How mobile units are shaping opioid treatment experiences: Insights from patients of mobile and traditional opioid treatment programs

Abstract

Introduction: Persistent barriers to accessing medications for opioid use disorder (MOUD) exist. To ease barriers, CODAC Behavioral Healthcare, the largest opioid treatment provider in Rhode Island, began operating its mobile medical unit (MMU) providing MOUD and other healthcare services to a high-need community in July 2022. We evaluated current operations through formative interviews with individuals receiving care from the MMU and compared their perspectives with those of patients at traditional brick-and-mortar clinics. Methods: Authors conducted and transcribed one-on-one interviews in August 2024 with thirty patients of the MMU (n = 15) and of brick-and-mortar clinics (n = 15). Authors analyzed qualitative data using template thematic analysis with a primarily deductive codebook informed by key concepts from two implementation science frameworks. Themes were generated. Results: Interviewed patients were 41.4 years old on average and just over half were male (56.7%). Almost all, 86.7%, were White. All except one patient were receiving methadone. Patients in both settings learned about treatment through word-of-mouth and referrals, with MMU patients valuing accessibility but noting areas for improved outreach. Patients had extensive histories with treatment, shaped by past experiences and beliefs about MOUD. While all valued several aspects of low-threshold MOUD (e.g., take-homes), some brick-and-mortar patients aimed to eventually stop methadone, citing health concerns, whereas MMU patients focused on stability. Patients valued rapid initiation, efficient dosing, and support for basic needs like food, clothing, and transportation. While brick-and-mortar patients received more referrals for external medical services, MMU patients appreciated on-site care but primarily sought immediate resources. MMU patients who desired more intensive services found counseling services insufficient. All patients reported benefits of treatment, including reduced substance use and improved well-being, with many advocating for expanded mobile services to reach more people. Conclusion: This study underscores the advantages of mobile units in reducing barriers to MOUD and healthcare access, particularly for populations seeking basic needs. Patient-centered adaptations, such as expanded hours and increased ancillary services, may further optimize care. Ongoing research is needed to evaluate the long-term impact of mobile units on treatment engagement and healthcare outcomes.