The Arkansas Rural Opioid Use Team Education (A-ROUTE) Needs Assessment highlights the ongoing challenges and advancements in addressing substance use disorder (SUD) in rural Arkansas, focusing on 10 counties with high poverty rates, low healthcare access, and elevated overdose rates. This report emphasizes the need for continued investment in prevention, treatment, and recovery initiatives. Key findings include rising SUD screening and positive identification rates, yet limited treatment capacity for methamphetamines, alcohol, and fentanyl. The assessment also identifies significant disparities in provider availability, especially mental health and medication-assisted treatment (MAT) services, and highlights successful community partnerships and collaborative programs. Recommendations underscore leveraging partnerships, expanding SUD services, and pursuing funding opportunities to address the SUD burden effectively. Stakeholders are encouraged to utilize this report for planning and grant applications to advance local interventions. View the needs assessment here: https://aroute.org/wp-content/uploads/2024/11/AROUTE_NeedsAssessment_Final2.pdf