The opioid epidemic in rural communities: Can telehealth increase access to medications for opioid use disorder and offset barriers to care?

Background: Substance and opioid use disorder (SUD/OUD) treatment remains limited in rural communities. This paper examines rural telehealth use, its impact on medication for opioid use disorder (MOUD) provision, and issues that require attention for sustainment. Methods: Ninety-two project directors of the Rural Communities Opioid Response Program's (RCORP) consortia provided required data on service areas, service delivery, and grant performance. We combined these data with National Survey of Drug Use and Health and U.S. Census Bureau's American Community Survey data to estimate the number of individuals in a service area who should have received MOUD based on the national prevalence of MOUD provision. Results: Consortia reduced the number of rural counties without access to any OUD treatment by 49 % using telehealth. The number of consortia using telehealth increased by 72 % during the first year of the COVID-19 pandemic. Forty-two percent of rural consortia used telehealth to deliver MOUD. Consortia using telehealth for MOUD provision had significantly higher rates of individuals receiving MOUD and MOUD for 3 or more months compared with those not using telehealth for MOUD. They also had 4.5 times the odds of meeting the national prevalence of MOUD provision compared to those not using telehealth for MOUD. Barriers to telehealth use are reported herein. Conclusion: Telehealth used to deliver MOUD increased MOUD access and retention in rural areas. Increasing the comfort level of telehealth-delivered services, helping staff understand the research on telehealth effectiveness and virtual drug screen protocols, and ensuring reimbursement will be critical for sustainment.