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Substance Use Care in Rural Communities

New Content ItemRural communities bear a disproportionate burden of substance use epidemics and their consequences that contribute to greater morbidity and lower life expectancy compared with people living in more urban areas. The roots of increased opioid and methamphetamine use in rural America are complex and may include a greater availability of prescription opioids due to local economies reliant on occupations with a high-risk of injury and targeted marketing by pharmaceutical companies, economic hardship caused by out-migration and high unemployment rates, and limited healthcare infrastructure with less opportunities for substance use screening and treatment. All of this contributes to overdose and mortality rates that can exceed those in urban centers.

Despite the increased burden of substance use in rural areas, access to harm reduction and treatment services in rural communities is often limited. Preliminary regional data suggests that drug use, overdoses (non-fatal and fatal), and demand for treatment services have increased during the COVID-19 pandemic. Patients with substance use disorders have an increased risk of being infected with COVID-19 and insufficient hospital capacity in rural areas may increase mortality rates. 

Addiction Science and Clinical Practice (ASCP) is developing a collection that address the impact on the quality of care for people using drugs and alcohol in rural communities, novel models for improving access to substance use disorder screening and treatment, and interactions between harm reduction and substance use treatment services, and the COVID-19 pandemic in rural communities. The overall goal of this special collection is to advance scientific understanding of the wide array of issues impacting the care of people with substance use in rural communities. Articles include original research, systematic reviews, meta-analyses, commentaries, and study protocols that advance our understanding of substance use issues in rural communities.

The deadline for submitting has now passed. Articles will be added to the collection as soon as they are ready to be published following acceptance.

Funding for the publication of a limited number of articles is available thanks to the generosity of the National Drug Abuse Treatment Clinical Trials Network (CTN). 

For further information on this collection, please contact Co-Guest Editors, P. Todd Korthuis, Erin L. Winstanley, and Sterling M. McPherson via editorial@ascpjournal.org. The Editors of the collection declare no competing interests.


  1. Among people who inject drugs (PWID), obtaining syringes via syringe services programs (SSPs) and pharmacies reduces injection sharing practices associated with hepatitis C virus (HCV). Whether indirect use of...

    Authors: Eric Romo, Abby E. Rudolph, Thomas J. Stopka, Bo Wang, Bill M. Jesdale and Peter D. Friedmann
    Citation: Addiction Science & Clinical Practice 2023 18:2
  2. Medication for opioid use disorder (MOUD) includes administering medications such as buprenorphine or methadone, often with mental health services. MOUD has been shown to significantly improve outcomes and suc...

    Authors: Treah Haggerty, Nicholas A. Turiano, Tyra Turner, Patricia Dekeseredy and Cara L. Sedney
    Citation: Addiction Science & Clinical Practice 2022 17:72
  3. Injection drug use (IDU) remains the strongest risk factor for hepatitis C virus (HCV) in the United States. HCV rates are increasing in rural areas among young adult people who inject drugs (PWID). People wit...

    Authors: Akash Gupta, Fatma M. Shebl, Yao Tong, Katherine Wagner, Ingrid V. Bassett, Kimberly Page and Erin L. Winstanley
    Citation: Addiction Science & Clinical Practice 2022 17:58
  4. In an effort to address the current opioid epidemic, a number of hospitals across the United States have implemented emergency department-based interventions for engaging patients presenting with opioid use di...

    Authors: Dennis P. Watson, Monte D. Staton and Nicole Gastala
    Citation: Addiction Science & Clinical Practice 2022 17:41
  5. To characterize and address the opioid crisis disproportionately impacting rural U.S. regions.

    Authors: Richard A. Jenkins, Bridget M. Whitney, Robin M. Nance, Todd M. Allen, Hannah L. F. Cooper, Judith Feinberg, Rob Fredericksen, Peter D. Friedmann, Vivian F. Go, Wiley D. Jenkins, P. Todd Korthuis, William C. Miller, Mai T. Pho, Abby E. Rudolph, David W. Seal, Gordon S. Smith…
    Citation: Addiction Science & Clinical Practice 2022 17:38
  6. Though methadone has been shown to effectively treat opioid use disorder, many barriers prevent individuals from accessing and maintaining treatment. Barriers are prevalent in less populated areas where treatm...

    Authors: Emily Pasman, Rachel Kollin, Michael Broman, Guijin Lee, Elizabeth Agius, Jamey J. Lister, Suzanne Brown and Stella M. Resko
    Citation: Addiction Science & Clinical Practice 2022 17:35
  7. Drug overdose rates in the United States have been steadily increasing, particularly in rural areas. The COVID-19 pandemic and associated mitigation strategies may have increased overdose risk for people who u...

    Authors: Suzan M. Walters, Rebecca S. Bolinski, Ellen Almirol, Stacy Grundy, Scott Fletcher, John Schneider, Samuel R. Friedman, Lawrence J. Ouellet, Danielle C. Ompad, Wiley Jenkins and Mai T. Pho
    Citation: Addiction Science & Clinical Practice 2022 17:24
  8. Alcohol use increases risk for morbidity and mortality and is associated with over 3 million annual deaths worldwide. Contingency Management (CM) is one of the most effective interventions for substance use di...

    Authors: Crystal L. Smith, Nicole M. Rodin, Julie Y. Hwang, André Q. C. Miguel, Kim Johnson, Michael G. McDonell and Sterling M. McPherson
    Citation: Addiction Science & Clinical Practice 2022 17:20
  9. In the United States, methadone for opioid use disorder (OUD) is highly regulated. Federal agencies announced guidelines in March 2020 allowing for relaxation of take-home methadone dispensing at opioid treatm...

    Authors: Ximena A. Levander, Kim A. Hoffman, John W. McIlveen, Dennis McCarty, Javier Ponce Terashima and P. Todd Korthuis
    Citation: Addiction Science & Clinical Practice 2021 16:72
  10. Telemedicine (TM) enabled by digital health technologies to provide medical services has been considered a key solution to increasing health care access in rural communities. With the immediate need for remote...

    Authors: Yih-Ing Hser, Allison J. Ober, Alex R. Dopp, Chunqing Lin, Katie P. Osterhage, Sarah E. Clingan, Larissa J. Mooney, Megan E. Curtis, Lisa A. Marsch, Bethany McLeman, Emily Hichborn, Laurie S. Lester, Laura-Mae Baldwin, Yanping Liu, Petra Jacobs and Andrew J. Saxon
    Citation: Addiction Science & Clinical Practice 2021 16:24