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.
Need: Increase medical management knowledge for New Mexico primary care providers in order to provide care for the thousands of rural and underserved patients with hepatitis C, a chronic, complex condition that has high personal and public health costs when left untreated.
Intervention: Project leveraging an audiovisual platform to accomplish "moving knowledge, not patients" that used a "knowledge network learning loop" of disease-specific consultants and rural healthcare teams learning from each other and learning by providing direct patient care.
Results: In 18 months, the urban specialist appointment wait list decreased from 8 months to 2 weeks due to Hepatitis C patients receiving care from the project's participating primary care providers. Improved disease outcomes were demonstrated along with cost savings, including those associated with travel. The project model, now known as Project ECHO® – Extension for Community Healthcare Outcomes — has evolved into a telementoring model used world-wide.
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.
Need: To support pregnant and parenting women with a history of substance use, mental health, or co-occurring disorders in rural areas of Montana.
Intervention: One Health, a consortium of Federally Qualified Health Centers (FQHCs), developed a team of "recovery doulas" – individuals who are dual-certified as doulas and peer-support specialists. The One Health recovery doula program offers group and individual services to women and their partners from pregnancy through the first years of parenthood.
Results: A team of nine recovery doulas (or doulas-in-training) employed by One Health offer services in ten rural Montana counties. Recovery doulas have provided essential support to women with substance use disorder, survivors of sexual abuse, unhoused individuals, and individuals facing other complex challenges.
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: Since 2015, ARMOT has received over 2,956 referrals.