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Rural Health Information Hub
Rural Health Information Hub

Sustainability Strategies for Substance Use Disorder Programs

Various strategies can promote the sustainability of rural substance use disorder (SUD) programs. For general information on program sustainability, see Sustainability Strategies for Rural Community Health Programs in the Rural Community Health Toolkit.

Building Staff and Organizational Capacity

Some rural SUD programs focus on building staff capacity to sustain activities after initial grant funding ends. This involves ensuring staff have the necessary knowledge and skills to do their jobs. Strategies for building staff capacity include:

  • Developing training programs, such as train-the-trainer models
  • Engaging with technical assistance resources, such as the Strategic Prevention Technical Assistance Center (SPTAC), a Substance Abuse and Mental Health Services Administration (SAMHSA) initiative that offers webinars, online courses, and individual consultations
  • Participating in fellowships, such as the Addiction Medicine Fellowship Program, which provides stipends to fill addiction medicine and psychiatry fellowship positions and offers experiential training opportunities in rural, community-based settings.

Rural SUD programs should also focus on building their organizational capacity, which includes physical space and technology. Depending on the program model and community demand for services, programs may need to expand their infrastructure, such as opening another clinic or enhancing current facilities, to support service delivery and program growth. If a program offers or is expanding to include telehealth services, it should make sure to have the technology to support telehealth.

Maintaining and Expanding Partnerships

Ongoing coordination with program partners can support sustainability. Partners may be responsible for continuing certain program components, such as activities, services, staff training, or other implementation efforts. They may continue to provide resources, support services, and patient referrals, even after grant funding ends. Examples of activities partners may conduct to support sustainability include:

  • Hospitals – make training on SUDs an annual requirement for staff
  • Community-based organizations – integrate educational efforts into existing SUD efforts
  • Law enforcement agencies – monitor prescription drug drop boxes that are in fixed locations in the community

To strengthen partnerships, rural SUD programs should consider formalizing their partnerships through a Memorandum of Understanding (MOU). In addition, rural SUD programs should focus on maintaining existing partnerships while seeking to develop new partnerships to further support sustainability.

Program Champions

Having a program champion can be helpful in developing and sustaining program activities. A champion may be a core program staff member, someone in the community with lived experience, a trusted healthcare provider, or someone who understands how the program operates. Champions can support program implementation and educate the community about the benefits and evidence supporting SUD treatment services.

Programs can consider having more than one champion. Having multiple champions will strengthen sustainability in the event of staff or community member departures.

Providing Education

Providing education about SUD programs helps increase awareness and understanding of the programs in the community. Education can reduce the stigma associated with SUDs and medication for treatment. It may also increase awareness of programs, which may lead to new partnerships and referrals.

Key audiences for education include patients, community members, partners, and other collaborators. A rural SUD program can use communication strategies to deliver education, including informational sessions, pamphlets, brochures, editorials, and social media posts. Many programs share success stories or "bright spots" from individuals who received treatment. This information may also be useful for other communities seeking to replicate SUD programs.

Developing Materials to Support Replication

Some programs achieve sustainability through replication and expansion. To help other communities replicate a program, rural SUD programs can prepare materials with guidelines and lessons learned for designing, implementing, evaluating, and sustaining the intervention. For more information on strategies for disseminating program information, see Module 7: Dissemination of Rural Substance Use Disorder Program Best Practices.

Working with Policymakers and Payers

Rural communities may need to collaborate with policymakers and payers to ensure ongoing access to and coverage for SUD treatment options. This may include advocating for increased coverage for take-home naloxone or SUD-related telehealth services.

Resources to Learn More

Prevention Network
Website
Hosts several training events for professionals to build their capacity to implement effective substance use prevention practices. Includes an overview of the events and a link to the event calendar.
Organization(s): Prevention Network