Opioid Crisis

The Nation is in the midst of an unprecedented opioid epidemic. 116 people a day die from opioid-related drug overdoses. Prevention and access to treatment for opioid addiction and overdose reversal drugs are critical to fighting this epidemic. Primary care settings have increasingly become a gateway to better care for individuals with both behavioral health (including substance use) and primary care needs. The Health Resources and Services Administration (HRSA) supports its grantees with resources, technical assistance, and training to integrate behavioral health care services into practice settings and communities. 

How HRSA is Addressing the Opioid Crisis

Expanding access through health centers and other primary care settings

• In 2017, HRSA awarded $200 million to 1,178 health centers across the nation to expand mental health services and substance use disorder treatment. In 2016, HRSA also awarded $94 million to 271 health centers through the Substance Abuse Services Expansion funding to increase capacity to treat patients with substance use disorder.
• HRSA's Rural Health Opioid Program provides approximately $2.5 million for 10 rural health organizations across nine states. This program helps community members struggling with opioid use disorder find local treatment options and support services.
• HRSA and SAMHSA jointly support the Center for Integrated Health Solutions. This Center provides direct technical assistance resources to HRSA-funded safety-net providers; helping to integrate mental health and substance use disorder treatment within primary care settings, including medication-assisted treatment.
• HRSA supports testing evidence informed interventions for integrating behavioral health with primary medical care  for people living with HIV; using an implementation science model to develop tools and resources for Ryan White HIV/AIDS Program provider sites.
• HRSA's 340B Drug Pricing Program supports affordable medication-assisted treatment.
• HRSA’s Title V Maternal and Child Health Services Block Grant Program allows states the flexibility to address high-need issues for maternal and child health, including screening tools for early detection of high-risk women and standardizing care for infants with neonatal abstinence syndrome.

Using telehealth to treat opioid use disorder

• The Substance Abuse Treatment Telehealth Network Grant Program provides $700,000 for evidence-based, telehealth programs and networks to improve access to substance use disorder treatment in rural, frontier and underserved communities. Similarly, the Regional Telehealth Resource Center Program supports the development and advancement of telehealth programs in high-need communities.
• HRSA supports a Substance Use Warmline  so primary care providers can access expert clinical consultation to assist them in caring for patients with substance use disorders.
• Roughly 150 health centers participate in a HRSA-funded Opioid Addiction Treatment (OAT) Extension for Community Healthcare Outcomes (ECHO) . This Project ECHO model is a virtual, national technical assistance effort to enhance health center capacity to treat substance use disorder, including medication assisted treatment and pain management. Additionally, through the Pain Management Extension for Community Health Outcomes (ECHO) Pilot , 20 health centers are developing evidence-based prescribing guidelines and non-pharmacological approaches for pain management and related behavioral health services, including opioid use disorder. 

Connecting stakeholders to opioid-related resources

• HRSA supports training dissemination and information portals that provide resources on emerging public health issues including opioids. The Rural Health Information Hub  has a number of opioid resources and toolkits targeted to rural providers. Similarly, the TARGET Center  helps providers caring for persons living with HIV/AIDS and includes a toolkit on integrating medication-assisted treatment in HIV primary care.  State public health professionals can use the MCH Navigator  to access learning tools to help mothers with opioid use disorder and infants with neonatal abstinence syndrome.
• HRSA’s Healthy Start and Maternal, Infant and Early Childhood Home Visiting programs screen, educate and connect perinatal women and parents of young children to treatment and recovery support services.
• Through its ten regional offices, HRSA shares information and connects stakeholders to opioid resources. Staff take part in local, state, and federal opioid workgroups, taskforces, and meetings with local and state health departments and Tribal organizations.

Sharing best practices and regional approaches

HRSA hosts webinars and regional events across the country that explore collaborative opportunities and ways to leverage expertise and resources to respond to the opioid crisis. HRSA events include the 2018 HIV/AIDS Bureau Partners meeting where participants discussed the impact of the opioid epidemic on Ryan White HIV/AIDS Program providers and patients. HRSA also participates in Department-wide events, including the 2017 Region 8 Opioid Summit  in Denver, CO.

Increasing opioid use disorder training in primary care

In 2017, HRSA provided over $4 million in supplemental funding for medication-assisted treatment training to nearly 60 Primary Care Training and Enhancement Program grantees. HRSA also funded Area Health Education Centers to develop and enhance health education and trainings - including on opioid use disorder prevention. The Behavioral Health Workforce Education and Training Program establishes and expands interdisciplinary behavioral health training for students/interns, faculty, and field supervisors. Through the Health Center Program, HRSA provides extensive training and technical assistance to potential and existing health center grantees nationwide, including opioid use disorder treatment and pain management.

Informing policy and future investments

HRSA-supported Rural Health Research Centers develop and disseminate research and policy briefs examining opioid use and treatment policies  on the Rural Health Research Gateway . For example: a brief on the Changes in the Supply of Physicians with a DEA DATA Waiver to Prescribe Buprenorphine for Opioid Use Disorder  (PDF - 1.4 MB). With HRSA support, the Association of State and Territorial Health Officials published a case study  (PDF - 4.5 MB) that identified lessons learned and best practices for health officials from an analysis of Indiana’s response to the 2015 Hepatitis C Virus outbreak among injectable opioid users in Scott County.

Addressing opioid-related poisonings and overdoses

In 2017, HRSA awarded $17.1 million to support all 55 poison control centers’ efforts to prevent and provide treatment recommendations for poisonings, including from misuse of prescription and illicit opioids. The Rural Opioid Overdose Reversal Program Best Practices Guide  (PDF - 1.9 MB) provides a summary of lessons learned from HRSA’s Rural Opioid Overdose Reversal Program that supported overdose education and naloxone distribution programs in rural communities.