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Rural Health
Resources by Topic: Substance use and misuse

Trends in the Utilization of Emergency Department Services, 2009-2018
Examines emergency department (ED) utilization. Explores ED visits resulting in hospital admission, visits ending in release, and visits associated with mental health or substance use disorder diagnoses. Presents information on the patient, hospital, and payer characteristics for each of these three categories, including metropolitan status. Describes federal efforts to discourage inappropriate ED use.
Date: 03/2021
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Alcohol- and Drug-Related Consequences Across Latent Classes of Substance Use Among American Indian Adolescents
Examines differences across four classes of substance use behaviors by American Indian (AI) adolescents. Classes include: no substance use in the past month; marijuana and cigarette use only; alcohol, marijuana, and cigarette use only; and other substance use in addition to alcohol, marijuana, and cigarettes. Goal of study is to determine the extent of substance-related mortality and morbidity, tendency toward developing a substance-use disorder, and other related health disparities.
Author(s): Schick, M.R., Goldstein, S.C., Nalven, T., Spillane, N.S.
Citation: Addictive Behaviors, 113
Date: 02/2021
Type: Document
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Traffic Safety in Appalachia: Final Report
Defines the traffic safety culture in Appalachia and discusses causes of common safety problems in the region, including drug- and alcohol-impaired driving. Explores environmental concerns of Appalachian drivers, such as expansive rural regions, mountainous and curved terrain, and dense forests exposed to extreme weather elements. Includes analysis of Appalachian traffic fatalities, fatal crash data statistics, and an evaluation of the Appalachian Development Highway System as a possible intervention measure for treating traffic safety problems. Also includes a case study of severe crashes in Appalachian North Carolina, featuring statistics with breakdowns by rural and urban areas.
Additional links: Research Brief
Author(s): Wesley Kumfer, Katherine Harmon, Bo Lan, et al.
Date: 02/2021
Type: Document
Sponsoring organization: Appalachian Regional Commission
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Opioid and Substance Use Strategies for Critical Access Hospitals
Recording of a February 26, 2021, webinar discussing the role of Critical Access Hospitals (CAHs) in addressing opioid and substance use disorders (O/SUDs) in local systems of care. Provides a framework to support CAH opioid and substance use initiatives. Highlights examples of O/SUD activities taken by CAHs and offers lessons learned.
Additional links: Presentation Slides
Date: 02/2021
Type: Video/Multimedia
Sponsoring organization: Flex Monitoring Team
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Projected Estimates of Opioid Mortality After Community-Level Interventions
Presents a study on the effectiveness of different evidence-based practices to prevent opioid overdose mortality in simulated rural and urban communities. Highlights data by evidence-based practice and by projected rural and urban population group, which is broken down by age, sex, and opioid injection versus non-injection.
Author(s): Benjamin P. Linas, Alexandra Savinkina, R. W. M. A. Madushani, et al.
Citation: JAMA Network Open, 4(2), e2037259
Date: 02/2021
Type: Document
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Capacity of Rural Counties to Address an HIV or Hepatitis C Outbreak
Examines data from 20 states potentially at risk of a human immunodeficiency virus (HIV) or hepatitis C virus (HCV) outbreak to determine which services local health departments (LHDs) provide to help identify or address HIV or HCV. Examples of relevant services include HIV testing, substance use services, and infectious disease surveillance, among others. Includes rural/urban differences in LHD services and staff, LHD partnerships and collaboration, and demographic characteristics of at-risk counties.
Author(s): Jennifer Lenardson, Jaclyn Janis, Amanda Burgess, Karen Pearson, Martha Elbaum
Date: 02/2021
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Opioid-Related Visits to Rural Emergency Departments
Explores the impact of the opioid crisis on rural emergency departments (EDs) by analyzing 2006 and 2013 Nationwide Emergency Department Sample (NEDS) data. Compares opioid-related ED visits in rural and urban hospitals by type of opioid involved and year. Breaks down data by patient characteristics, comorbid diagnosis at admission, and outcome of ED visit.
Author(s): Erika C. Ziller, Jean A. Talbot, Deborah Thayer, Carly Milkowski
Date: 02/2021
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Opioid-Related and Stimulant-Related Adult Inpatient Stays, 2012-2018
Presents statistics on inpatient hospital stays related to the dependence, abuse, and adverse effects of opioids and stimulants between 2012 and 2018. Examines data by patient characteristics, including age, sex, race/ethnicity, urban or rural location of residence, and income.
Date: 02/2021
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Socioenvironmental Risk Factors for Adolescent Marijuana Use in a United States-Mexico Border Community
Reports on a study of predominantly Hispanic high school students in a rural border community, examining community and immigration-related stress, normalized drug trafficking, and negative perceptions of their neighborhood. Discusses the link between these socioenvironmental risk factors and tobacco, alcohol, and marijuana use, as well as implications for health promotion and public health practitioners.
Author(s): Elizabeth Salerno Valdez, Luis Valdez, Josephine Korchmaros, et al.
Citation: American Journal of Health Promotion, 35(1), 20-27
Date: 01/2021
Type: Document
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Rural Emergency Medical Service Providers Perceptions on the Causes of and Solutions to the Opioid Crisis: A Qualitative Assessment
Study examining the perspectives of rural emergency medical service (EMS) providers on key issues related to the opioid crisis, including prescription, ease of access to opioids, socioeconomic vulnerability, mental health, and lack of alternative treatment options. Discusses qualitative data taken from 123 surveys addressing perceived causes and solutions to the crisis.
Author(s): Heather Blue, Ashley Dahly, Susan Chhen, et al.
Citation: Journal of Primary Care and Community Health, 12, 2150132720987715
Date: 01/2021
Type: Document
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