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Opioids & SU
The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
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Access to treatment for opioid use disorder (OUD) in rural areas within the United States remains a challenge. Providers must complete 8-24 h of training to obtain the Drug Addiction Treatment Act (DATA) 2000 waiver to have the legal authority to prescribe buprenorphine for OUD. Over the last 4 years, we executed five dissemination and implementation grants funded by the Agency for Healthcare Research and Quality to study and address barriers to providing Medications for Opioid Use Disorder Treatment (MOUD), including psychosocial supports, in rural primary care practices in different states. We found that obtaining the DATA 2000 waiver is just one component of meaningful treatment using MOUD, and that the waiver provides a one-time benchmark that often does not address other significant barriers that providers face daily. In this commentary, we summarize our initiatives and the common lessons learned across our grants and offer recommendations on how primary care providers can be better supported to expand access to MOUD in rural America.
Health policy-makers are faced with a demand for health care that exceeds supply, driven in part by an ageing population and an increased prevalence of chronic disease. An integrated 'people-centred' model of care across primary, secondary and tertiary health care can strengthen the health system by streamlining services to improve the patient journey and outcomes. Integrated care offers an opportunity to reduce admissions and re-admissions to hospitals, reduce presentations to emergency departments and improve the capacity of outpatient clinics while delivering better outcomes to patients. Queensland's $35 million Integrated Care Innovation Fund (ICIF) has provided seed funding to 24 projects covering a wide spectrum of chronic disease management and complex disease. Programs such as the ICIF offer an opportunity to provide a new approach to caring for vulnerable populations such as the frail and elderly; children with behavioural and developmental issues; children in out-of-home care; rural and remote populations; and people with mental health issues, whose care runs the risk of 'falling through the cracks' with conventional healthcare approaches.