COURAGE: Combating Opioid Use in Rural Appalachia with Grace and Expertise

Overview

Opioid use has ravaged the rural Appalachian region of East Tennessee, with the prevalence of opioid-related overdoses, neonatal opioid withdrawal syndrome (NOWS), and family dissolution exceeding that of the overall state and nation. Since 2018, the Rural Community Opioid Response Program-East Tennessee Consortium (RCORP-ETC) has applied research-based evidence and community expertise to address the prevention, treatment, and recovery related to opioid use disorder (OUD). Overall, the RCORP-ETC, managed by the University of Tennessee (UT), has 157 members, affiliated with 33 organizations who address OUD prevention, treatment, and recovery. Representation includes justice, education, child protection, faith, workforce development, and many others; creating an interdisciplinary approach. Five primary RCORP-ETC organizational members will build on RCORP-ETC’s current momentum: (1) UT, (2) ICARe-Union County; (3) Live Free-Claiborne; (4) The Hill-Claiborne, and (5) United Methodist Church of Newport, TN. Shaun Lynch, DPharm of Campbell County, an individual member of the RCORP-ETC, will also serve as key personnel with COURAGE: Combating Opioid Use in Rural Appalachia with Grace and Evidence. COURAGE will address two overarching goals: (1) promote opioid use disorder (OUD) prevention with an emphasis on youth and the adults who care for them and (2) enhance OUD treatment and recovery by promoting integrated, interdisciplinary care. The COURAGE service area will include six entirely rural counties (Scott, Campbell, Union, Claiborne, Grainger, and Cocke) and 2 census tracts in one partially rural county (Jefferson; census tracts 47089070700 (now 47089070701, 47089070702) and 47089070900). UT, with representation from Public Health, Nursing, and Pharmacy. UT Public Health will provide project management, data coordination, and develop, coordinate, manage the hub and spoke expansion, and supervise all youth-related activities and training. UT Nursing will be responsible for facilitating the MOUD expansion project, contributing to and monitoring the faith-based mentorship program, co-facilitating the RCORP-ETC meetings, overseeing the drug takeback program, assisting with the hub and spoke expansion, developing and reviewing resources, curricula, and monthly key messages. UT Pharmacy will develop and provide delivery of four pharmacist training modules, mentor 10 pharmacists, structure and facilitate an annual dinner to promote interdisciplinary approaches to OUD treatment and recovery, and assist in overseeing the MOUD expansion program. A UT graduate research assistant and UT student researchers will be responsible for overseeing the production of all curricula, creating and translating resources, updating the website, and facilitating programming to promote youth development, including youth mentoring and training for parents and teachers. ICARe-Union County will be responsible for the scheduling of teacher in-services, youth programming, and parenting sessions, primarily in Union County. ICARe will also provide a facilitator for 10 training sessions. Live Free-Claiborne will be responsible for marketing and providing HIV and Hepatitis C testing to participants in their syringe services program. Live Free will assist in the development and distribution of written resources and quarterly trainings for the Live Free clients. The Hill Claiborne and United Methodist Church of Newport, TN are champions of OUD prevention and ministry. They will mentor 20 faith-based leaders in the integration and promotion of OUD treatment and recovery. This will include curriculum development. Shaun Lynch, DPharm will be responsible for assisting in the development of a mentoring curriculum to promote MOUD and Narcan distribution for pharmacists, co-facilitate quarterly trainings, and mentor 10 pharmacists across the three years of the project, to enhance their efforts in OUD treatment and recovery.