Substance Use
Rural Health

Rural Community Action Guide

Author: Office of National Drug Control Policy
Region: USA
Last modified: 15 May 2026

The Rural Community Action Guide provides topical insights on how rural leaders can and are addressing drug use and its consequences to build strong and healthy rural places.

The Rural Community Action Guide complements
the Strategy by providing topical insights on how
rural leaders can and are addressing drug use and its
consequences to build strong and healthy rural places.
Developed with input from a series of roundtables
on opioid misuse hosted by the U.S. Department of
Agriculture, and key partners, this comprehensive
report presents strategies to strengthen the local
responses to addiction in rural communities and fresh
ideas to adopt flexible, creative solutions at the local
level.
Rural communities face many hurdles in addressing
opioid and other drug addiction. Research shows that
people living in rural America who need help are falling
through the cracks, often losing their lives. Treatment services are insufficient to meet rural demand.
Access to quality medical care, resources, and training is limited in rural communities, particularly for
specialized populations, such as pregnant women, parents, and seniors. Further, drug courts, which are
known to be significantly more effective than incarceration for non-violent offenders, are not available
in many rural areas.
Between 1999 and 2015, drug overdose deaths in rural counties jumped by 325 percent2

as compared

to 198 percent in metropolitan areas.