Health Services/Population Health

30. Differences in Urban and Rural Implementation of Substance Misuse Recovery Programs in Illinois

Introduction: As of 2023, over 46 million Americans met DSM-5 criteria for a past year substance use disorder. Research shows that substance use disorders are chronic. However, traditional treatment approaches rely on isolated, brief treatment episodes. Recovery care models offer alternative approaches emphasizing long-term support. One promising intervention is the Recovery Oriented System of Care (ROSC), which develops recovery programs across multiple systems. The implementation of these ROSC programs in real world settings remains unclear. This study focuses on how ROSC programs are implemented in Illinois.

Methods: Members of ROSC programs (N=18) were interviewed about programming, outreach, decision making and leadership structure. Data was analyzed using Atlas.ti. Grounded theory was used to generate themes.

Results: The Illinois ROSC’s local county-based structure helped rural counties better coordinate services. The following themes show how counties restructured and coordinated substance treatment services and programs using the ROSC system: 1) by confronting culture – ROSCs provided support and helped confront specific themes in rural culture which stigmatized persons with substance use issues, 2) by building trust among those with lived experience – ROSCs created leadership positions and provided opportunities to meet, network, and share recovery stories, 3) by utilizing bridging social capital approaches – ROSC networks include diverse members, such as persons with lived experiences, community leaders, law enforcement, and service providers, to balance public health with public safety.

Impact: ROSC programs improved care coordination by confronting culture, building trust, and utilizing bridging social capital approaches. This research showed that the implementation of local county-based ROSC programs in Illinois provided clinical and medical benefit by connecting clinicians and consumers. This occurred through promoting harm reduction activities and monthly network meetings and by reducing stigma towards substance misuse disorders. This study is limited by a small sample size and geographic area.  Future studies should evaluate ROSC program implementations on a national level.

Organization: Saint Louis University

Marino AM, Duncan ED, Galbreath IM, van den Berk-Clark CJ