Research Reports

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.

Domestic violence, including intimate partner violence (DV/IPV), is a pervasive issue within the Commonwealth of Pennsylvania. As this crime commonly goes unreported, this study seeks to understand the lack of reporting from the perspective of victim-survivors. Through one-on-one interviews, coupled with a supplemental survey, this study examines the barriers that victim-survivors may face when it comes to reporting DV/IPV victimization to law enforcement. Further, this study examines how barriers may differ among rural and urban Pennsylvanians, and how this may impact their ability to access services or resources from local victim service agencies. Policy considerations stemming from the findings are reviewed.