Rural Expanded Access to OUD Care & Linkage Using Toxicologists for Telehealth Initiated Treatment

The overarching goal of this project is to increase the availability of OUD treatment in rural counties in the state of Georgia by using Emergency Department (ED)-based telehealth strategies to initiate MOUD and connect patients to treatment.The investigators will implement a novel collaboration between rural EDs, medical toxicologists at the Georgia Poison Center (GPC), peer recovery coaches (PRCs) and RCOs throughout Georgia to bridge the gap between OUD treatment need in rural EDs and specialty physician availability at the GPC.Research activities will be conducted during two broad phases, at three rural EDs in Georgia: planning and implementation. During the planning phase, aggregate data will be obtained to determine each ED's existing practices treating patients with OUD and opioid withdrawal. During the implementation phase, the researchers will prospectively study a poison center OUD consultation and PRC intervention as it is rolled out at each site, collecting participant-level data. Sites will be rolled into the implementation phase in a stepped-wedge fashion, so there will be times when some sites are in the planning phase while others are in the implementation phase.

Inclusion Criteria:Age 18 years or olderEnglish speakingClinically soberMedically and psychiatrically stableExclusion criteria:Already receiving MAT or psychotherapy for OUD prior to ED arrivalPrior participation in the studyUnable to provide informed consentIf their clinical condition worsens such that continued participation would be considered unsafe in the opinion of the PRC or ED staffPrisonersIndividuals who are not yet adults (infants, children, teenagers)Cognitively impaired or Individuals with Impaired Decision-Making CapacityIndividuals who are not able to clearly understand English