Barriers to Utilizing Substance Use Disorder Treatment and Harm Reduction Services in Appalachia

Substance use is a growing concern across the United States. The Appalachian region has been noted for having substantial issues with substance use partly due to socioeconomic hardships and various diseases of despair. Effective and well-established treatments for substance use disorders (SUD) exist, however these treatments are underutilized throughout much of Appalachia. Harm reduction services effectively mitigate the risks associated with substance use for people who use drugs, but access to these services is often a problem in Appalachia. This literature review explores the barriers to accessing SUD treatments and harm reduction services in rural Appalachia. Both authors performed a distillation of published, peer-reviewed empirical articles to identify studies that analyzed barriers or obstacles to SUD treatment or harm reduction services among Appalachian stakeholders. The most common barriers to accessing SUD treatment in Appalachia include real or perceived legal consequences, varying levels of stigma, access and resource issues, educational and awareness matters, and impacts stemming from social networks. Increased research on barriers to seeking SUD treatment in Appalachia would help with the delivery and efficacy of SUD treatments and harm reduction strategies. Public Health Significance Statement This review of previously conducted research explores barriers to accessing substance use disorder treatments and harm reduction services in rural Appalachia. The most common barriers to accessing substance use disorder treatments and harm reduction services were potential legal consequences, stigma, lack of transportation, and lack of finances. More research and educational efforts are needed to increase access to these services in Appalachia.