Treatment of Alcohol Use Problems Among Rural Populations: a Review of Barriers and Considerations for Increasing Access to Quality Care

Abstract

Purpose of Review Individuals living in rural areas face unique challenges when accessing services for alcohol-related problems and are at increased risk of experiencing alcohol-related harms. We outline research on rural-urban treatment gaps in alcohol use treatment, identify common barriers to treatment, and provide recommendations for how to address the difficulties faced by this population. Recent Findings Globally, individuals living in rural and remote areas are less likely to receive care for alcohol-related concerns compared to those residing in urban areas. Rural areas suffer from insufficient access to specialty providers, and rural residents are likely to experience greater stigma regarding seeking treatment for alcohol-related concerns. Summary Given rural-urban disparities in access to treatment for alcohol use concerns, treatment efforts should incorporate stakeholders across the medical system. Telehealth options are particularly promising for increasing access to care. Adaptations should emphasize existing strengths among rural populations, such as strong religious beliefs and close community ties.

Urbanicity and alcohol use epidemiology in the 21st century

“…Alcohol use disorder treatment levels are poor for both urban and rural areas. People living in urban regions are more likely to obtain care for issues related to alcohol than people in rural and isolated locations [33 ▪▪ ]. Rural populations may encounter increased stigma when seeking therapy for issues related to alcohol as they have less access to specialized physicians [33 ▪▪ ].…”

“…People living in urban regions are more likely to obtain care for issues related to alcohol than people in rural and isolated locations [33 ▪▪ ]. Rural populations may encounter increased stigma when seeking therapy for issues related to alcohol as they have less access to specialized physicians [33 ▪▪ ]. Urban and rural areas receive vastly different levels of treatment for alcohol use disorders, particularly when it comes to evidence-based care.…”

Acceptability and feasibility of a mobile behavioral economic health intervention to reduce alcohol use in adults in rural areas

“…At-risk alcohol use in adults is undertreated in healthcare settings ( Sacks et al, 2015 , Stahre et al, 2014 ). In particular, rural populations experience increasing disparities in alcohol-related harms, including alcohol-related mortality ( Friesen et al, 2022 , Spencer et al, 2020 ), and are less likely to receive alcohol-related care ( Ali et al, 2022 , Davis and O’Neill, 2022 ). Compared to urban centers, alcohol-related care in rural areas is less affordable ( Pringle et al, 2006 ), of lower quality ( Edmond et al, 2015 ), and less accessible ( Cyr et al, 2019 , Small et al, 2010 ), with very few early interventions tailored to meet the specific needs of people in rural areas.…”