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Rural Response to the Opioid Crisis – Models and Innovations

These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.

Evidence-Based Examples

Project ECHO® – Extension for Community Healthcare Outcomes
Updated/reviewed July 2017
  • Need: To increase the capacity for more effective treatment of chronic, complex conditions in rural and underserved communities.
  • Intervention: Through a specially-designed project, remote primary care providers work with academic specialists as a team to manage chronic conditions of rural patients, expanding remote providers' knowledge base through shared case studies.
  • Results: Patient management and care provided by rural providers through ongoing education and mentoring from Project ECHO® has proved as effective as treatment provided by specialists at a university medical center.

Effective Examples

Project Lazarus
Updated/reviewed November 2021
  • Need: To reduce overdose-related deaths among prescription opioid users in rural Wilkes County, North Carolina
  • Intervention: Education and tools are provided for prescribers, patients and community members to lessen drug supply and demand, and to reduce harm in prescription opioid use
  • Results: Opioid overdose death rates have decreased in Wilkes County
Vermont Hub-and-Spoke Model of Care for Opioid Use Disorder
Updated/reviewed August 2020
  • Need: Increase access to medication-assisted treatment for opioid use disorder in rural Vermont.
  • Intervention: Statewide hub-and-spoke treatment access system.
  • Results: Increased treatment capacity and care coordination.
Midcoast Maine Prescription Opioid Reduction Program
Updated/reviewed May 2020
  • Need: Reduction in the number of emergency department dental patients abusing opioid prescriptions in rural southeastern Maine.
  • Intervention: Using a one-page opioid prescription guideline, opioid prescribing and emergency room visits for dental pain decreased.
  • Results: The rate of opioid prescription dropped nearly 20% after implementation, and in comparing the 12-month period before and after implementation, dental pain emergency department visits decreased from 26 to 21 per 1,000.

Other Project Examples

Morrison County Accountable Community for Health
Updated/reviewed September 2021
  • Need: To combat prescription drug misuse in rural Morrison County, Minnesota.
  • Intervention: The Morrison County ACH brings together primary care, social services, law enforcement, and other partners to make sure that patients receive treatment and support.
  • Results: One pharmacy saw a 40% reduction in the number of prescribed opioids, and the ACH was able to taper 684 patients off opioids completely.
funded by the Health Resources Services Administration New Horizons Substance Use Recovery Network
Updated/reviewed August 2021
  • Need: In northern Michigan, a need for an integrated approach to deliver medication-assisted treatment for established patients of Federally Qualified Health Centers with opioid use disorder.
  • Intervention: Collaboration between one FQHC across 3 sites, a local waivered prescriber group, and a behavioral health organization created an integrated treatment approach for opioid use disorder.
  • Results: Increased access to medication-assisted treatment and comprehensive substance use disorder services leading to increased retention in treatment and increased engagement in stable recovery from opioid and alcohol use disorders.
funded by the Federal Office of Rural Health Policy Addiction Recovery Mobile Outreach Team (ARMOT)
Updated/reviewed December 2020
  • Need: To reduce the number of overdoses and overdose-related deaths from opioids in rural Pennsylvania.
  • Intervention: ARMOT provides 1) case management and recovery support services to individuals with substance use disorders and 2) education and support to rural hospital staff, patients, and their loved ones.
  • Results: In the first 5 years of the program, ARMOT received over 1,950 referrals.
funded by the Federal Office of Rural Health Policy MaineGeneral Harm Reduction Program
Updated/reviewed December 2020
  • Need: To reduce deaths from opioid overdoses in rural Maine.
  • Intervention: The MaineGeneral Harm Reduction Program provides community education/training for healthcare staff, first responders, community agency staff, and community members in rural Kennebec and Somerset counties.
  • Results: MaineGeneral continues to train providers, provide stigma assessments, and distribute Narcan kits.
funded by the Federal Office of Rural Health Policy SLV N.E.E.D.: Naloxone Education Empowerment Distribution Program
Updated/reviewed August 2020
  • Need: Growing concern in rural Colorado communities regarding prescription and illegal opioid overdoses.
  • Intervention: Education efforts for health workers and the larger community, in addition to establishing a naloxone overdose reversal drug program.
  • Results: In addition to continuing to train nearly all first responders to administer naloxone, the organization provides harm reduction education in various community settings.
Litchfield County Opiate Task Force
Added March 2020
  • Need: To reduce substance use and harm from the opioid crisis in rural Litchfield County, Connecticut.
  • Intervention: A community network has come together to improve treatment and develop creative ideas and interventions as a response to the opioid crisis.
  • Results: More than 50 people from various sectors of the community meet each month. The LCOTF has also improved service coordination, access, and cross-sector communication; helped expand the number of agencies offering medication-assisted treatment; and introduced harm reduction resources.

Last Updated: 11/1/2021