This is a meeting summary from the California Health Care Foundation (CHCF), which convened a gathering of rural health leaders, addiction specialists, and policy experts to understand the challenges in rural Northern California and to identify potential solutions.

There is a focus of providing medications for opioid use disorder (MOUD) in primary care and addressing barriers to improve the implementation of this response approach. Existing program models that hold promise in integrating MOUD into primary care are highlighted in this document. 

This is a report from the National League of Cities and Policy Research, Inc. that details the various co-responder models available to city and county leaders to respond to behavioral health crises. These innovate models are cost-effective options to divert individuals away from the criminal justice system. Specific models implemented across the United States are highlighted. 

This is an academic paper that proposes an innovative model to increase initiation of medications in those with opioid use disorder (OUD). Medication treatment would be initiated in recovery community organizations (RCOs), which typically deliver recovery support services. Treatment could begin in two scenarios: after an overdose or through peer outreach or walk-ins to the RCOs. Those initiated on medications would continue to get treatment through the RCO. This is a theoretical model and has yet to be implemented. 

This is a policy brief from the National Congress of American Indians Policy Research Center that highlights that the opioid crisis has impacted American Indians and Alaska Natives (AI/AN) more than other groups. Causes mentioned are overprescribing and a high prevalence of trauma in AI/AN. The brief calls for tribes to respond with a multifaceted, collaborative approach to address this complex problem. 

This is a report from the Arnold Foundation intended to support state Medicaid agencies and payers in improving access to substance use disorder (SUD) treatment, quality, and capacity, with a special focus on medications for opioid use disorder (MOUD). 

This is an academic paper that reviews the relaxed regulations and laws around medications for opioid use disorder and discusses the possibilities of expanding low-threshold access, such as prescribing methadone in primary care and higher utilization of long-acting injectables. 

This paper gives an overview of the academic literature on non-traditional routes for initiating a patient with opioid use disorder on buprenorphine. Some of the settings discussed are emergency departments, the criminal justice system, and community outreach. These routes may serve as vital touchpoints to increase capacity of medications for opioid use disorder (MOUD). 

This report from USDA and ONDCP is a compilation of qualitative data collected from numerous community organizations, which provides an overview of the key challenges rural communities face when addressing the consequences of prescription opioid misuse and the use of illicit substances, divided into sections on unique rural challenges, prevention, treatment, and recovery. There is also a supplement that showcases localized efforts implemented to help mitigate the impact of substance use disorder.

This is a toolkit from the ONDCP and USDA that serves as a guide to resources that can help make a difference in rural communities in addressing the opioid crisis and substance use in general. It features a comprehensive funding clearinghouse, interactive tools to assess the opioid problem at the county level, a treatment and services locator, a links to technical assistance and trainings. 

This is a toolkit which compiles evidence-based and promising resources and models that aim to support organizations implementing rural medication for opioid use disorder programs across the United States. 

This is a toolkit from the National Organization of State Offices of Rural Health that provides access to trainings, webinars, informational materials, a report, and other resources to help rural communities prevent overdoses and overdose deaths. 

This is a working paper from the Maine Rural Health Research Center (authors Gale, Hansen, and Williamson) and is a qualitative study based on interviews with key stakeholders in Indiana, North Carolina, Vermont, and Washington State that explores promising state and community strategies to tackle the opioid crisis in rural communities and identifies rural challenges to the provision of opioid use disorder prevention, treatment, and recovery services. Specific promising program models are highlighted in this document.