Work

The opioid epidemic in rural communities: Can telehealth increase access to medications for opioid use disorder and offset barriers to care?

Year: 2025

Type: article

Abstract: Substance and opioid use disorder (SUD/OUD) treatment remains limited in rural communities. This paper examines rural telehealth use, its impact on medication for opioid use disorder (MOUD) provision, and issues that require attention for sustainment. Ninety-two project directors of the Rural Communities Opioid Response Program’s (RCORP) consortia provided required data on services areas, service delivery, and grant performance. We combined these data with National Survey of Drug Use and Health and U.S. Census Bureau’s American Community Survey data to estimate the number of individuals in a service area who should have received MOUD based on the national prevalence of MOUD provision. Consortia reduced the number of rural counties without access to any OUD treatment by 49% using telehealth. The number of consortia using telehealth increased by 72% during the first year of the COVID-19 pandemic. Forty-two percent of rural consortia used telehealth to deliver MOUD. Consortia using telehealth for MOUD provision had significantly higher rates of individuals receiving MOUD and MOUD for 3 or more months compared with those not using telehealth for MOUD. They also had 4.5 times the odds of meeting the national prevalence of MOUD provision compared to those not using telehealth for MOUD. Barriers to telehealth use are reported herein. Telehealth used to deliver MOUD increased MOUD access and retention in rural areas. Increasing the comfort level of telehealth-delivered services, helping staff understand the research on telehealth effectiveness and virtual drug screen protocols, and ensuring reimbursement will be critical for sustainment. • Rural consortia reduced the number of counties without access to treatment for opioid use disorder by 49% using telehealth, and increased the number of consortia using telehealth by 72%. • The provision of medication for opioid use disorder (MOUD) and MOUD retention were significantly greater among rural consortia using telehealth for prescribing MOUD compared with rural consortia that did not use telehealth for this specific service. • Using telehealth for MOUD provision provided a platform for consortia to meet the national prevalence of MOUD provision in their communities. • Telehealth-delivered services addressed transportation barriers, workforce shortages, and stigma, all of which impact access to MOUD treatment in the rural U.S. • Barriers to implementation included broadband and financial problems, service provider and client discomfort with telehealth, and provider belief that telehealth is not as effective as in-person services and that substance use might be hidden or missed as a result.

Source: Drug and Alcohol Dependence

DOI: 10.1016/j.drugalcdep.2025.112628

Authors: Kathleen Meyers, Shannon Herman, Heather Schuler, Carolyn Mun, Elena Bresani, Richard Koban Payne

Institution: JBS International (United States)

Language: English

Topic: Opioid Use Disorder Treatment

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: hybrid

Estimated APC paid: $4,380