The East Tennessee Medication Assisted Treatment (MAT) Program addresses the epidemic of prescription drug and opioid addiction for adults living in the healthcare shortage areas of Appalachian Tennessee through the expansion and enhancement of treatment services capacity. In conjunction with support from the University of Tennessee Medical Center and the Mobile Rural Health Clinic, the program will provide direct Medication Assisted Treatment and Recovery Support Services while utilizing the Community Reinforcement Approach (CRA) and Assertive Continuing Care (ACC). Over a five year period, the treatment capacity expansion is expected to serve an additional 375 adults who are un/underinsured and unable to afford quality services through alternate means.
The national opioid crisis has had an unequivocal impact on the rural Appalachian areas of East Tennessee. Higher rates of poverty, in combination with a historical shortage of outpatient medical providers, lack of public transportation in the region and stigma surrounding substance use and co-occurring mental health issues has created disproportionate disparities in access to care. The program’s goal is to address those disparities and alleviate unmet needs of individuals struggling with an Opioid Use Disorder who have otherwise been unable to access quality care. Specific focus will be placed on patients who’ve been initiated on MAT within the Regional Hospital’s Emergency Department and patients presenting to the Mobile Rural Health Clinic. Priority populations include IV drug users, pregnant and post-partum women and individuals with co-occurring mental health disorders. Peer navigators, already situated within the University of Tennessee Medical Center ED, will engage, screen and transport patients initiated on Buprenorphine in the ED directly to outpatient services. Both Telehealth services and community-based recovery support will be utilized to access substance use treatment for clients presenting to the Mobile Rural Health Clinic.
A Recovery-oriented, trauma-informed and equity-based approach will be utilized via an integrated services team consisting of a Physician, Nurse Practitioner, RN, Recovery Specialist/Case Manager, Peer Recovery Specialist and MS level prepared clinicians. Clients will have access to comprehensive substance use and co-occurring treatment services, including coverage of medication, therapy, intensive case management, harm-reduction services, psycho-education and peer recovery support services. While approved medications will be used to address the physiological components of addiction, CRA and ACC will address the psycho-social determinants and will teach clients and families how to build recovery skills, find/use positive reinforcers for staying substance-free, access community resources to support positive change and strengthen the individual’s natural support system. The program will result in the following positive outcomes: abstinence or significant reduction in substance use, improved social connectedness, engagement in mental health or pre-natal services when needed, and improved level of psycho-social functioning as evidenced by acquisition of skills, stability of housing and/or employment.