# Counteracting Structural Barriers to Increase Access to Medications for Opioid Use Disorder (MOUD) Among Unhoused Montanans

> **NIH NIH OT2** · MISSOULA AIDS FUND, INC. D/B/A OPEN AID ALLIANCE · 2024 · $375,000

## Abstract

The opioid epidemic has disproportionately impacted the unhoused population with an overdose death
rate 20 times higher than that of the general population. Medications for opioid use disorder (MOUD) is
highly effective in saving lives, but unhoused individuals experience many structural barriers to
accessing treatment – stigmatization by healthcare providers, limited acceptance of Medicaid, and
personal instability that precludes treatment co-requirements. Those barriers are compounded for
unhoused individuals in Montana (MT) where the number of Montanans with opioid use disorder (OUD)
outweigh treatment capacity by 10-fold with 92% of individuals with OUD (housed and unhoused) not
receiving treatment. To combat these barriers, we will utilize three evidence-based interventions proven
to increase engagement of underserved populations: 1) MOUD care based in syringe service programs
(SSPs), 2) a nurse-led model of MOUD, and 3) peer navigator supported care. We will embed these
interventions into the five SSPs that span the state of MT – sites located in both urban and rural areas
with three sites adjacent to American Indian Reservations. Following the OUD cascade of care
framework, we will assess the following measures among SSP clients: 1) engaged in care services at SSP,
2) OUD diagnosis by SSP prescriber, 3) MOUD initiations, 4) patient days on MOUD, and 5) MOUD for ≥
60 days, 90 days, and 180 days. In each SSP, we aim to surpass the state average of Montanans utilizing
MOUD. In whole, we intend to make these SSPs the state model for equitable OUD care.

## Key facts

- **NIH application ID:** 11167942
- **Project number:** 3OT2OD035589-01S1
- **Recipient organization:** MISSOULA AIDS FUND, INC. D/B/A OPEN AID ALLIANCE
- **Principal Investigator:** Rebecca Ramos
- **Activity code:** OT2 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $375,000
- **Award type:** 3
- **Project period:** 2023-09-22 → 2028-09-21

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11167942

## Citation

> US National Institutes of Health, RePORTER application 11167942, Counteracting Structural Barriers to Increase Access to Medications for Opioid Use Disorder (MOUD) Among Unhoused Montanans (3OT2OD035589-01S1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/11167942. Licensed CC0.

---

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