Expanding the Opioid Use Disorder Medication Treatment Workforce in Rural Communities Through the RCORP Initiative

Purpose: The Rural Communities Opioid Response Program (RCORP) was funded to help rural communities improve prevention, treatment, and recovery services for Opioid Use Disorder (OUD), including increasing the supply of clinicians with a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine, which was required before 2023. This research investigates the impact of RCORP funding on the supply of DEA-waivered clinicians in rural communities.

Methods: We used 2017-2022 DEA lists of waivered clinicians to assign clinicians to US counties. Using RCORP service area data, we classified rural counties as either being served by an RCORP grantee or not. We calculated the number of counties in each category with a waivered clinician, clinician-to-population ratios, and treatment slot-to-population ratios.

Findings: In 2017, 3.7% more of RCORP funded counties had a waivered clinician than non-RCORP counties. RCORP counties also had 1.2 more waivered clinicians per 100,000 population and 57.5 more treatment slots per 100,000 population compared to non-RCORP counties. From 2017 to 2022, these differences more than doubled. The supply of waivered clinicians varied across Census Divisions. In most Census Divisions, a greater percentage of RCORP counties had a waivered clinician as well as more waivered clinicians and treatment slots per population, except for the Pacific Census Division, which had more clinicians and treatment slots per population in non-RCORP counties.

Conclusions: Study findings suggest that federal investments to expand rural OUD patients' access to care may have been successful, but only if increases in clinician supply translate into greater provision of OUD treatment.