Date of Award

Spring 2019

Document Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Mary Lindsey Smith, PhD, MSW


opioid use disorder, medicated assisted treatment, Primary Care Providers, Emergency Department Providers, EMS Providers, opioid treatment, treatment gaps


The Centers for Disease and Control (CDC) describes opioid use disorder (OUD) also known as opioid addiction as the problematic pattern of opioid use leading to clinically significant impairment or distress. In 2016, about 2.1 million people were diagnosed of OUD in the US. In Maine, York County has the third highest drug overdose response and had 166 deaths occurring between 2012-2016. York County is a designated medically underserved area and has a shortage of provider workforce and limited treatment infrastructure. To further understand the challenges providers in York County encounter in managing patients with OUD, 6 focus groups was conducted for Primary Care Providers (PCP) and Emergency Department (ED) Providers in 6 locations. Also, an online survey was administered to EMS providers. Analysis of the data was used to determine the treatment gaps and challenges these providers encounter in the management of OUD in York County. Results of this survey revealed that EMS providers have received more training on OUD than PCP and ED providers and that the major challenges that affects OUD management identified by all three provider groups include: inadequate treatment resources needed for OUD management, inadequate workforce capacity, access to care, stigma and difficulty engaging patients. This capstone will inform the Rural York County Opioid Planning Project aimed at expanding access to Medicated Assisted Treatment (MAT) and increasing efficiency, integration and coordination among and between service providers. Also, the results of this capstone will be relevant to a broader public health and health systems audience who are trying to address the current opioid crisis.



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