Two Appalachian states bound by one epidemic take different paths forward

The Davis Mountain Clinic, housed in a retrofitted shipping container, offers a hybrid telehealth model that addresses the unique barriers facing aging rural populations. Since opening in October 2025, the clinic provides a physical space with reliable connectivity and an on-site registered nurse who performs physical exams and helps facilitate virtual visits with remote physicians and specialists. Beyond medical visits, patients report successful navigation of healthcare systems with the clinic and Nurse Brewer's support.

North Carolina has expanded a network of peer-run mental health programs, including peer cafes, respite houses, and support hotlines, staffed by people with lived experience of mental health and substance use challenges. These spaces offer free activities, crisis support, and community connection as alternatives to clinical settings. Research found that peer programs reduce emergency department visits by more than 40% over a three year span.

To address overdose deaths, multiple organizations across Athens County and Ohio University have implemented free Narcan distribution and training programs since 2023, including overdose response training sessions and no-barrier access to free Narcan kits through campus cabinets, health departments, and community organizations partnered with Ohio's Project DAWN network. The programs have helped distribute hundreds of Narcan boxes and to normalize overdose response training and reduce stigma around addiction.

Project CARA (Care that Advocates Respect/Resilience/Recovery for All) supports pregnant and parenting people with substance use disorders, providing healthcare, addiction resources and obstetrics care in one spot. The program's hub-and-spokes model makes care more accessible, especially for those in remote areas. Data from the Project also indicates that participants of the program are more likely to attend prenatal and postpartum appointments than those outside of the program.

The Olympia Bupe Clinic's walk-in model for treating opioid addiction allows patients to receive medication-assisted treatment with buprenorphine on their first visit without barriers or extensive wait times. This low-barrier approach eliminates the hurdles people often face when seeking treatment. The Clinic also hires staff with lived experience with addiction to build trust and community with patients.

In order to tackle opioid addiction, the state of Virginia found a way to make drug treatment accessible to people with medicaid by boosting “reimbursement rates to addiction treatment providers.” Historically, drug treatment hasn’t been covered by health insurance. Virginia is changing that. Already, “the percent of Medicaid members with an opioid use disorder who received treatment went up by 29 percent from April to December 2017 compared to the same period the previous year.”

In Española, New Mexico, a state-funded program called the Pathways Community HUB Model brings law enforcement, health care providers, and treatment centers together to make sure they have a whole picture of each addiction patient's medical and criminal background. The program allows all entities to have access to a single database with medical and criminal records, allowing people working to combat addiction in the community to have a better idea of each patient's story.

Village Health Teams are groups of community health workers helping rural women access family planning services. They travel from home to home offering counseling, education and connection to the resources women need but struggle to access, including condoms and pills, often all without having to visit a health facility. VHTs have reached several thousand residents, both with short and long-term contraceptive methods.

The Bauchi State Impact Project aims to improve maternal and newborn health by training 100 people to become skilled birth attendants. Despite infrastructure challenges, the Project not only provides work and purpose to those trained, but also helps make childbirth safer by providing much-needed care.

Multiple Native American tribal nations are incorporating traditional sweat lodge ceremonies into substance use disorder treatment programs. Participants attend sweat lodge sessions, either as part of court-ordered programs or voluntarily, where they engage in culturally relevant, spiritual practices. Many of the court-ordered clients consistently choose to return to sweat lodges beyond their required attendance, sometimes even preferring them to traditional AA/NA meetings.