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Population Health, Rural Disparities, Stigma, Substance Use Disorders, Workforce



  1. Heitkamp, Thomasine L. MSW, LCSW
  2. Fox, LaVonne F. PhD


Abstract: This article provides an overview of the barriers to accessing intervention, treatment, and recovery supports for persons impacted by substances in rural communities. It defines "rural" and the complications of accessing intervention and treatment services in rural communities including the limitations of accessibility, availability, affordability, and acceptability of care. Ten suggestions, based on needs in rural communities and evidence-based practices, are outlined. They include suggestions for addressing the shortage of care providers in rural communities; educating and training professionals who are willing to adopt evidence-based practices; advancing a population health approach; addressing the limitation of substance use intervention and access to treatment because of stigma; adopting Screening, Brief Intervention, and Referral to Treatment and integrated care; ensuring support to address alcohol, stimulant, and opioid use disorder; offering culturally competent care; addressing the limitations of funding to access care in rural areas; and expanding the use of technology to deliver telehealth services. The recommendations are practical and support both the current and future health and behavioral health workforce serving people with substance use disorders in rural communities and health care administrators. If implemented, this will begin to address the disparities people residing in rural areas experience in securing treatment for substance use disorder and expand access to support for early intervention for people at risk through the adoption of evidence-based practices.