# Right Tools, Right Time, Right Place: Telehealth for Opioid Use Disorder in Vulnerable Settings

> **NIH NIH R44** · BOULDER CARE, INC. · 2024 · $297,061

## Abstract

Project Summary/Abstract
RFA-DA-24-018
Field-Deployable, Low-Cost Point-of-Need Approaches and Technologies to Lower the Barriers to
Substance Use Disorders (SUD) Diagnosis and Treatment
Twenty years after the FDA approval of buprenorphine for treatment of opioid use disorder (OUD), its
availability remains far too restricted. This restriction is in spite of regulatory relaxations over these two
decades: from increased panel size to broadening qualifying clinicians to ultimately removing any
required waiver. It has also become clear that certain circumstances make patients especially
vulnerable to harm from OUD. These include settings where medical attention is possible but
buprenorphine is not provided (e.g, jails and prisons, emergency departments, and residential
treatment for OUD), geographic areas where people are especially isolated from treatment (e.g, rural
Tribal Nations), and life circumstances that confer additional risk (e.g., the perinatal period).
We now have new tools to deliberately reach these settings. The regulatory suspension of an in-person
visit during the COVID-19 pandemic allowed telehealth to dramatically increase its ability to care for
patients, especially those with Medicaid. This increase in telehealth care has consequently allowed for
research as to its effectiveness. Repeated studies find remote treatment with buprenorphine to be as
good—and often better—than in-person treatment as usual. Research also calls attention to gaps that
must be addressed to achieve treatment success with telehealth, including an affordable,
readily-available working phone with reliable cellular and/or network coverage.
These relatively low-cost technologies are the ones we propose to make available in the crucial settings
described previously. Provision of a smartphone and connectivity will allow people in high-risk situations
to begin treatment with Boulder Care’s proven approach and capabilities. We propose 5 partnerships
that will, in Phase I, allow us to develop and test workflows with 5 participants per site and refine them
for each setting, culminating with qualitative and quantitative research findings, including focus groups
with participants and sites. With our workflows studied and optimized, our Phase II will then enroll 50
participants in Boulder Care from these 5 sites. Our primary endpoint, as with our prior SBIR grant, is
duration of treatment with buprenorphine over a 48 week period. Secondary patient-centered outcomes
will include measures of quality of life, functional outcomes, and assessments of recovery capital.
Our partners include Sano Health, an experienced provider of technologies to vulnerable populations,
and National Survivors Union, an organization of People Who Use Drugs who are accomplished
community researchers. Together with site partners, this collaboration has proven, real-world,
community-based expertise and will provide scalable life-saving treatment at the point of need.

## Key facts

- **NIH application ID:** 10985969
- **Project number:** 1R44DA061386-01
- **Recipient organization:** BOULDER CARE, INC.
- **Principal Investigator:** Stephanie Papes
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $297,061
- **Award type:** 1
- **Project period:** 2024-09-15 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10985969

## Citation

> US National Institutes of Health, RePORTER application 10985969, Right Tools, Right Time, Right Place: Telehealth for Opioid Use Disorder in Vulnerable Settings (1R44DA061386-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10985969. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*