Substance use disorder treatment and technology access among people who use drugs in rural areas of the United States: A cross-sectional survey

Dana Button, Ximena A. Levander, Ryan R. Cook, William C. Miller, Elizabeth M. Salisbury-Afshar, Judith I. Tsui, Umedjon Ibragimov, Wiley D. Jenkins, Ryan P. Westergaard, P. Todd Korthuis

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate how technology access affected substance use disorder (SUD) treatment prior to COVID-19 for people who use drugs in rural areas. Methods: The Rural Opioid Initiative (January 2018-March 2020) was a cross-sectional study of people with prior 30-day injection drug or nonprescribed opioid use from rural areas of 10 states. Using multivariable mixed-effect regression models, we examined associations between participant technology access and SUD treatment. Findings: Of 3,026 participants, 71% used heroin and 76% used methamphetamine. Thirty-five percent had no cell phone and 10% had no prior 30-day internet use. Having both a cell phone and the internet was associated with increased days of medication for opioid use disorder (MOUD) use (aIRR 1.29 [95% CI 1.11-1.52]) and a higher likelihood of SUD counseling in the prior 30 days (aOR 1.28 [95% CI 1.05-1.57]). Lack of cell phone was associated with decreased days of MOUD (aIRR 0.77 [95% CI 0.66-0.91]) and a lower likelihood of prior 30-day SUD counseling (aOR 0.77 [95% CI 0.62-0.94]). Conclusions: Expanding US rural SUD treatment engagement via telemedicine may require increased cell phone and mobile network access.

Original languageEnglish (US)
JournalJournal of Rural Health
DOIs
StateAccepted/In press - 2022

Keywords

  • addiction
  • opioids
  • rural health
  • telemedicine

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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