U.S. maps depicting spatiotemporal patterns of synthetic opioid, any opioid, and psychostimulant overdose death rates from 2012 to 2020 and discusses overdose trends and potential response.
Author(s): McKinley E. Saunders, Jamie L. Humphrey, Barrot H. Lambdin
Citation: Preventing Chronic Disease, 20
Date: 03/2023
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Availability of Behavioral Health Providers and Services in Rural Areas, with Holly Andrilla
An episode of the Exploring Rural Health podcast featuring Holly Andrilla, Deputy Director of the WWAMI Rural Health Research Center. Focuses on rural availability of psychiatrists, psychologists, psychiatric nurse practitioners, social workers, and counselors, as well as recent developments in access to medication for opioid use disorder (MOUD).
Date: 03/2023
Sponsoring organization: Rural Health Information Hub
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Last Updated: 12/15/2025