Expanding substance abuse/CO-occurring treatment and recovery support services for fentanyl overdose clients in rural middle tennessee - targeted capacity expansion: special projects (TCE) no

TI-22-002 (2022-2025) this project will address the fentanyl overdose crisis in tennessee (TN) by expanding access to treatment and psychosocial services for 240 rural clients who have recently experienced overdose in a 21-county catchment area of rural middle tennessee. Using a comprehensive continuum-of-care model that integrates an array of evidence-based approaches to provide substance use treatment, psychosocial therapies, recovery support services, and harm reduction with a strong peer-support network, this project will facilitate long term recovery for this under-resourced population. These rural communities already have a critical GAP in treatment services for substance use disorders as well as a severe lack of behavioral health providers, and are currently experiencing a surge of fatal and non-fatal overdoses, largely due to the increasing prevalence of fentanyl. In 2019, the TN department of health's office of information and analytics reported 23,910 overdose-related hospital discharges, representing a sizeable stress on a system already struggling with the covid-19 pandemic in the state. This project will divert people experiencing overdose from emergency departments and hospitals into long-term treatment, thus easing the burden on local medical infrastructure. In 2020, 66.4% of overdose deaths were fentanyl related in tennessee and fentanyl was associated with 69.6% of overdose deaths in the catchment area. Preliminary data suggest that this figure will increase in 2021 and 2022. The rural poor are especially vulnerable to overdose, as local hospital closures have made IT increasingly difficult to access full-service medical facilities. Elevated poverty rates (14.8%) and low education levels in the catchment area parallel closely with the numbers of fatal and non-fatal overdose. Buffalo valley INC. (BVI) will provide assessment for opioid use disorder, illicit drug use, alcohol dependence, and CO-occurring mental health disorders. Based on these assessments and by engaging assertive community treatment (act) as the guiding evidence-based practice, BVI will deliver a full continuum of services to eligible clients, including integrated treatment with mental and physical healthcare, medication, psychotherapy, case management, and transitional and permanent housing in rural middle tennessee. Clients will be offered comprehensive residential and outpatient treatment, relapse prevention, narcan training, peer support, vocational training, and transportation services. In order to render this broad spectrum of services, BVI will partner with other experienced service providers: recovery navigators, hospitals, ERS, law enforcement, faith-based entities, and employment agencies. BVI has extensive treatment infrastructure in the heart of the project catchment area, hohenwald, TN, as well as seven satellite facilities, two mobile health clinics to serve remote, distressed counties, and over 650 housing units in the area, and is well positioned to serve the POF. The project's specific goals are: 1. To develop and implement outreach and engagement strategies for recruiting 240 rural clients who have recently experienced overdose to treatment (80 per year); 2. To conduct screening and assessments to identify 240 rural overdose clients (80 per year) with SUD, OUD, and/or and CO-occurring disorders eligible for SUD/COD treatment and other services; 3. To provide evidence-based treatment, including medication, counseling, psychosocial, peer and recovery support services, case management, and harm reduction services to 240 rural clients (80 per year); and 4. To decrease OUD, SUD, and COD at six-month follow-up for 240 rural clients in the catchment area (80 per year).