{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:38:51Z","timestamp":1792211931924,"version":"4.4.0"},"reference-count":61,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>The US is confronted with a rise in opioid use disorder (OUD), opioid misuse, and opioid-associated harms. Medication treatment for opioid use disorder (MOUD)\u2014including methadone, buprenorphine and naltrexone\u2014is the gold standard treatment for OUD. MOUD reduces illicit opioid use, mortality, criminal activity, healthcare costs, and high-risk behaviors. The Veterans Health Administration (VHA) has invested in several national initiatives to encourage access to MOUD treatment. Despite these efforts, by 2017, just over a third of all Veterans diagnosed with OUD received MOUD. VHA OUD specialty care is often concentrated in major hospitals throughout the nation and access to this care can be difficult due to geography or patient choice. Recognizing the urgent need to improve access to MOUD care, in the Spring of 2018, the VHA initiated the Stepped Care for Opioid Use Disorder, Train the Trainer (SCOUTT) Initiative to facilitate access to MOUD in VHA non-SUD care settings. The SCOUTT Initiative's primary goal is to increase MOUD prescribing in VHA primary care, mental health, and pain clinics by training providers working in those settings on how to provide MOUD and to facilitate implementation by providing an ongoing learning collaborative. Thirteen healthcare providers from each of the 18 VHA regional networks across the VHA were invited to implement the SCOUTT Initiative within one facility in each network. We describe the goals and initial activities of the SCOUTT Initiative leading up to a two-day national SCOUTT Initiative conference attended by 246 participants from all 18 regional networks in the VHA. We also discuss subsequent implementation facilitation and evaluation plans for the SCOUTT Initiative. The VHA SCOUTT Initiative could be a model strategy to implement MOUD within large, diverse health care systems.<\/jats:p>","DOI":"10.1080\/08897077.2020.1787299","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T11:55:59Z","timestamp":1595418959000},"page":"275-282","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":128,"title":["Stepped Care for Opioid Use Disorder Train the Trainer (Scoutt) Initiative: Expanding Access to Medication Treatment for Opioid Use Disorder within Veterans Health Administration Facilities"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2453-8871","authenticated-orcid":false,"given":"Adam J.","family":"Gordon","sequence":"first","affiliation":[{"name":"Vulnerable Veteran Innovative PACT (VIP) Initiative, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA"},{"name":"Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA"},{"name":"Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Drexler","sequence":"additional","affiliation":[{"name":"Office of Mental Health and Suicide Prevention, Veterans Health Administration, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Veterans Affairs (VA) Puget Sound Health Care System, Health Services Research &amp; Development (HSR&amp;D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, Washington, USA"},{"name":"VA Puget Sound Health Care System, Center of Excellence in Substance Addiction Treatment and Education, Seattle, Washington, USA"},{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Burden","sequence":"additional","affiliation":[{"name":"Office of Mental Health and Suicide Prevention, Veterans Health Administration, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nodira K.","family":"Codell","sequence":"additional","affiliation":[{"name":"Vulnerable Veteran Innovative PACT (VIP) Initiative, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Mhatre-Owens","sequence":"additional","affiliation":[{"name":"Vulnerable Veteran Innovative PACT (VIP) Initiative, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew T.","family":"Dungan","sequence":"additional","affiliation":[{"name":"Vulnerable Veteran Innovative PACT (VIP) Initiative, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5118-7624","authenticated-orcid":false,"given":"Hildi","family":"Hagedorn","sequence":"additional","affiliation":[{"name":"Center for Care Delivery and Outcomes Research Minneapolis VA Health Care System, Minneapolis, Minnesota, USA"},{"name":"Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,7,1]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/add.14394"},{"issue":"2","key":"e_1_3_5_3_2","article-title":"Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence","author":"Mattick RP","year":"2014","unstructured":"Mattick RP, , Breen C, , Kimber J, , Davoli M. 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