Opioid Use Disorder

This webinar will describe ways to explore social determinants of health (SDOH) and exemplify challenges/ opportunities in Rural America.

More than 450 clinicians and counselors in rural New England were surveyed about stigma as a barrier to treating patients for opioid used disorder (OUD) as well as practitioners’ beliefs about medications for OUD.  Over half (55 percent) ranked stigma as the highest barrier among other factors such as time and staffing, medication diversion, and organizational/clinic barriers.

Although pregnancy is motivation for opioid use disorder treatment, there is a risk of relapsing after childbirth. Unpacking Perinatal Experiences with Opioid Use Disorder: Relapse Risk Implications studies the perinatal experiences that can inform clinical social workers and other health/behavioral health providers on when and how to provide support during this time period. 

n December 2022, Congress eliminated the DATA-Waiver program registration allowing providers to prescribe buprenorphine to treat patients for OUD. The University of Vermont Center on Rural Addiction, a HRSA Rural Center of Excellence on Substance Use Disorders, offers an incentive to help defray previous training costs of $750 to each qualifying provider who obtained a DATA-Waiver. To qualify, providers must be practicing in a HRSA-designated rural county in Vermont, Maine, New Hampshire, or Northern New York.

Clinicians no longer need DATA 2000 Waiver training to prescribe buprenorphine; however, the payment program to defray earlier training costs is still active.  Launched in June 2021, the initiative pays for providers who previously received a waiver to prescribe buprenorphine, a medication used to treat opioid use disorder.  Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who previously trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019.

The Consolidated Appropriations Act of 2023 removed the federal requirement for providers to have an X-waiver to prescribe medications for the treatment of OUD. The act amended the Controlled Substances Act. Depending on state law, practitioners who have a current DEA registration with Schedule III authority will be able to prescribe buprenorphine for OUD starting now.

The Substance Abuse and Mental Health Services Administration released a notice of proposed rulemaking that would allow certified opioid treatment programs to begin prescribing the drug via audio-only or video-enabled telehealth. See additional information under Policy Updates below. The proposed changes come on top of recent findings by HHS of the positive impact of its revised Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder that removed two longstanding requirements for obtaining a waiver to treat up to 30 patients with buprenorphine: 1) the requirement for specific training, and 2) the need for otherwise eligible clinicians to certify their ability to provide or refer patients for counseling and other services. Rural primary care providers have obtained the DEA waiver at a lower rate than urban clinicians; decreased burden and greater flexibility in the guidelines, along with broader use of telehealth could help close that gap.

This webinar provided RCORP grantees with the tools to complete a disparities impact statement, to support efforts to address populations in rural communities that have historically suffered from poorer health outcomes and health inequities as a part of the prevention, treatment, and recovery of SUD/OUD.

The Disparities Impact Statement (DIS) template is a deliverable for this project that you will be required to complete. There was a webinar discussing the DIS for all relevant cohorts on November 15, 2022. This webinar provided RCORP grantees with the tools to complete a disparities impact statement, to support efforts to address populations in rural communities that have historically suffered from poorer health outcomes and health inequities as a part of the prevention, treatment, and recovery of SUD/OUD. We strongly encourage you to review these documents or listen to the recording when it is posted to the RCORP- TA portal at a later date. Please be in contact with your Technical Expert Lead (TEL) with any questions. 

In this cross-sectional study of 266 Medicaid MCO plans and 39 FFS programs, FFS programs offered more generous MOUD coverage, but a higher percentage of FFS programs imposed PA than MCO plans.