Health and Social Service Needs of People who Inject Drugs Living in Rural Settings in the United States: A Qualitative Study

Objective: Rural communities continue to be among the most severely affected by the opioid epidemic, showing some of the highest rates of overdose deaths and increasing rates of injection drug use. Lack of resources among other barriers contribute to the needs of this population going unmet. We assessed service needs among people who inject drugs (PWID) in rural regions, barriers to the implementation of these services, and optimal strategies to intervene with people who inject drugs, as well as to better link them to needed programs and services. Methods: We carried out thematic content analysis of 46 in-depth interviews with key respondents who worked with or had knowledge of the needs of PWID. Results: Respondents saw a need for increased access to services (eg, healthcare, harm reduction, addiction treatment), different treatment options, and education related to substance use as the most needed services among this population. Conclusions: Opioid use disorder interventions and initiatives must address these core service and education needs to best serve PWID. Increasing access to services in rural communities must be a priority for policymakers, local respondents, and healthcare providers.