Rural Access to Opioid Treatment Program Clinics and Certified Community Behavioral Health Clinics
Opioid use disorder (OUD) remains a public health crisis and national epidemic. Deaths from opioid overdose (OD) continue to increase, in both metropolitan and rural communities, and there is evidence that the rate of OD has increased amid the COVID-19 pandemic.
Although medications for opioid use disorder (MOUD) can decrease the likelihood of fatal OD, this treatment option is underutilized, and rural areas face particularly limited capacity for delivering MOUD treatment. Most of the nation's 1,100 Opioid Treatment Programs (OTPs) are located in urban centers. In contrast, buprenorphine (BUP) therapy is more widely delivered across rural and urban areas in office-based opioid treatment programs. The number of U.S. BUP-waivered and BUP-dispensing physicians has increased, but numbers remain insufficient to meet the growing national need for treatment.
Integration of physical and behavioral health and mental health parity has been a goal of all major health reforms in the past 20 years. Care integration is particularly important for OUD, which has many physical health comorbidities. To speed integration of physical and behavioral health, the Substance Abuse and Mental Health Services Administration (SAMHSA) established the Certified Community Behavioral Health Center (CCBHC) program in 2016. CCBHCs provide routine outpatient care within 10 business days after an initial contact, and they are required to serve anyone who requests care for mental health or substance use, regardless of their ability to pay, place of residence, or age—including developmentally appropriate care for children and youth.
Access to MOUD offers the greatest potential to impact the OUD crisis. The growth of CCBHCs enhances access to medication by also offering comprehensive behavioral and physical health care, potentially improving treatment outcomes.
We will explore the growth in CCBHCs and OTPs across the U.S., highlighting access in rural communities. The outcome of this project will be data tables, dashboard maps, and visualizations that will be valuable to federal and state policymakers, program administrators, and local communities to easily identify gaps in services and treatment options and outcomes.