ArticleSocial science & medicine (1982)2024
Barriers to opioid use disorder treatment among people who use drugs in the rural United States: A qualitative, multi-site study.
Article in Social science & medicine (1982), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 46 citations in OpenAlex.
- Convenience, rapport and skill: effective rural hepatitis C treatment, qualitative findings from a mobile harm reduction-informed tele-medicine intervention in Northern New England, 2022-2024.Harm reduction journal · 2026Trial
- Differential associations between social determinants of health and the initiation of medications for opioid use disorder across care settings.npj health systems · 2026Article
- Medications for opioid use disorder, recovery supports, and overdose risk -- a database linkage study of a rural cohort of people who inject drugs and use opioids.BMC public health · 2026Article
- Frequent police contact and nonfatal overdose among people who use drugs in rural Appalachia.Drug and alcohol dependence · 2026Article
- Correlates of Rural Naloxone Possession Among People Who Use Drugs: A Multi-State Cross-Sectional Analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Tailoring of a chronic pain self-management intervention for individuals with opioid use disorder in office-based addiction treatment.Journal of substance use and addiction treatment · 2026Article
- Transitions from first drug use to illicit opioid and injection drug use in a multisite rural U.S. cohort of people who use drugs.Harm reduction journal · 2026Article
- Central amygdalar PKCδ neurons mediate fentanyl withdrawal.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Opioid consumption, availability, and policy alignment in primary hospice and palliative care in China: a multicomponent comparative analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Treating Opioid Use Disorder With Methadone in Pharmacies.JAMA network open · 2026Article
- Acceptability and Appropriateness of Harm Reduction Vending Machines Compared to Syringe Service Programs in Appalachian Kentucky.Journal of studies on alcohol and drugs · 2026Article
- Rurality weakens the positive association between the COVID-19 pandemic and substance use treatment involving medications for opioid use disorder.Drug and alcohol dependence reports · 2026Article
- Qualitative analysis of barriers and facilitators to healthcare engagement for people with injecting-related invasive infections using a social ecological framework.Addiction (Abingdon, England) · 2025Article
- Barriers, beliefs, and biomedical prevention: a qualitative study of PrEP among justice-involved peripregnant women who use drugs.Health & justice · 2025Article
- Allocative efficiency of opioid overdose prevention strategies for people incarcerated in New Jersey.Harm reduction journal · 2025Article
- Patient Satisfaction Among Opioid Use Disorder Treatment Sample in an Opioid Treatment Program: A Mixed Method Research Study.Epidemiologia (Basel, Switzerland) · 2025Article
- Implementation opportunities for optimizing retention on buprenorphine treatment for people with opioid use disorder in West Virginia.Drug and alcohol dependence · 2025Article
- Benzodiazepines and Opioid co-use Among Rural People Who Use Drugs: Findings From the Rural Opioid Initiative.Substance use & addiction journal · 2025Article
- Investigating heterogeneous effects of an expanded methadone access policy with opioid treatment program retention: a Rhode Island population-based retrospective cohort study.American journal of epidemiology · 2025Article
- A multi-method spatial examination of factors associated with changes in geographic accessibility to buprenorphine providers in HEALing communities study states Kentucky, Massachusetts, and Ohio.Preventive medicine reports · 2025Article
Corrections and comments
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Authors and funding
15 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundIn 2020, 2.8 million people required substance use disorder (SUD) treatment in nonmetropolitan or 'rural' areas in the U.S. Among this population, only 10% received SUD treatment from a specialty facility, and 1 in 500 received medication for opioid use disorder (MOUD). We explored the context surrounding barriers to SUD treatment in the rural United States.
methodsWe conducted semi-structured, in-depth interviews from 2018 to 2019 to assess barriers to SUD treatment among people who use drugs (PWUD) across seven rural U.S. study sites. Using the social-ecological model (SEM), we examined individual, interpersonal, organizational, community, and policy factors contributing to perceived barriers to SUD treatment. We employed deductive and inductive coding and analytical approaches to identify themes. We also calculated descriptive statistics for participant characteristics and salient themes.
resultsAmong 304 participants (55% male, mean age 36 years), we identified barriers to SUD treatment in rural areas across SEM levels. At the individual/interpersonal level, relevant themes included: fear of withdrawal, the need to "get things in order" before entering treatment, close-knit communities and limited confidentiality, networks and settings that perpetuated drug use, and stigma. Organizational-level barriers included: strict facility rules, treatment programs managed like corrections facilities, lack of gender-specific treatment programs, and concerns about jeopardizing employment. Community-level barriers included: limited availability of treatment in local rural communities, long distances and limited transportation, waitlists, and a lack of information about treatment options. Policy-level themes included insurance challenges and system-imposed barriers such as arrest and incarceration.
conclusionOur findings highlight multi-level barriers to SUD treatment in rural U.S. communities. Salient barriers included the need to travel long distances to treatment, challenges to confidentiality due to small, close-knit communities where people are highly familiar with one another, and high-threshold treatment program practices. Our findings point to the need to facilitate the elimination of treatment barriers at each level of the SEM in rural America.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.