The Rural Opioid Initiative Consortium description: providing evidence to Understand the Fourth Wave of the Opioid Crisis

Richard A Jenkins¹, Bridget M Whitney², Robin M Nance², Todd M Allen³, Hannah L F Cooper⁴, Judith Feinberg⁵, Rob Fredericksen², Peter D Friedmann⁶, Vivian F Go⁷, Wiley D Jenkins⁸, P Todd Korthuis⁹, William C Miller¹⁰, Mai T Pho¹¹, Abby E Rudolph¹², David W Seal¹³, Gordon S Smith^{5

14}, Thomas J Stopka¹⁵, Ryan P Westergaard¹⁶, April M Young¹⁷, William A Zule¹⁸, Joseph A C Delaney¹⁴, Judith I Tsui², Heidi M Crane¹⁹; Rural Opioid Initiative

Affiliations

¹ Prevention Research Branch, National Institute on Drug Abuse, 3WFN MSC 6024, 301 North Stonestreet Ave, Bethesda, MD, 20892, USA.
² University of Washington Harborview Medical Center, 325 9th Ave, Box 359931, Seattle, WA, 98106, USA.
³ Ragon Institute of MGH, MIT and Harvard, Rm 764 400 Technology Square, Cambridge, MA, 02139, USA.
⁴ Rollins School of Public Health, Emory University, Grace Crum Rollins Building 1518 Clifton Road, Atlanta, GA, 30322, USA.
⁵ West Virginia University, 930 Chestnut Ridge Road, PO Box 9156, Morgantown, WV, 26505, USA.
⁶ Baystate Medical Center-University of Massachusetts, Office of Research, UMass Chan Medical School - Baystate, 3601 Main Street, 3rd Floor, Springfield, MA, 01199, USA.
⁷ University of North Carolina-Chapel Hill, 363 Rosenau Hall CB# 7440, Chapel Hill, NC, 27599, USA.
⁸ Southern Illinois University, 201 E Madison Street, Springfield, IL, 62702, USA.
⁹ Oregon Health & Science University, 3270 Southwest Pavilion Loop OHSU Physicians Pavilion, Suite 350, Portland, OR, 97239, USA.
¹⁰ The Ohio State University, 302 Cunz Hall 1841 Neil Ave, Columbus, OH, 43210, USA.
¹¹ University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA.
¹² Department of Epidemiology and Biostatistics, Temple University College of Public Health, 1301 Cecil B Moore Avenue, Ritter Annex 905, Philadelphia, PA, USA.
¹³ Tulane University, 1440 Canal Street, Suite 2210, New Orleans, LA, 70112, USA.
¹⁴ College of Pharmacy, University of Manitoba, Apotex Centre, 750 McDermot Ave. W, Winnipeg, MB, R3E 0T5, Canada.
¹⁵ Tufts University School of Medicine Public Health and Community Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA.
¹⁶ University of Wisconsin-Madison, 1685 Highland Avenue, 5th Floor, Madison, WI, 53705-2281, USA.
¹⁷ University of Kentucky, 760 Press Avenue Suite 280, Lexington, KY, 40536, USA.
¹⁸ RTI International, 3040 E. Cornwallis Road, PO Box 12194, Research Triangle Park, NC, 2709-2194, USA.
¹⁹ University of Washington Harborview Medical Center, 325 9th Ave, Box 359931, Seattle, WA, 98106, USA. hcrane@uw.edu.

PMID: 35883197
PMCID: PMC9321271
DOI: 10.1186/s13722-022-00322-5

The Rural Opioid Initiative Consortium description: providing evidence to Understand the Fourth Wave of the Opioid Crisis

Richard A Jenkins et al. Addict Sci Clin Pract. 2022.

. 2022 Jul 26;17(1):38.

doi: 10.1186/s13722-022-00322-5.

Authors

Affiliations

¹ Prevention Research Branch, National Institute on Drug Abuse, 3WFN MSC 6024, 301 North Stonestreet Ave, Bethesda, MD, 20892, USA.
² University of Washington Harborview Medical Center, 325 9th Ave, Box 359931, Seattle, WA, 98106, USA.
³ Ragon Institute of MGH, MIT and Harvard, Rm 764 400 Technology Square, Cambridge, MA, 02139, USA.
⁴ Rollins School of Public Health, Emory University, Grace Crum Rollins Building 1518 Clifton Road, Atlanta, GA, 30322, USA.
⁵ West Virginia University, 930 Chestnut Ridge Road, PO Box 9156, Morgantown, WV, 26505, USA.
⁶ Baystate Medical Center-University of Massachusetts, Office of Research, UMass Chan Medical School - Baystate, 3601 Main Street, 3rd Floor, Springfield, MA, 01199, USA.
⁷ University of North Carolina-Chapel Hill, 363 Rosenau Hall CB# 7440, Chapel Hill, NC, 27599, USA.
⁸ Southern Illinois University, 201 E Madison Street, Springfield, IL, 62702, USA.
⁹ Oregon Health & Science University, 3270 Southwest Pavilion Loop OHSU Physicians Pavilion, Suite 350, Portland, OR, 97239, USA.
¹⁰ The Ohio State University, 302 Cunz Hall 1841 Neil Ave, Columbus, OH, 43210, USA.
¹¹ University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA.
¹² Department of Epidemiology and Biostatistics, Temple University College of Public Health, 1301 Cecil B Moore Avenue, Ritter Annex 905, Philadelphia, PA, USA.
¹³ Tulane University, 1440 Canal Street, Suite 2210, New Orleans, LA, 70112, USA.
¹⁴ College of Pharmacy, University of Manitoba, Apotex Centre, 750 McDermot Ave. W, Winnipeg, MB, R3E 0T5, Canada.
¹⁵ Tufts University School of Medicine Public Health and Community Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA.
¹⁶ University of Wisconsin-Madison, 1685 Highland Avenue, 5th Floor, Madison, WI, 53705-2281, USA.
¹⁷ University of Kentucky, 760 Press Avenue Suite 280, Lexington, KY, 40536, USA.
¹⁸ RTI International, 3040 E. Cornwallis Road, PO Box 12194, Research Triangle Park, NC, 2709-2194, USA.
¹⁹ University of Washington Harborview Medical Center, 325 9th Ave, Box 359931, Seattle, WA, 98106, USA. hcrane@uw.edu.

PMID: 35883197
PMCID: PMC9321271
DOI: 10.1186/s13722-022-00322-5

Abstract

Objective: To characterize and address the opioid crisis disproportionately impacting rural U.S. regions.

Methods: The Rural Opioid Initiative (ROI) is a two-phase project to collect and harmonize quantitative and qualitative data and develop tailored interventions to address rural opioid use. The baseline quantitative survey data from people who use drugs (PWUD) characterizes the current opioid epidemic (2018-2020) in eight geographically diverse regions.

Results: Among 3,084 PWUD, 92% reported ever injecting drugs, 86% reported using opioids (most often heroin) and 74% reported using methamphetamine to get high in the past 30 days; 53% experienced homelessness in the prior 6 months; and 49% had ever overdosed. Syringe service program use varied by region and 53% had ever received an overdose kit or naloxone prescription. Less than half (48%) ever received medication for opioid use disorder (MOUD).

Conclusions: The ROI combines data across eight rural regions to better understand drug use including drivers and potential interventions in rural areas with limited resources. Baseline ROI data demonstrate extensive overlap between opioid and methamphetamine use, high homelessness rates, inadequate access to MOUD, and other unmet needs among PWUD in the rural U.S. By combining data across studies, the ROI provides much greater statistical power to address research questions and better understand the syndemic of infectious diseases and drug use in rural settings including unmet treatment needs.

Keywords: Injection drug use; Methamphetamine; Opioids; Overdose; Rural; Substance use.

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Conflict of interest statement

No conflict declared.

Figures

**Fig. 1**
Location of studies in the Rural Opioid Initiative

See this image and copyright information in PMC

References

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The Rural Opioid Initiative Consortium description: providing evidence to Understand the Fourth Wave of the Opioid Crisis

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The Rural Opioid Initiative Consortium description: providing evidence to Understand the Fourth Wave of the Opioid Crisis

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Conflict of interest statement

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