Behavioral Health Service Availability and Substance-Specific Treatment Utilization in the Rural United States

Substance use disorder (SUD) remains a significant public health concern in rural U.S. communities, where treatment utilization among nonmetropolitan residents is low, underscoring access to care as a critical priority. This project evaluates how the rural SUD treatment environment, defined as the availability, characteristics, services offered, and geographic distribution of facilities, aligns with substance-specific treatment needs and patterns of utilization among people living in rural communities. Using restricted-use 2025 National Survey on Drug Use and Health (NSDUH) data and facility-level data from the 2025 National Substance Use and Mental Health Services Survey (N-SUMHSS), we will compare alcohol-, opioid-, and stimulant-related needs with local service capacity and delivery methods. Findings will inform rural health planning at federal, state, and local levels by identifying where services match population needs and where gaps persist. Analyses of geographic variation in service availability, types of care, and delivery models will guide resource allocation and decisions to strengthen capacity or extend reach through telehealth, mobile and community-based services, transportation supports, and integration with existing health care settings. These strategies are particularly important in communities where establishing new facilities is not feasible.