A statewide treatment system to expand the availability of all three forms of medications for opioid use disorder
The Washington State Hub and Spoke Model, administered through the Division of Behavioral Health and Recovery at the Washington State Department of Social and Health Services and funded by SAMHSA, is a replication of a successful hub and spoke model in Vermont. It is a model for a statewide treatment system to expand the capacity to deliver medications for opioid use disorder (MOUD), which include methadone, buprenorphine, and extended-release naltrexone.
Taking into account that individuals with opioid use disorder (OUD) seek treatment in a variety of settings, employing the model of a central hub with extending spokes has the potential to engage more people in evidence-based care. Hub sites identify, collaborate, and subcontract with spokes to provide integrated care with medication treatment, regardless of how participants enter the system. There are currently eleven hubs across the state that are each connected to numerous spokes. Some of the more non-traditional spokes include prisons, jails, jail release programs, drug courts, probation, and police and fire departments, increasing the touchpoints were individuals can more readily access MOUD.
The Washington State Hub and Spoke model differs from other models to deliver MOUD because the hub can be any organization that has MOUD expertise and capacity to manage the network, whereas the Vermont and other hub and spoke models use addiction treatment providers as the hub. As a result, three of the networks had some form of primary care provider as the hub. The Washington model also includes a nurse care manager as a key element, drawing from the Massachusetts model.
More information on the hub and spoke model can be found in the news articles here and here. More detail on how this model deliveries MOUD can be found in the peer-reviewed paper here. The model is currently being evaluated by Brandeis University. See the presentation here for an overview of Washington State's response to the opioid crisis.