In the past year, substance misuse-associated death has increased by 15% in the United States. Among those deaths, adolescents have the fastest-growing rates of mortality. Substance uses has a huge impact on all aspects of life such as economics, mental health, education, people’s relationships, and careers. Barriers to utilizing opioid (OUD) treatment include many components and factors. Such as transportation, family relations, finances, and the list goes on. This article explores the barriers to substance misuse treatment, but more specifically in rural America. The rural setting proposes unique challenges and barriers for not only substance misuse treatment but many healthcare services.  

           The study consisted of 18 graduate-level social work and counseling psychology students located in largely rural OUD and substance use disorders settings for a two-semester internship. This internship was a part of the Opioid Workforce Expansion Program. The goal of this internship was to increase the number of healthcare workers trained in substance misuse treatments in rural settings. 13 out of the 18 students were from rural areas themselves. After the 9-month internship, the students were part of focus groups to discuss their internships. The response of the participants resulted in three themes, Substance Use Treatment and Criminalization Policies, Rurality, and COVID-Related Adjustments. 

           One of the big things discussed in these focused group was that rurality present unique barriers, due to the close intimacy of the area conflict arose when peers and family member tried to receive treatment. This is unfortunate because those who misuse substances get stigmatized and this stigma seems to follow the patient much longer after recovery in rural settings than compared to others. Due to the culture of rural settings, treatment should focus even more on individual needs. The reason is due to smaller numbers something such as group therapy may not be possible. The article concludes that understanding the ongoing support these clients need to address barriers once treatment is engaged is crucial to treatment persistence.  

Takeaway: Rural settings provide unique barriers to those seeking substance misuse treatment. Understanding these ongoing barriers and supporting the client’s needs is crucial to treatment persistence.

Hargons, C. N., Benner, K. E., & Wyman-Bookwalter, C. (2023). Identifying and addressing barriers to effective substance misuse treatment in rural settings. Journal of Rural Mental Health. Advance online publication.