Substance use disorder has received increased public attention due to rising rates of opioid-related overdose deaths and misuse of prescription opioids. While opioid use disorder is an important issue, alcohol use disorder can also be a significant contributor to individuals’ complex health and social needs, due in no small part to alcohol’s legal status, social acceptance, and wide availability. Individuals who accrue the highest medical expenditures are more likely to use or be dependent on alcohol. This type of substance use disorder can impact one’s ability to find and maintain housing and employment, manage chronic conditions, and maintain interpersonal relationships. Alcohol also has far greater secondary harm to others than other addictions.  

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It is widely recognized that good outcomes for patients with complex care needs are achievable when health care providers work locally and in tandem with community, government, and other partners. Interprofessional, cross-sector, and cross-agency collaboration between organizations that share responsibility for serving a group of individuals living in a community or particular geography is an effective way to stabilize health, decrease unnecessary utilization, improve care delivery, and reduce avoidable costs.  

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Rural areas present unique challenges and opportunities for individuals with complex needs and those providing their care. These environments may face healthcare workforce shortages, rising rates of opioid use, and geographical barriers to care. However, rural communities often foster close-knit social networks and an entrepreneurial approach to complex health and social issues.

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Safe, stable housing is a key component of maintaining health and wellbeing. However, the identification documents required to qualify for public or affordable housing can be difficult to obtain for people with complex health and social needs. Individuals experiencing homelessness may lack the stability and resources needed to obtain the necessary documents for housing. 

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