CTN-0102: Rural Expansion of Medication Treatment for Opioid Use Disorder

Yih-Ing Hser, PhD
Lead Investigator

Integrated Substance Abuse Programs
University of California

People who use opioids in rural areas suffer worse health and less insurance coverage. The opioid problem in rural areas is of particular concern, as rural areas have higher overdose rates despite equivalent rates of OUD. This is because rural areas have a scant number of clinics and clinicians who provide medication treatment for OUD. Thus, people living in rural areas must travel long distances to access clinics that may or may not have expertise in providing treatment to patients with OUD. Telemedicine (TM) could efficiently increase capacity for delivery of buprenorphine in rural areas and may increase the number of patients receiving medication treatment and improve treatment retention and outcomes. While the development of medication treatment for opioid use disorder (MOUD) capacity in primary care settings with optimal /comprehensive services is desirable, the current opioid crisis with escalating overdose death rates in rural areas suggests a need to implement an efficient, cost-effective system of MOUD services that can be scaled up quickly. The use of a centralized and Medicare covered TM vendor utilizing a developed methodology and established organizational infrastructure offers the great potential for a rapid roll-out to increase access to MOUD and improve treatment retention in rural areas. This cluster-randomized clinical trial with two phases will test expanded treatment access to improve retention on MOUD in highly impacted rural areas. Phase 1 will include implementing telemedicine in a limited number of rural sites with varying levels of OBOT to inform implementation strategies for the main trial and Phase II will include evaluate comparative effectiveness between office-base opioid treatment (OBOT) vs OBOT + TM in 30 sites.

Funded by the NIH HEAL InitiativeSM.

    Node Involvement

    Lead Node(s):

  • Greater Southern California Node

  • All Participating Nodes:

  • Greater Southern California Node
  • Pacific Northwest Node