Improving Access to Opioid Use Disorder Treatment in Rural South Carolina with Long-Acting Injectables

This policy brief examines barriers to opioid use disorder (OUD) treatment in rural South Carolina and explores the role of long-acting injectable (LAI) buprenorphine in improving access and outcomes. It highlights systemic challenges such as pharmacy-level stigma, inconsistent buprenorphine availability, low Medicaid reimbursement, and structural inequities tied to poverty and geography. Evidence from clinical studies shows that LAIs like Sublocade and Brixadi can reduce logistical burdens, support sustained abstinence, and improve patient quality of life, though providers note reduced opportunities for frequent monitoring. The brief recommends expanding pharmacist training, supporting mobile and telehealth-based LAI programs, improving Medicaid reimbursement, and piloting rural “LAI-first” treatment models to better serve high-need communities.

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