Rebuilding the Foundation of Rural Community Health after COVID-19 themedicalcareblog.com/covid-19-impac… via The Medical Care Blog

A4: Stigma is a significant barrier. Must reinforce that OUD is a chronic relapsing disease and not criminal behavior. #ruralhealthchat

A4: Stigma, shame, and criminalization deter people from seeking help. #ruralhealthchat

A4: Transportation barriers – lack of personal and public transportation, long travel distances, costs. #ruralhealthchat

A4: High costs are a barrier, many opioid treatment programs operate on a cash only basis. #ruralhealthchat

A5: Engage communities in broad-based collaborative models to address prevention, tx, and recovery. #ruralhealthchat

A5: Community models: Project Lazarus in NC, Project Vision in Rutland, VT, Little Falls, MN. #ruralhealthchat

A5: Other community models - SAMHSA's Communities that Care and Recovery Oriented Systems of Care programs. #ruralhealthchat

A5: Engage hospitals, providers, social services, law enforcement, faith communities, schools, govt, consumers #ruralhealthchat

A5: Focus on supply reduction: Project Vision, drug take back programs, prescribing guidelines, use of PDMPs. #ruralhealthchat

I agree Chris but relevant elements of the framework can be adopted even if funding is not available. #ruralhealthchat

A6: Avoid criminalizing OUDs – engage users in tx rather than incarceration – Project Angels in Gloucester, MA #ruralhealthchat

A6: Prescribers must also take some ownership - use of PDMP, prescribing guidelines, “oxy-free” emergency departments #ruralhealthchat

A6: Increase pain management support – direct services, telehealth consultations, Project ECHO #ruralhealthchat

A6: Supply reduction – drug market intervention model, take back programs, evidence-based prescribing guidelines. #ruralhealthchat

A7: Use evidence-based models from SAMHSA, NIDA. Investigate successful rural models: RHIhub. #ruralhealthchat

A7; Engage hospitals through their community benefit and community health needs assessment obligations. #ruralhealthchat

A8: Project Vision in Rutland, VT has reduced heroin supplies and reduced the burden on the community. #ruralhealthchat

A8: Vermont Recovery Network provides a range of recovery services statewide and in rural VT. #ruralhealthchat

Great discussion everyone! #ruralhealthchat