During the COVID-19 pandemic, overdose deaths increased 38.4% in a 12-month period in the United States – the largest increase in the nation's history. The health crisis was especially felt in Arizona communities, which have higher overdose rates and lower access to opioid treatment providers than the national average. 

Yet, the COVID-19 pandemic also created an opportunity to improve access to medication for opioid use disorder, or MOUD, which is considered the "gold standard" treatment and includes methadone, buprenorphine and naltrexone. During the pandemic, federal regulators relaxed policies to make it easier for people to access MOUD treatment without risking in-person interactions. What remains to be learned is which Arizona MOUD providers implemented these flexible policies and how that affected patient health.  

The University of Arizona Southwest Institute for Research on Women, or SIROW, received a $230,357 grant from the Foundation for Opioid Response Efforts, or FORE, to study the impact of COVID-19 on MOUD access and patient health. The research team will document the effects of policy changes made as a result of the pandemic by conducting a survey of 1,000 Arizona MOUD providers and interviews with 200 MOUD patients, with a focus on rural and tribal communities.

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"This is a community-based action research project to address the maldistribution of MOUD in Arizona," said Beth Meyerson, principal investigator and research professor with SIROW. Meyerson noted that the opportunity came out of a longstanding relationship with the community.

"Our partners identified this as an opportunity to create evidence to inform federal policy," she said.

"We have a short window of time to evaluate the impact of temporary policy changes related to providing medications for opioid use disorder and telehealth so we can develop longer-term, evidence-based solutions that sustain access to better and more equitable care beyond the pandemic," said Dr. Karen A. Scott, president of FORE. "We are proud to partner with the University of Arizona on this initiative, which includes an important focus on access and equity issues facing tribal, rural and remote communities, as well as other communities of color."

The study is led by a multidisciplinary research team and involves multiple UArizona centers and community partners. At UArizona, SIROW's Meyerson, Keith Bentele and Brenda Granillo will join Ben Brady, a researcher with the Mel and Enid Zuckerman College of Public Health and the Comprehensive Pain and Addiction Center.

Christopher Abert, executive director  of the Southwest Recovery Alliance, or SWRA, and Danielle Russell from Sonoran Prevention Works are the community-based co-investigators. The project will be directed by a statewide MOUD Patient and Provider Advisory Board, and patient interviews will be conducted by trained community members.

"It means a lot to us that FORE and SIROW have chosen to advance patient-centered, evidence-based solutions," Abert said. "This study will ensure that people living with opioid use disorder can be co-creators of evidence to influence policy changes and address health inequities."

"This project represents the community-based action research that SIROW is known for," said Josephine Korchmaros, director of SIROW, which is housed in the College of Social and Behavioral Sciences. "This is an opportunity to create policy and system changes that will impact people's lives for years to come."