Published: 04/28/2026 | Author: Quentin Blount

The University of Idaho is working to close a critical gap in opioid addiction care that has already cost hundreds of lives in the state. A program is training Idaho clinicians on treating opioid use disorder. The goal is to equip frontline providers with the updated knowledge as fentanyl, xylazine, and other substances continue to reshape the opioid crisis across the state.

Idaho already has an impressive range of programs available to combat substance misuse. In the Gem State, local communities have banded together to start grassroots chapters of Narcotics Anonymous to offer peer support for those impacted by drug use.

Yet a significant share of people never receive proven treatment and a lack of trained providers is a major reason why. The need persists, with 264 Idahoans dying from opioid-related drug overdoses in 2023. 

The Opioid Crisis

The treatment gap is especially pronounced in rural states like Idaho, where access to opioid treatment programs (OTP) is limited by geography. While 20% with opioid use disorder achieve two years of abstinence without meds, those who relapse face a high risk of death. This makes medication-assisted treatment (MAT) a life-or-death issue for thousands of patients.

After someone has overdosed once, the chance of dying within the next year is one in ten.

The Opioid Care Gap in Idaho

According to Dr. Jacob Harris, an addiction medicine specialist at the VA Medical Center in Boise, one reason so few people receive medication is that Idaho’s health care community isn’t sufficiently trained to confidently treat the condition. Reticence is driven by lack of training, not knowing where to start and fear of doing it incorrectly. 

Under the University of Idaho’s School of Health and Medical Professions, Project ECHO Idaho operates the Opioids, Pain and Substance Use Disorders (OPSUD) series. Physicians, nurse practitioners and other primary care clinicians learn about the latest theories and practices for treating substance use disorders and pain.

The online series equips Idaho health care workers to prescribe meds and treat patients as laws, addiction trends and treatment recommendations change.

Fentanyl’s Role & the Shifting Drug Landscape

The opioid crisis hasn’t stood still. The opioid landscape has evolved over the past several years as people move from prescription opioids to street oxycodone, then heroin and now fentanyl. Illegal dealers often lace these opioids with other substances to intensify their effects.

Today, new drugs have emerged. Xylazine is a non-opioid veterinary tranquilizer that slows the heart rate and produces long-lasting euphoria and emerged in U.S. drug supplies in the early 2000s. Kratom is a non-federally regulated drug that mimics opioid-like sedative and euphoric effects and has impacted Idaho for more than a decade.

The 2025 OPSUD series consisted of learning how to ID, test and treat addiction or overdoses involving these substances.

One session highlighted a lesser-known fentanyl overdose symptom called “wooden chest syndrome,” in which rigid chest muscles make breathing extremely difficult. It’s a sobering reminder that even experienced clinicians have more to learn.

Medications and Expanding Access

The two primary medications for opioid use disorder are methadone, usually dispensed through opioid treatment programs, and buprenorphine, which patients can take at home. Since methadone is only available through OTP facilities typically located in larger cities, buprenorphine has expanded access to life-saving treatment in rural areas.

In addition, naloxone (brand name Narcan) is an emergency medication that can reverse an opioid overdose within minutes.

Prior to 2023, prescribers had to complete special DEA X-waiver training to prescribe medications for opioid use disorder. That requirement was removed. Now, with eight hours of continuing education per year, prescribers are licensed to provide controlled medications. The OPSUD series meets these requirements.

Harm Reduction & NA

Medication and clinical care comprise only part of the solution. Peer support and community-based recovery play a vital role in long-term opioid addiction recovery.

For many Idahoans, Narcotics Anonymous (NA) meetings provide free, peer-led support for people struggling with narcotic addiction at every stage of recovery. NA meetings are available in communities across Idaho in-person and online.