Rural FM Residency Drives Substance Use Disorder Response through Community Training

Background: The rates of opioid use disorder (OUD) and opioid-related deaths have been on the rise for the past few years. Schuylkill and Carbon county Pennsylvania, our area of practice, leads the US in opioid overdose mortality. With Mortality rates of 25/100,000 and 18/100,000 respectively for 2016, with the national average around 14/100,000. Our long-term outcome is to reduce opioid deaths in Schuylkill and Carbon county by 50% and 33%, respectively by September 2022.

Methods: Through the support of the FQRHP, HRSA, and HHS (grant #GA1RH33545), we have created a multi-faction collaborative consortium encompassing: local school districts, county agencies, nonprofits, and rural health centers. Our multi-tiered plan consists of; increased patient screening for OUD via Screening Brief Intervention Referral to Treatment (SBIRT), community/provider OUD education, creating medical assisted treatment locations, community naloxone education and distribution, and anti-stigma training. Our first tier approach focused on internal training and education. We held monthly OUD meetings with the committee, provided hospital and office employees with OUD education and anti-stigma training, as well as credentialing providers in MAT. Our second-tier approach focused on community education and outreach. We trained various community groups in OUD recognition, Narcan administration, and anti-stigma education. In addition, we also focused our efforts on community gatherings and small face to face presentations to provide a more intimate educational experience.

Results: We have successfully trained and provided 166 individuals at our rural site and 730 individuals at our urban site with Narcan and OUD training. In addition, we have provided over 200 community members with OUD education and anti-stigma training. We have enrolled and are currently treating 943 patients for OUD. Finally, through internal training, we have credentialed/trained approximately 73 providers in MAT and Suboxone.

Conclusions: There is currently an urgent need to implement cost-efficient and effective strategies to reduce opioid-related morbidity and mortality. Our vision is to create a safe, supportive, and healthy community that cultivates a continuum of care for opioid and substance use disorder including prevention, treatment, and recovery. If our consortium is successful, we plan to share our model with neighboring counties and states to help facilitate a national decrease in opioid-related mortality.

References: Data.pa.gov. 2020. Pennsylvania Opioids | PA Open Data Portal. [online] Available at: [Accessed 5 November 2020].
Wilson N, Kariisa M, Seth P, Smith H IV, Davis NL. Drug and Opioid-Involved Overdose Deaths — United States, 2017–2018. MMWR Morb Mortal Wkly Rep 2020;69:290–297. DOI: https://dx.doi.org/10.15585/mmwr.mm6911a4external icon.
Dunne RB. Prescribing naloxone for opioid overdose intervention. Pain Manag. 2018;8(3):197-208. doi:10.2217/pmt-2017-0065