Workforce to Support SUD Programs
The workforce needed for rural substance use disorder (SUD) programs depends on the program model, workforce availability, and service delivery policies. Rural areas often face workforce challenges such as provider shortages, training requirements, and the need for integrated care. To address these challenges, rural SUD programs may need to adopt flexible staffing models, relying on a mix of professionals and paraprofessionals to provide comprehensive care. Some programs may need to establish partnerships to expand service capacity and address workforce shortages.
Depending on the program model used, rural programs may need multiple eligible providers to treat SUD, such as physicians, nurse practitioners, physician assistants, and others. Workforce needs are also influenced by policies guiding the use and distribution of medication to treat SUD. Any provider with a current U.S. Drug Enforcement Administration (DEA) registration that includes prescribing of Schedule III drugs may prescribe buprenorphine to treat SUD. In rural communities, provider types who may be SUD treatment prescribers include:
- Certified nurse midwives (CNMs)
- Certified registered nurse anesthetists (CRNAs)
- Clinical nurse specialists (CNSs)
- Nurse practitioners (NPs)
- Physicians (MDs and DOs)
- Physician assistants (PAs)
In addition to having eligible providers who can prescribe medication, SUD programs may seek to engage other types of staff for:
- Care coordination
- Case management
- Clinical services beyond medication for opioid use disorder
- Health education
- Program intake
- Psychosocial services
Many of these roles can be filled by individuals in a variety of occupations and with different backgrounds, education, and training. For example, one program may rely on administrative staff to conduct patient intake, while another may rely on nurses (such as registered nurses or nurse care managers) or behavioral health staff (such as social workers or counselors). Some staff may have multiple roles, such as program intake and coordinating care. For example, health educators can conduct and bill for Screening, Brief Intervention, and Referral to Treatment (SBIRT) in addition to providing health education. The flexibility to use different types of staff in different roles may be particularly helpful for rural SUD programs with limited workforce. Additionally, programs may choose to hire staff directly or partner with other organizations to increase program capacity.
SUD programs that provide mental health and suicide prevention services will need to have counseling staff available. Counseling staff may include licensed clinical social workers (LCSWs), licensed professional counselors (LPCs), psychologists, or Licensed Clinical Alcohol & Drug Abuse Counselors (LCADACs). The National Alliance on Mental Illness describes different types of mental health professionals and their different roles.
Resources to Learn More
Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: A Treatment Improvement
Protocol (TIP) Series 50
Document
Provides information and guidelines for substance use counselors, program administrators, and
clinical supervisors working with adult patients who are experiencing suicidal thoughts or exhibiting
suicidal behaviors. Includes a case study of a rural patient.
Organization(s): Substance Abuse and Mental Health Services Administration
Date: 10/2015
How to Receive
Medications for Opioid Use Disorder (MOUD) Training
Website
Information and resources regarding clinician training for medications for opioid use disorder to
prevent, identify, and treat opioid use disorder. Identifies how clinicians working to address opioid
use disorder may be eligible for free training and free mentoring services.
Organization(s): Health Resources & Services Administration