Data were obtained from the Health Treatment Services Locator web portal administered by SAMSHA by selecting all “mental health” (MH) clinics. Data were originally extracted on 06/05/2022 and again on 05/05/2023. For rural county identification, 2013 USDA Rural-Urban Continuum Codes (RUCCs) were linked to treatment centers with codes 1-3 designated as urban and 4-9 designated as rural. Per capita population estimates were based on 2022 US census data. Opioid-involved OD mortalities were obtained via international classification of disease (ICD-10) codes from the multiple-cause-of-death WONDER portal administered by the Centers for Disease Control and Prevention (CDC). Underlying causes of death included accidental poisoning (X40-X44), intentional self-poisoning (X60-X64), assault (X85), and poisoning from undetermined intent (Y10-Y14) for all opioids as a contributing cause of death (T40.0-T40.4,T40.6).