Ellis MS, et al. - This study was conducted to present polysubstance use trends and variability among individuals with opioid use disorder in rural vs urban settings. Researchers examined survey data on past-month use of prescription and illicit opioids and 12 non-opioid psychoactive drug classes from a national sample of rural (n = 3,872) and urban (n = 8,153) residents entering treatment for opioid use disorder (OUD) from 2012 to 2019. They compared trend analyses for opioid and stimulant use between rural and urban persons with opioid use disorder. Significant variability was found in polysubstance use that may distinguish specific prevention and treatment needs for subpopulations of OUD patients: interventions focused on reducing opioid prescriptions, early engagement with mental health resources, wider distribution of naloxone, and screening/treatment plans that take into account the use of multiple substances.