Substance use and treatment
Research Products & Journal Articles
Browse the full list of research publications on this topic completed by the Rural Health Research Centers.
Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.
Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.
2022
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Medicaid Expansion and Access to Naloxone in Metropolitan and Nonmetropolitan Areas
Journal Article
Rural and Underserved Health Research Center
Date: 11/2022
This study evaluated the association of Medicaid expansion at the state level on the number of naloxone prescriptions dispensed and the percentage paid by Medicaid. Increasing the percentage of Medicaid-paid naloxone prescriptions improved access in metro areas.
2021
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Use of Electronic Health Records to Manage Tobacco Screening and Treatment in Rural Primary Care
Journal Article
Maine Rural Health Research Center
Date: 09/2021
This study compares the performance of rural and urban primary care providers in adhering to evidence-based smoking-related standards of care and assesses the degree to which electronic health record use was related to improved adherence to these standards in the practice of rural versus urban providers. -
Voices From the Field: A Qualitative Study of the Challenges and Promising Practices of Rural Public Health in Addressing HIV and Hepatitis C
Journal Article
Maine Rural Health Research Center
Date: 05/2021
Interviewing public health professionals from six rural states, researchers examined the challenges involving HIV, HCV, and serving rural people who inject drugs and determined strategies to address those challenges. -
Tracking the Geographic Distribution and Growth of Clinicians With a DEA Waiver to Prescribe Buprenorphine to Treat Opioid Use Disorder
Journal Article
WWAMI Rural Health Research Center
Date: 03/2021
The increase in clinicians who can prescribe buprenorphine improves access to treatment for opioid use disorder. Small remote rural communities continue to experience access challenges. 63.1% of all rural counties had at least one clinician with a Drug Enforcement Administration waiver, but more than half of small remote rural counties did not. -
Capacity of Rural Counties to Address an HIV or Hepatitis C Outbreak
Policy Brief
Maine Rural Health Research Center
Date: 02/2021
This study examines rural-urban differences in state and local health department capacity to prevent, prepare for, and respond to an HIV or hepatitis C outbreak. -
Opioid-Related Visits to Rural Emergency Departments
Policy Brief
Maine Rural Health Research Center
Date: 02/2021
The purpose of this project was to compare rural and urban opioid-related emergency department visits. Data from the Nationwide Emergency Department Sample were used to examine rural and urban opioid-related visits over time and to compare the outcomes of these visits. -
Rural HIV Prevalence and Service Availability in the United States: A Chartbook
Chartbook
Maine Rural Health Research Center
Date: 02/2021
This chartbook examines 2016 HIV prevalence and the availability of HIV prevention, testing, and treatment services across the rural-urban continuum and by U.S. census region. -
Rural-Urban Residence and Maternal Hepatitis C Infection, U.S.: 2010-2018
Journal Article
Maine Rural Health Research Center
Date: 02/2021
This study uses data from the U.S. natality files to examine rural-urban differences in county-level rates of maternal infection with hepatitis C virus (HCV) during 2010-2018. Findings can help inform implementation of community-level interventions to reduce maternal HCV infection and narrow rural-urban disparities.
2020
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Substance Use Among Rural and Urban Youth and Young Adults
Policy Brief
Maine Rural Health Research Center
Date: 11/2020
This study uses national data to examine rural-urban differences in the rates of substance use among youth and young adults. Findings can help inform rural-specific prevention strategies and research targeting rural communities. -
Measure and Data Element Identification for the HRSA Evidence-Based Tele-Behavioral Health Network Program and the HRSA Substance Abuse Treatment Telehealth Network Grant Program
Policy Brief
Rural Telehealth Research Center
Date: 04/2020
This brief details work to identify measures and develop data elements appropriate to tele-behavioral health, create an Excel-based tool, and collect data from grantees in the Health Resources and Services Administration's Evidence-Based Tele-Behavioral Health Network Grant Program and Substance Abuse Treatment Telehealth Network Grant Program. -
Early-Career and Graduating Physicians More Likely to Prescribe Buprenorphine
Journal Article
Rural and Underserved Health Research Center
Date: 01/2020
Only a small percentage of people who need treatment for opioid use disorder receive it, including buprenorphine. This paper shows differences in rates of prescribing buprenorphine and intentions to prescribe buprenorphine between early- and mid-to-late career family physicians, based on a survey of physicians taking a certification examination. -
Practice Predictors of Buprenorphine Prescribing by Family Physicians
Journal Article
Rural and Underserved Health Research Center
Date: 01/2020
Physicians may prescribe buprenorphine if they obtain a waiver, but relatively few family physicians do so. This paper examines the association between practice characteristics and the likelihood that a family physician will prescribe buprenorphine, based on a survey of physicians seeking board certification in family medicine.
2019
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Prescribing Practices of Nurse Practitioners and Physician Assistants Waivered to Prescribe Buprenorphine and the Barriers They Experience Prescribing Buprenorphine
Journal Article
WWAMI Rural Health Research Center
Date: 10/2019
This study surveyed rural and urban nurse practitioners (NPs) and physician assistants (PAs) with Drug Enforcement Agency waivers to provide medication treatment for opioid use disorder by prescribing buprenorphine. Rural NPs and PAs reported facing many of the same barriers to providing buprenorphine as rural physicians have reported. -
Rural-Urban Differences in the Decline of Adolescent Cigarette Smoking
Journal Article
Maine Rural Health Research Center
Date: 03/2019
Comparing survey data from 2008-2010 with 2014-2016, we examined change over time in cigarette smoking among rural and urban adolescents. We found that both rural and urban rates declined, but the decrease was smaller in rural counties, which widened the rural-urban gap in adolescent smoking rates.
2018
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Overcoming Barriers to Prescribing Buprenorphine for the Treatment of Opioid Use Disorder: Recommendations From Rural Physicians
Journal Article
WWAMI Rural Health Research Center
Date: 10/2018
Rural physicians with a Drug Enforcement Administration waiver to prescribe buprenorphine who were treating a higher than average number of opioid use disorder patients were interviewed about strategies and best practices for overcoming commonly cited barriers to incorporating and providing medication assisted treatment into their practices. -
Projected Contributions of Nurse Practitioners and Physicians Assistants to Buprenorphine Treatment Services for Opioid Use Disorder in Rural Areas
Journal Article
WWAMI Rural Health Research Center
Date: 08/2018
This study projected the potential increase in medication assisted treatment availability for opioid use disorder (OUD) provided by nurse practitioners (NPs) and physician assistants (PAs) for rural patients under the Comprehensive Addiction and Recovery Act, which allows NPs and PAs to obtain a waiver to prescribe buprenorphine for OUD. -
Geographic Distribution of Providers With a DEA Waiver to Prescribe Buprenorphine for the Treatment of Opioid Use Disorder: A 5‐Year Update
Journal Article
WWAMI Rural Health Research Center
Date: 06/2018
This study compares the geographic distribution of physicians, physician assistants, and nurse practitioners waivered to prescribe buprenorphine in 2012 and 2017. -
Geographic Variation in the Supply of Selected Behavioral Health Providers
Journal Article
WWAMI Rural Health Research Center
Date: 06/2018
This study examined the supply of select behavioral health providers by metropolitan, micropolitan, and non-core county and Census Division. Psychiatrists, psychologists, and psychiatric nurse practitioners are unequally distributed throughout the U.S., with disparities between Census Divisions and rural vs. urban areas. -
Prescribing Practices of Rural Physicians Waivered to Prescribe Buprenorphine
Journal Article
WWAMI Rural Health Research Center
Date: 06/2018
This study finds more than 60% of rural counties don't have a physician waivered to prescribe buprenorphine, which is used to treat opioid use disorder.
2017
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Barriers Rural Physicians Face Prescribing Buprenorphine for Opioid Use Disorder
Journal Article
WWAMI Rural Health Research Center
Date: 07/2017
Opioid use disorder is a serious public health problem. Management with buprenorphine is an effective medication-assisted treatment, but 60.1% of rural counties lack a physician with a Drug Enforcement Agency waiver to prescribe buprenorphine. This national study surveyed all rural physicians who have received a waiver in the United States. -
Use of the Emergency Department for Mental Health and Substance Abuse Among Women
Fact Sheet
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 07/2017
This study identifies trends among women in rural and urban communities who utilize the emergency department for mental health and substance abuse. The information can be used to help communities provide more relevant, appropriate, and less costly care. -
Changes in the Supply of Physicians With a DEA DATA Waiver to Prescribe Buprenorphine for Opioid Use Disorder
Policy Brief
WWAMI Rural Health Research Center
Date: 05/2017
This project mapped the location of physicians with a DEA DATA 2000 waiver to prescribe buprenorphine for opioid use disorder in July 2012 and April 2016. The number of counties without a waivered physician and the ratio of waivered physicians per 100,000 population is reported by the rural/urban status of the county. -
Rural Opioid Prevention and Treatment Strategies: The Experience in Four States
Policy Brief
Maine Rural Health Research Center
Date: 04/2017
Little is known about what states with large rural populations are doing to combat opioid use disorders (OUD) in rural communities. This qualitative study identified rural challenges to the provision of OUD prevention, treatment, and recovery services and explored promising strategies to tackle the opioid crisis in rural communities.
2016
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Rural Opioid Abuse: Prevalence and User Characteristics
Policy Brief
Maine Rural Health Research Center
Date: 02/2016
Opioid abuse is the fastest growing substance abuse problem in the nation and the primary cause of unintentional drug overdose deaths. This study examined the rural-urban prevalence of non-medical use of pain relievers and heroin in the past year and the socioeconomic characteristics associated with their use and other risky behavior.
2015
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Geographic and Specialty Distribution of U.S. Physicians Trained to Treat Opioid Use Disorder
Journal Article
WWAMI Rural Health Research Center
Date: 01/2015
Examines the distribution of physicians authorized to treat opioid use disorder in the United States, and proposes increasing access to office-based treatment as a promising strategy to address rising rates of opioid use disorder in rural areas.
2014
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The 2014 Update of the Rural-Urban Chartbook
Chartbook
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 10/2014
This chartbook includes trends and disparities in urban/rural health. Reports on population characteristics include age, race and ethnicity, and poverty; risk factors such as smoking, alcohol use, and obesity; mortality data; health status measures such as adolescent births and total tooth loss; healthcare access/use; and mental health measures.
2012
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Adolescent Alcohol Use: Do Risk and Protective Factors Explain Rural-Urban Differences? (Policy Brief)
Maine Rural Health Research Center
Date: 03/2012
This policy brief finds that after controlling for a broad range of key risk and protective factors, it is clear that an unexplained rural effect persists with rural adolescents still exhibiting higher alcohol use than their urban counterparts. -
Adolescent Alcohol Use: Do Risk and Protective Factors Explain Rural-Urban Differences? (Working Paper)
Maine Rural Health Research Center
Date: 03/2012
This study examines alcohol use among rural and urban adolescents between the ages of 12 and 17.
2009
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Availability, Characteristics, and Role of Detoxification Services in Rural Areas
Maine Rural Health Research Center
Date: 12/2009
Few detox providers (n=235) serve rural America; 82% of rural residents live in a county without a detox provider. More than half of all rural detox providers serve patients across a 100-mile radius, making travel distances a barrier to outpatient care. Referral options to substance abuse treatment are limited, especially in isolated rural areas. -
Few and Far Away: Detoxification Services in Rural Areas (Research & Policy Brief)
Maine Rural Health Research Center
Date: 12/2009
This policy brief finds that few rural detox providers exist; 82% of rural residents live in a county without a detox provider. More than half of all rural detox providers serve a 100-mile radius. Travel distances are a barrier to outpatient detox models. Referral options to substance abuse treatment are limited, especially in isolated rural areas.
2008
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Distribution of Substance Abuse Treatment Facilities Across the Rural - Urban Continuum (Research & Policy Brief)
Policy Brief
Maine Rural Health Research Center
Date: 02/2008
This research and policy brief highlights findings from a recent study examining the distribution of substance abuse treatment facilities in rural and urban counties and identifying the type and intensity of services provided.
2007
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Distribution of Substance Abuse Treatment Facilities Across the Rural - Urban Continuum
Maine Rural Health Research Center
Date: 10/2007
This study examines the distribution of substance abuse treatment services across the continuum of rural and urban counties, identifying the type and intensity of services provided. -
Substance Abuse Among Rural Youth: A Little Meth and a Lot of Booze
Maine Rural Health Research Center
Date: 06/2007
This research and policy brief examines substance abuse among rural youth, with rural-urban comparisons of methamphetamine, Oxycontin, and alcohol abuse.
2006
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Problem Drinking: Rural and Urban Trends in America, 1995/1997 to 2003
Journal Article
WWAMI Rural Health Research Center
Date: 03/2006
Assesses the prevalence of, and recent trends in, alcohol use among adults 18 years and older in rural areas of the United States. The paper finds that heavy drinking was highest and increasing in urban areas, but that binge drinking was greater in rural areas. It recommends tailoring interventions specifically to meet the needs of rural residents. -
Prevalence and Trends in Smoking: A National Rural Study
Journal Article
WWAMI Rural Health Research Center
Date: 2006
Using data from the Behavioral Risk Factor Surveillance System, the prevalence of smoking between 1994-1996 and 2000-2001 did not change substantially for the United States as a whole. The prevalence of smoking for rural residents decreased by more than 2 percent in six states. However, it increased by 2 percent or more in ten states. -
PTSD and Substance Use: Unrecognized Sequelae of Bioterrorism in Primary Care Providers
Journal Article
FORHP-funded Individual Grantees
Date: 2006
Study looks at rural primary care providers' knowledge of likely mental disorders, their risk factors, and preferred treatment options following a public health emergency. -
Rural and Frontier Mental and Behavioral Health Care: Barriers, Effective Policy Strategies, Best Practices
Maine Rural Health Research Center
Date: 2006
This report discusses barriers to mental and behavioral health service delivery in rural America. It includes model programs and model policy strategies for rural mental and behavioral healthcare delivery and discusses the roles that telehealth and that the State Offices of Rural Health should play in service delivery.
2003
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Rural-Urban Difference in Health Care Benefits of Community-Based Sample of At-Risk Drinkers
Journal Article
WICHE Center for Rural Mental Health Research
Date: 2003
Compares the cost-containment strategies used by health plans of insured at-risk drinkers residing in rural and urban areas.