The Washington State Medication Assisted Treatment-Prescription Drug and Opioid Addiction Project (WA-MAT-PDOA) will expand access to integrated medication assisted treatment (MAT) with buprenorphine for individuals with opioid addiction. An office-based opioid treatment (OBOT) model that serves a predominantly rural population will provide new tools to replicate integrated MAT statewide. The WA-MAT-PDOA collaborates with others to address the rising rates of opioid-related problems, including overdose deaths and addiction treatment admissions. Adults with an opioid use disorder (OUD) for prescription opioids or heroin in the following high risk communities will be served: King County and five predominantly rural counties in southwest Washington (Grays Harbor, Lewis, Mason, Pacific and Thurston). Strategies and interventions will include three evidence-based/informed practices including; 1) MAT with buprenorphine/ naloxone (Bup/Nx); 2) the Massachusetts Office-Based Opioid Treatment with Buprenorphine (OBOT-B) model, and 3) a non-EBP, The Johns Hopkins School of Medicine Collaborative Opioid Prescribing model of Opiate Treatment Program (OTP)-OBOT will be used. The goals are to: increase the number of patients receiving MAT by increasing capacity in primary care office based settings and OTPs; enhance the integrated care that MAT-PDOA patients receive; improve retention rates for MAT-PDOA enrollees; decrease drug and alcohol use rates six months after treatment admission; and reduce adverse outcomes related to OUD. Objectives include, but are not limited to: 1) serve 776 patients over a three-year period, 2) train clinical staff in the use of EBPs, 3) serve patients in a culturally competent, patient-centered care manner, 4) reduce opioid related deaths, and 5) seek sustainable program financing. This project includes a collaboration with various agencies that will provide technical support, ongoing evaluation, policy support, and pursuit of model sustainability.