OSU sociologist Railey works to combat substance use stigma in rural communities

OSU sociologist Railey works to combat substance use stigma in rural communities

Wednesday, November 5, 2025

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Oklahoma State University's Dr. Ashley Railey is working to change how rural communities address substance use through evidence-based strategies that reduce stigma and expand access to treatment.

"Rural communities have faced economic hardships that have been correlated with the rise in the opioid epidemic over the past few decades and similar substance use concerns," said Railey, an assistant professor in the Department of Sociology. "Multiple stigmatizing beliefs are shown to exist in rural areas, which can make addressing any one belief challenging."

In October, Railey was featured on The HPP Podcast, where she talked about her recent Health Promotion Practice Journal publication on using social marketing campaigns to combat negative attitudes surrounding substance use. The research, which was focused on Indiana, offers a blueprint for academic and community partnerships nationwide.

"Across the U.S., evidence suggests that people who use drugs are disproportionately viewed as dangerous, to blame for their disease, and unreliable," Railey said. "Combined with limited availability of health care services that are often seen in rural areas, these views - or stigma - can prevent people from seeking out and receiving help, limit the provision of services, and create divisions within communities about who is deserving, or not, of treatment and recovery services."

Raily explained that in addition to health care and social services access, "social influence through a few key stakeholders can be very visible in rural areas as well."

"This can be a benefit to addressing widespread stigma, but can also be a challenge when those beliefs are very strong," Railey said.

In order to effectively address these various issues, Railey's research employs community-engaged approaches that allow residents to participate in developing solutions rather than having programs imposed from the outside. This method has proven particularly effective in rural settings where trust and local buy-in are essential.

"Including the community members and organizations in interpreting the research findings, devising feasible approaches for the community, and delivering the campaign materials in a way that aligns with their resources and timelines are key community-engaged approaches," Railey said. "Essentially, involving the community in the research from start to finish."

Railey's work also advocates for harm reduction strategies, which recognize multiple pathways to reducing substance use harms beyond traditional abstinence-only models.

"Harm reduction means reducing the negative impacts of substance use, so focusing on how to limit the consequences of engaging in substance for individuals, families and communities, particularly by focusing on different approaches to recovery for different people," Railey said. "It shifts the focus from blaming the individual for their disease to devising solutions that can address each individual's circumstances."

While Railey is a researcher and professor, she is aware that her work is only truly successful when there is open communication and collaboration between the academic and community partners involved.

"Community-academic partnerships are valuable for translating research into practice, but require more than just providing the results to the community or the community telling academia what to research," Railey said. "The constant dialogue and feedback helps for learning on both sides, which ultimately facilitates the tailoring of the work to the specific beliefs and structure of the community."

To learn more about Railey's work, listen to the October 22 episode of the HPP Podcast on Spotify or Apple Podcasts.

Health Promotion Practice (HPP) is a bi-monthly, peer-reviewed journal that publishes authoritative research, commentary, practical tools and promising practices that strategically advance the art and science of health promotion and disease prevention. The journal is unique in its focus on practical scholarship and strategic information for professionals engaged in developing, implementing and evaluating health promotion policy and programs. HPP is one of the three journals of The Society for Public Health Education (SOPHE).