We Drove to the Moon: Ensuring Methadone Access in Rural Kentucky through Peer Transportation

Methadone, a gold standard treatment for opioid use disorder, faces limited access due to federal regulations restricting its dispensing to licensed opioid treatment programs (OTPs). Transportation is a critical barrier reported by rural area residents, where the distances to OTPs are over six times farther than for urban residents. To overcome this barrier in rural Kentucky, the HEALing (Helping to End Addiction Long-term^SM) Communities Study (HCS) partnered with Voices of Hope, a local recovery community organization, to develop a peer transportation program as part of the Recovery Coach Linkage and Retention Programs. The transportation program ran from 6/2021 to 12/2022 in 8 KY HCS counties and funded peer drivers (ie, individuals in recovery) to provide transportation to medication for opioid use disorder appointments and recovery-related services. Peer drives transported 197 participants 232,700 miles; most (78.5%) were to a single OTP in rural Madison County, KY, over 550 days. The program was an innovative solution. Peer drivers had greater flexibility and a broader scope of work compared to traditional options like Medicaid-provided nonemergency medical transportation. Furthermore, peer drivers could transport participants in unconventional locations, as outlined in the presented case study, and build rapport with participants through sharing lived experience. Implementing similar, peer-based transportation programs is a novel solution to a critical need.