Substance Use and Misuse in Rural Areas – Resources
Selected recent or important resources focusing on Substance Use and Misuse in Rural Areas.
Achieving Behavioral Health Care Integration in Rural America
Provides an overview of behavioral health and primary care integration and how integration may be different in rural areas than in urban and suburban areas. Examines the barriers to integration in rural areas and opportunities for policies that can improve access to care. Offers policy recommendations to better coordinate and integrate primary care and behavioral health services for high-risk groups and expand the ability of primary care providers to handle the lower-acuity behavioral health needs of patients through enhanced payments, training, and improved access to behavioral health providers for consultation and referral. Builds on the March 2021 report, Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration.
Author(s): Kendall Strong, Michele Gilbert, Julia Harris, et al.
Date: 05/2023
Sponsoring organization: Bipartisan Policy Center
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Provides an overview of behavioral health and primary care integration and how integration may be different in rural areas than in urban and suburban areas. Examines the barriers to integration in rural areas and opportunities for policies that can improve access to care. Offers policy recommendations to better coordinate and integrate primary care and behavioral health services for high-risk groups and expand the ability of primary care providers to handle the lower-acuity behavioral health needs of patients through enhanced payments, training, and improved access to behavioral health providers for consultation and referral. Builds on the March 2021 report, Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration.
Author(s): Kendall Strong, Michele Gilbert, Julia Harris, et al.
Date: 05/2023
Sponsoring organization: Bipartisan Policy Center
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Understanding the U.S. Behavioral Health Workforce Shortage
Discusses the shortage of behavioral health professionals across the country and highlights some of the contributing factors. Breaks down factors affecting licensed providers, clinical supporters, community care workers, and frontline workers. Makes recommendations for policymakers and includes considerations for rural areas.
Author(s): Nathaniel Counts
Date: 05/2023
Sponsoring organization: Commonwealth Fund
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Discusses the shortage of behavioral health professionals across the country and highlights some of the contributing factors. Breaks down factors affecting licensed providers, clinical supporters, community care workers, and frontline workers. Makes recommendations for policymakers and includes considerations for rural areas.
Author(s): Nathaniel Counts
Date: 05/2023
Sponsoring organization: Commonwealth Fund
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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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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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An Exploratory Study of a Hands-on Naloxone Training for Rural Clinicians and Staff
Presents a study on the efficacy of a hands-on naloxone training for rural healthcare providers as a means of reducing opioid overdose fatalities in rural areas. Discusses the fentanyl-driven surge in opioid overdose deaths and describes the 1-hour training session, which involved a lecture and hands-on training with naloxone.
Author(s): Shameka L. Cody, Cheryl B. Hines, Christina J. Glenn, et al.
Citation: Journal of Nursing Scholarship, 55(3), 599-604
Date: 05/2023
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Presents a study on the efficacy of a hands-on naloxone training for rural healthcare providers as a means of reducing opioid overdose fatalities in rural areas. Discusses the fentanyl-driven surge in opioid overdose deaths and describes the 1-hour training session, which involved a lecture and hands-on training with naloxone.
Author(s): Shameka L. Cody, Cheryl B. Hines, Christina J. Glenn, et al.
Citation: Journal of Nursing Scholarship, 55(3), 599-604
Date: 05/2023
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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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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 five 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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Provides an overview of a 12-month State Policy Academy on Rural Mental Health Crisis Services to help five 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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A Qualitative Analysis of Rural Syringe Service Program Fidelity in Appalachian Kentucky: Staff and Participant Perspectives
Presents a study exploring the fidelity of rural syringe service programs (SSPs) to the core components of SSPs. Highlights five SSPs in rural Appalachia and evaluates the programs' adherence to the six core components of SSPs. Bases findings on interviews with clients and staff.
Author(s): E.J. Batty, U. Ibragimov, M. Fadanelli, et al.
Citation: Journal of Rural Health, 39(2), 328-337
Date: 03/2023
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Presents a study exploring the fidelity of rural syringe service programs (SSPs) to the core components of SSPs. Highlights five SSPs in rural Appalachia and evaluates the programs' adherence to the six core components of SSPs. Bases findings on interviews with clients and staff.
Author(s): E.J. Batty, U. Ibragimov, M. Fadanelli, et al.
Citation: Journal of Rural Health, 39(2), 328-337
Date: 03/2023
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Teens Linked to Care Toolkit
A 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 two 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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A 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 two 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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Community Member Perspectives on Adapting the Cascade of Care for Opioid Use Disorder for a Tribal Nation in the United States
Explores the potential efficacy of the Opioid Use Disorder (OUD) Cascade of Care model for American Indian and Alaska Native communities. Bases conclusion on interviews with clinicians, peer support specialists, cultural practitioners, and others familiar with OUD treatment for Anishinaabe people in rural Minnesota. Breaks down data by age, sex, and employment type.
Author(s): Frank Johnson Jr, Amy RedCloud, Jennifer Mootz, et al.
Citation: Addiction, 118(8), 1540-1548
Date: 03/2023
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Explores the potential efficacy of the Opioid Use Disorder (OUD) Cascade of Care model for American Indian and Alaska Native communities. Bases conclusion on interviews with clinicians, peer support specialists, cultural practitioners, and others familiar with OUD treatment for Anishinaabe people in rural Minnesota. Breaks down data by age, sex, and employment type.
Author(s): Frank Johnson Jr, Amy RedCloud, Jennifer Mootz, et al.
Citation: Addiction, 118(8), 1540-1548
Date: 03/2023
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Review of Four CARA Programs and Preparing for Future Evaluations
Report highlights a review of four 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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Report highlights a review of four 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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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: 4/1/2025