{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:26:22Z","timestamp":1792409182887,"version":"4.4.0"},"reference-count":72,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The opioid overdose crisis requires strengthening treatment systems with innovative technologies. How people use telehealth for opioid use disorder (OUD) is evolving and differs in rural versus urban areas, as telehealth is emerging as a local resource and complementary option to in\u2010person treatment. We assessed changing trends in telehealth and medication for OUD (MOUD) and pinpoint locations of low telehealth and MOUD access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We used national data from the Mental health and Addiction Treatment Tracking Repository (2016\u20102023) to identify specialty outpatient SUD treatment facilities in the United States (\n                      <jats:italic>N<\/jats:italic>\n                      = 83,988). We modeled the availability of telehealth using multilevel multivariable logistic regression, adjusting for covariates. We included a 3\u2010way interaction to test for conditional effects of rurality, the number of MOUD medication types dispensed, and year. We included two random effects to account for clustering within counties and states.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      We identified 495 facilities that offered both telehealth and all three MOUD medication types (methadone, buprenorphine, naltrexone) in 2023, clustered in the eastern United States. We identified a statistically significant 3\u2010way interaction (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.0001), indicating that telehealth in facilities that did not offer MOUD shifted from more telehealth in rural facilities in earlier years to more telehealth in urban facilities in later years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Treatment facilities that offer both telehealth and all three MOUD medication types may improve access for hard\u2010to\u2010reach populations. We stress the importance of continued health system strengthening and technological resources in vulnerable rural communities, while acknowledging a changing landscape of increased OUD incidence and MOUD demand in urban communities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.12854","type":"journal-article","created":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:49:31Z","timestamp":1718239771000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A multilevel analysis of changing telehealth availability in opioid use disorder treatment settings: Conditional effects of rurality, the number and types of medication for opioid use disorder available, and time, US, 2016\u20132023"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8901-9012","authenticated-orcid":false,"given":"George","family":"Pro","sequence":"first","affiliation":[{"name":"Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4468-833X","authenticated-orcid":false,"given":"Jonathan","family":"Cantor","sequence":"additional","affiliation":[{"name":"RAND  Santa Monica California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don","family":"Willis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Community Health and Research, College of Medicine University of Arkansas for Medical Sciences  Fayetteville Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mofan","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Fairman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Fay W. Boozman College of Public Health University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7356-8313","authenticated-orcid":false,"given":"Jure","family":"Baloh","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Fay W. Boozman College of Public Health University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke EE","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Department of Health Behavior and Health Education, Fay W. 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