Intervention, Treatment, and Prevention Strategies to Address Opioid Use Disorders in Rural Areas

A Primer on Opportunities for Medicaid-Safety Net Collaboration

The prevalence of substance abuse disorders in the United States has increased dramatically in the past 15 years with catastrophic consequences, especially in rural regions of the United States. Deaths and injuries from illegal opioid and heroin use are more prevalent in rural states, and death from opioid overdose is 45 percent higher in rural regions than urban areas.

Through a cooperative agreement with the Health Resources and Services Administration (HRSA), the National Academy for State Health Policy (NASHP) has developed this primer for Medicaid officials and healthcare providers working to reduce opioid addiction in their state’s rural areas. It details the role HRSA-supported safety net providers play in improving emergency medical intervention and treatment to Medicaid enrollees, many of whom live in rural regions, and low-income and vulnerable populations facing opioid use disorders.

Informed by interviews with key state Medicaid and health safety net leaders, this primer highlights strategies states are using to better deploy emergency intervention to reduce opioid overdose deaths, improve access to care, and provide better treatment services in rural areas. This report also describes sustainable financing structures to support these strategies and services.

Here are some of the successful initiatives highlighted in the report that are helping states reduce overdose deaths and improve access and quality of care for rural, low-income residents struggling with opioid addiction:

  • Authorizing first responders, pharmacists, and laypeople/bystanders to administer/distribute naloxone to reduce overdose mortality;
  • Reducing barriers to using medication-assisted treatment, such as methadone, naltrexone, and buprenorphine;
  • Enhancing state telehealth infrastructure to improve treatment expertise among providers in rural communities;
  • Implementing innovative insurance coverage strategies to expand substance use disorder treatment services, and;
  • Focusing enrollment efforts on rural populations at risk for opioid abuse to get them the treatment they need.

Ultimately, valuable lessons and effective strategies will continue to emerge from the nation’s opioid crisis and evolve over time. Through this process, states will play an important role in identifying and refining best practices for rural populations and developing strategies to address future challenges.

Read the primer.
View the infographic.