The Substance Abuse & Mental Health Services Administration (SAMHSA) has called for the recruitment and training of EMS personnel to address issues regarding substance use disorders (SUDs) and co-occurring disorders (COD) substance use and mental disorders in rural communities. Roughly 46 million U.S. citizens live in rural areas and are met with significant health challenges, including “higher rates of chronic disease and suicide, worse maternal health, and limited access to care.” 1