Communities across the United States are grappling with unprecedented numbers of overdoses and deaths related to prescription opioids and heroin. In California, neither the problem nor the treatment resources are evenly distributed. To understand the challenges in rural Northern California and to identify potential solutions, the California Health Care Foundation (CHCF) convened rural health leaders, addiction specialists, and policy experts in the spring of 2016.

The gathering was part of the California Improvement Network, a community where together, health care leaders learn better ideas for care delivery.

Meeting participants discussed promising models of medication-assisted treatment (MAT) provision in primary care, as well as specific implementation challenges and strategies.

Key highlights:

• Engaging providers. Sharing patient stories, shadowing providers, and learning more about the patient population are ways to engage those providers who may be reluctant to incorporate MAT into their practice.
• Addressing pain. Participants discussed opportunities for broader use of buprenorphine for pain, especially for patients on high doses of opioids.
• Starting where impact could be greatest. Getting MAT to pregnant women with opioid use disorder would be a compelling way to start a buprenorphine program, and for providers to gain experience while improving the health of mothers and babies.
• Using existing assets. Integrating MAT into primary care requires careful and efficient use of clinical and financial resources. Participants shared ideas for building a service in a cost-efficient manner.

A summary of the main points made at this gathering is available as a Document Download.

This meeting was one of a two-part series. For a summary of the companion meeting, see Emergency Care for the Opioid Epidemic: Hospitals Step Up to Offer Buprenorphine in the ED.