Research Reports
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2025
Access to Medications for Opioid Use Disorder and Harm Reduction Services Across Rural Pennsylvania
October 29, 2025 | Health Care and Human Services
Over the 21st century, Pennsylvania communities have faced a severe opioid-driven overdose crisis, though deaths are now declining thanks to evidence-based interventions such as harm reduction services and medications for opioid use disorder (MOUD). However, major barriers persist in rural areas. This study examines access to MOUD and harm reduction services in rural Pennsylvania through surveys of 33 Single County Authorities, interviews with 59 stakeholders, including providers, criminal legal professionals, and residents with living experience, and site observations at four service locations. Findings show significant disparities in service availability, as many rural counties lack methadone or buprenorphine providers, have limited MOUD access in carceral settings, and few offer syringe services or drug-testing strips. Even where programs exist, transportation challenges, stigma, funding and insurance gaps, limited awareness, and scarce local capacity hinder access. The report concludes with policy recommendations to overcome these barriers and sustain progress in reducing overdose deaths.
Executive Summary
Tags: rural , opioid use disorder , medications for opioid use disorder , harm reduction , barriers to care , criminal legal system
Introducing the Center's new journal, Rural Policy: The Research Bulletin of the Center for Rural Pennsylvania.