With over 67,000 deaths due to drug overdoses in 2018, the majority caused by opioids, the United States (US) is facing an epidemic. The opioid prescription rate in Arkansas is 93.2 prescriptions for every 100 persons, making it the second highest rate in the US at nearly twice the national average (51.4 per 100). Rural communities in Arkansas face multi-faceted challenges in providing and accessing treatment and recovery services for opioid use disorders (OUDs). There is a significant shortage of psychiatrists, pain management specialists, and other addiction service providers. As a result, the burden of prevention, treatment, and recovery management falls largely on primary care providers (PCPs) and their care teams, many of whom lack the resources and time to treat such complex, costly, and high-risk patients.

There is strong evidence to support combining behavioral health services with primary care in rural communities. Using integrated behavioral health (IBH) services to address OUDs can reduce costs, decrease provider burnout, and improve provider satisfaction. IBH has also been shown to improve clinical outcomes and improve the quality of care patients receive.

The Arkansas Rural Opioid Use Team and Education (A-ROUTE) project will strengthen and expand the capacity of rural communities, PCPs, and mental health professionals to provide improved OUD prevention, treatment, and recovery services. This 18-month planning grant awarded by the Health Resources and Services Agency (HRSA) will engage a multi-sector consortium to conduct a needs assessment of 10 rural counties in Arkansas that are disproportionately affected by the opioid crisis. The A-ROUTE team will use this information to develop a strategic plan and road map to help Arkansas communities in crisis. The team will also form a technical assistance center and pilot test a training curriculum for PCPs and their care teams in four rural practices. The culmination of these efforts will be an enhanced landscape for the prevention, management, and treatment of OUDs in rural Arkansas.