Opioid Use in Rural Communities: A 4-part Series Addressing Implementation and Sustainability of Medication Treatment for Opioid Use Disorder in Clinical Settings

The Greater Southern California Node (GSCN) of the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN), in partnership with the Pacific Southwest Addiction Technology Transfer Center (PSATTC), presented a 4-part training series addressing the implementation and sustainability of medications for opioid use disorders (MOUD) in rural settings. The series was hosted by Larissa Mooney, M.D., who is a Professor of Clinical Psychiatry and the Director of the Addiction Psychiatry Division in the Department of Psychiatry and Biomedical Sciences at UCLA. She is also a Principal Investigator for the GSCN of the NIDA CTN.

Expert clinical researchers and clinicians in rural communities from across the U.S. shared practical knowledge and skills for improving care for patients with OUD. Please note, individuals can earn one-hour of free CMEs and CEUs for each individual course they complete.

If you missed the live sessions and would like to participate in the on-demand courses and get CME/CE/PSY credit, click here:

 
 

Session 1: October 12, 2022 from 12:00-1:00pm PST

Hindrances and Helps in Delivering MOUD Care in Rural Areas

The substance use disorder treatment and care options in rural communities differ from those in urban areas. Rural communities may experience insufficient or lack of insurance coverage, geographic isolation, transportation barriers, low health literacy, substance use-related stigma, a smaller health care workforce, a lack of substance use specialty care options, and limited availability of bilingual providers. This session explored some of the unique characteristics of rural communities and discussed the strengths and challenges to delivering MOUD care within rural areas. Presenters also discussed the models they use for providing MOUD in their settings, and possible solutions to addressing some of these challenges.

Facilitator and Presenters:

Facilitator:

Larissa Mooney, MD, Professor of Clinical Psychiatry and Director of Addiction Psychiatry Division, Department of Psychiatry and Biomedical Sciences, University of California, Los Angeles

Presenters:

John Brooklyn, MD, Clinical Associate Professor, Family Medicine & Psychiatry, University of Vermont

Caleb Holtzer, MD, Family Medicine Physician, Providence Family Medicine, Chewelah, WA

Candy Stockton, MD, Public Health Officer, Humboldt County

 

Session 2: December 7, 2022 from 12:00-1:00pm PST

Telemedicine and Increasing Access to MOUD Care

The strengths and challenges to providing MOUD in each community and clinic vary. This session discussed the role that telemedicine can play in expanding access to MOUD in such areas. Telemedicine can be provided by rural clinics themselves, or by external telemedicine providers to whom a rural clinic refers some or all of its patients with OUD. Through case examples, the presenters highlighted how telemedicine has been used to improve access to initiating and maintaining MOUD in rural communities, and shared experiences using telemedicine approaches.

Facilitator and Presenters:

Facilitator:

Andrew Saxon, MD, Physician, Clinical Immunology and Allergy, University of California, Los Angeles

Presenters:

Lewei "Allison" Lin, MD, MS, Assistant Professor & Addiction Psychiatrist, Department of Psychiatry, University of Michigan

Kelly Peck, MD, Research Assistant Professor, University of Vermont College of Medicine, Department of Psychiatry, University of Vermont Department of Psychological Science

Greg Greenburg, MD, Medical Director, New Life Health Authority

Joan Kandel, DO, FAAFP, FASAM, Physician, Bright Heart Health

 

Session 3: January 18, 2023 from 12:00-1:00pm PST


 
 

Session 4: February 15, 2023 from 12:00-1:00pm PST

Caring for Complex Patients in Resource-Limited Communities

One aspect of successfully implementing a clinic MOUD program is identifying how to best care for complex patients. Presenters shared case examples of delivering care to a range of clinically challenging patients within resource-limited rural communities. Presenters also discussed treatment and/or referral in the context of pregnancy, health and mental health comorbidities, infectious diseases (e.g., HIV, Hepatitis C), and polysubstance use. Presenters also discussed burn-out and self-care when caring for complex patients.

Facilitator and Presenters:

Facilitator:

Laura Mae Baldwin, MD, Professor of Family Medicine, University of Washington

Presenters:

Erin Winstanley, PhD, Associate Professor, Department of Behavioral Medicine & Psychiatry, West Virginia University

Jennifer Thomas, MD, Medical Director - Morris Hospital, Integrated Behavioral Health System, Braidwood, IL

Debra Newman, PA, Provider - First Judicial District Court, Adult Drug and Mental Health Treatment Courts, Santa Fe County, NM

 

The Substance Use Disorder Workforce in Rural Communities: Challenges and Opportunities

Patients with opioid use disorder (OUD) benefit from access to a continuum of substance use disorder treatment and care services. When a clinic has committed to providing pharmacotherapies to treat patients with OUD, it is critical to prepare administrative and clinical staff, and ensure the clinical workforce is trained and confident in their ability to use medications for opioid use disorders (MOUD). This session discussed strategies and tools for ensuring clinic readiness and best practices for offering MOUD. Speakers discussed ways to identify and engage site champions and other providers as they integrate MOUD into clinic workflows. Presenters also discussed a systems approach to preparing clinical staff and community partners for using medication, including how to identify specialty care if needed for rural patients with OUD.

Facilitator and Presenters:

Facilitator:

Thomas E. Freese, PhD, Co-Director, University of California, Los Angeles Integrated Substance Abuse Programs

Presenters:

Allison Ober, MSW, PhD, Senior Health Policy and Behavioral Science Researcher - RAND Corporation

Kathy Pinnell, RN-MSN, Nurse, Mount Carmel Hospital

Grace-Katie Bell, MSN, RN-BC, CARN, PHN, MAT/SUD consultant - Center for Care Innovation