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Rural Health Information Hub

Sustainability Strategies for MOUD Programs

A rural program providing medication for opioid use disorder (MOUD) should consider a variety of sustainability strategies. These include identifying program champions; forming partnerships; ensuring organizational capacity and infrastructure; and educating patients, community members, partners, and other collaborators.

For general information on program sustainability, see Sustainability Strategies in the Rural Community Health Toolkit.

Program Champions

Having a champion can be particularly helpful in developing and sustaining program activities. A program champion may be a waivered provider or someone who understands how the MOUD program operates. The champion may be core program staff or someone in the community with lived opioid use disorder (OUD) experience. Champions can help implement the program and educate the community about the benefits and evidence supporting MOUD. Programs should consider having more than one champion; this will ensure sustainability in case of departures of staff or community member champions.


Maintaining partnerships with other organizations can help a rural MOUD program continue its program activities for years to come. Having multiple partners working towards the same goal creates accountability across the program and allows programs to consistently reach and help new patients.

Individually, each partner organization may support different patient populations; however, the partnership strategy allows for patient referral across organizations and expands the reach of the program overall. For example, partners may refer new patients to the MOUD program, or they may provide specific support services to retain patients in treatment. Examples of partner organizations that can support a program's sustainability include: primary care providers, local public health departments, mental health providers, and housing organizations.

For additional information about how partnerships can support the sustainability of a rural substance use disorder program, see Partnerships in the Rural Prevention and Treatment of Substance Use Disorders Toolkit.

Organizational Capacity and Infrastructure

A rural MOUD program should consider its organizational capacity to treat patients, in terms of staffing, physical space, and technology. Depending on the program model and demand for services in the community, an MOUD program may need to consider expanding its infrastructure to support program growth, such as opening a second clinic or hiring additional nurses, primary care providers, and other staff. A program should ensure it has enough waivered providers to meet the prescribing needs of its patient population. If a program does not have enough waivered prescribers, it could partner with other medical providers to meet their program's prescribing needs. Additionally, if a program primarily provides telehealth services or would like to begin providing telehealth services, it should make sure to have the technology to support telehealth.

Providing Education

Providing education about the MOUD program increases familiarity with the services and understanding of the positive impact of the program in the community. Individuals that may need education include patients, community members, partners, and other collaborators. Education can reduce stigma associated with opioid use disorder (OUD) and medication for treatment. It may also increase awareness of the program, which may lead to new partnerships and referrals to the program. Communication strategies that a rural MOUD program can use to deliver education include informational sessions, pamphlets, brochures, editorials, and social media. Many rural programs focus on sharing program bright spots or success stories of individuals treated by the program.

For additional information, see Sustainability Strategies for Rural SUD Programs in the Rural Prevention and Treatment of Substance Use Disorders Toolkit.