Since 2018, the East Tennessee Rural Health Consortium (ETRHC; formally, RCORP-East Tennessee Consortium) has applied research-based evidence and community expertise to address prevention, treatment, and recovery related to opioid use disorder (OUD). Overall, the ETRHC, managed by the University of Tennessee (UT), has 157 members, affiliated with 33 organizations. Representation includes justice, education, child protection, faith, workforce development, public health, nursing, pharmacy, and others, creating an interdisciplinary approach to OUD prevention, treatment, and recovery. Five ETRHC organizations, including UT, ICARe-Unition County, LIVE Free-Claiborne, The Hill-Claiborne, and United Methodist Church of Newport, serve as key personnel with our RCORP Implementation IV award -- COURAGE: Combating Opioid Use in Rural Appalachia with Grace and Evidence. Together, we serve the rural east Tennessee counties of Campbell, Claiborne, Cocke, Grainger, Scott, Union, and Jefferson.
For persons with SUD/OUD, including people who inject drugs, two major barriers to access and use of treatment and recovery support services in rural communities are stigmatization and a fractured healthcare system. COURAGE seeks to reduce stigma and promote a greater integration of the healthcare of this population. This is achieved through providing mentorship and training to pharmacists, MOUD providers, and leaders of faith-based communities. To date, 7 pharmacists, 8 MOUD providers and 6 faith-based leaders have participated. These mentoring programs have led to participants’ attitude and perspective shifts, and motivation to incorporate new knowledge and skills in professional practices and faith-based congregations, including the initiation of recovery groups. Additionally, COURAGE focuses on preventing OUD with an emphasis on youth and the adults that care for them. The Youth HOPE curriculum is delivered annually to 55-60 5th grade students in Union County. Focusing on opioid use disorder, the youth have had the opportunity to learn and practice skills to conduct a community health assessment and advocate for a desired change they wish to see in their community. Youth surveys reveal significant increases in knowledge and stigma reduction associated with opioid use disorder. Finally, COURAGE supports HIV and HCV testing at LiveFree, a local syringe service program in Claiborne County that is uniquely affiliated with The Hill church. Testing has increased monthly and recently reached 12 testing events for the first two weeks in February. For more information and resources, visit our website at https://tnopioid.utk.edu/.