Characterizing Rural Substance Use Treatment Experiences Among Individuals Under Community Correctional Supervision.

Rowell-Cunsolo, Tawandra L; Blanford, Courtney; Seal, David; Jenkins, Wiley D; Mixson, L Sarah; Hoover, Daniel B; Stopka, Thomas J; Oser, Carrie B et al. · J Addict Med · 2026

cross_sectional · Level IV

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Abstract

More than 3.7 million individuals are currently under community correctional supervision (eg, probation, parole) in the United States, and approximately 46% of them use illicit substances. Although high rates of substance use and the need for high-quality treatment for this population have been acknowledged, additional research is needed to characterize treatment needs among this population, especially those residing in rural or underserved communities. Data were drawn from the Rural Opioid Initiative, a study focused on substance use in rural communities across 10 states in the United States. Our analyses examined past 6-month substance use disorder (SUD) treatment receipt among 978 participants under community supervision in the past 6 months. More than 55 percent had engaged in some type of treatment for substance use in the past 6 months; among those, nearly half (46%) had enrolled in inpatient or residential treatment. The odds of receiving treatment were greater among women than men (odds ratio [OR] 1.49, 95% confidence interval [CI] [1.15-1.94]), those with health insurance coverage (OR 3.10, 95% CI: [2.24-4.31]) and those with access to transportation (OR 1.54, 95% CI: [1.08-2.20]). Treatment receipt was lower among participants who used methamphetamine/amphetamine as their primary drug of choice compared with other substances. Initiatives to increase SUD treatment engagement among rural people who use drugs under community correctional supervision should address gaps in insurance coverage, transportation access, and treatment modalities that target stimulant use disorders. Gender-specific needs should also be considered when creating substance use interventions for this population.