By Rachel Crumpler
NC Health News
In 2024, more than 3,000 North Carolinians are estimated to have died from opioid overdose. Since 2000, more than 41,500 people have died from overdoses.
Even as the overdose death rate slowed slightly in the past year, state health officials are still looking for ways to expand access to medications for opioid use disorder.
To reach more people in need of this treatment — and to enter areas of North Carolina that have lacked access — state leaders are turning to a new approach: mobile clinics.
Operating as licensed extensions of existing brick-and-mortar opioid treatment programs, the mobile units can bring medications for opioid use disorder directly to communities — especially in rural and underserved areas where stigma, transportation barriers and lack of providers have stymied people’s ability to get care.
The U.S. Food and Drug Administration has approved three medications to treat opioid use disorder: buprenorphine, methadone and naltrexone. These medications help reduce cravings that people have for drugs and lower the risk of overdose, especially when paired with counseling. But only a fraction of people with opioid use disorder — in North Carolina and across the United States — receive the medications, which are widely considered the best way to address opioid addiction.
Mobile clinics are emerging as a key strategy to help close access gaps across the state.
The state’s first mobile clinic, operated by Morse Clinics, started serving patients in Raleigh in July. The milestone was marked by an Aug. 19 ribbon-cutting ceremony attended by state officials, health providers, people in recovery and first lady Anna Stein, who has identified reducing stigma faced by people with substance use disorders as one of three priority issues she’d like to tackle during her husband’s administration.
“Mobile units are an important step to filling unmet needs in our state,” Stein said at the event, noting that they can especially help serve harder to access populations, such as people living in rural areas, shelters or jails.
A second mobile unit run by New Season, a national addiction treatment provider with nine clinics in North Carolina, will start serving people in and around Greensboro in the coming weeks.
More are on the way. As many as 10 mobile units could be up and running across North Carolina in the coming months, said Anna Stanley, who oversees North Carolina’s programs that provide medications for opioid use disorder across the state.
Six units are being funded by $3.75 million that the N.C. Department of Health and Human Services received after Hurricane Helene and subsequently provided to Vaya Health, the regional behavioral health care organization that serves western and central North Carolina.
“This mobile OTP [Opioid Treatment Program] right here is symbolic of our commitment to end that stigma in North Carolina by bringing treatment directly to people where they live, work and where they feel safe,” Stanley said at the Sept. 10 ribbon-cutting event for the Greensboro mobile unit.
“Mobile units are super exciting because there is the opportunity for them to move and figure out where the need is,” she said.
Addressing unmet need
An estimated one in six North Carolinians has a substance use disorder, yet fewer than half of them receive any form of treatment, said Kelly Crosbie, director of the state’s Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Use Services. Even fewer, she said, get medications for opioid use disorder.
State data show an estimated 231,000 North Carolinians older than 12 struggle with opioid use disorder and could benefit from medication-based treatment.
“Methadone and other medications for opioid use disorder save lives,” Crosbie said. “They help people maintain long-term recovery to have the lives they were meant to have.”
Individual physicians can prescribe buprenorphine and naltrexone from their offices, but methadone — a critical option for many — is only available at the state’s 96 Opioid Treatment Programs, which offer access to all three FDA-approved medications. These programs are state and federally licensed to provide the medications and other support for treatment and recovery, including counseling, case management and peer support services.
But the treatment programs operate in just 55 of North Carolina’s 100 counties, leaving gaps in access and forcing many patients to travel long distances for care.
A DHHS spokesperson told NC Health News in July that 24,712 people from all 100 counties are enrolled at one of the state’s Opioid Treatment Programs. In 2024, these clinics served 31,641 patients, and they’re on track to serve an even greater number this year.
State health officials see mobile units as key in getting to the goal of having at least one Opioid Treatment Program in every county.
“[Mobile units] help us reach people who have been historically underserved — our folks that live in rural areas, or folks who do not have access to transportation, or just those who wouldn’t feel safe walking into a traditional OTP clinic,” Stanley said.
Nothing to be ashamed of
Mobile units help break down barriers to treatment, said Jim Shaheen, chief executive officer of New Season, the company operating North Carolina’s second mobile unit. He said he’s seen a positive impact from New Season’s first mobile clinic in Portland, Oregon, which launched last September — and he expects the same with this latest mobile unit.
At New Season’s Greensboro brick-and-mortar clinic, some patients travel 45 minutes or more for care, he said. Neighboring Alamance County lacks an Opioid Treatment Program altogether, leaving what Shaheen says is a clear unmet need.
“There’s a whole population of people who are not getting care at all,” Shaheen said. “And there is a whole population of people that we see in the clinic that are absent a lot, and the reason they’re absent is transportation.”
One of the mobile unit’s first stops will be at Bethel African Methodist Episcopal Church in Greensboro near North Carolina A&T University. Senior Pastor Clay Barrow said he was immediately on board with offering the church’s parking lot as a regular stop for the mobile clinic — and to help send the message that seeking treatment for addiction is nothing to be ashamed of.
“It’s an opportunity for the community to experience hope like it’s never experienced before and to experience healing like they’ve never experienced before,” Barrow said. “If all it takes is just to open up a parking lot and give folks a safe space — a safe harbor where they can come, receive medication, receive treatment — then that is what we need to do.”
Shaheen said the mobile unit could serve more than 100 people within its first 90 days. Patients served by the mobile unit will have access to the same care offered at a brick-and-mortar clinic, he said. It is equipped to start and continue people on medications for opioid use disorder, provide counseling and perform drug screens.
Eric Morse, chief medical officer at Morse Clinics, which operates the state’s first mobile clinic, said the response so far has been positive. Parked outside Healing Transitions’ men’s campus in Raleigh, a nonprofit that provides peer-based recovery services, the unit has already dispensed medications for opioid use disorder to 84 people since its launch on July 7, Morse said. Of those, 65 patients are still receiving treatment at the mobile unit, Morse said, while 19 have transferred to other Opioid Treatment Programs.
The van provides added convenience for Healing Transitions’ program participants, who can now access medications for opioid use disorder without leaving the property — a change that Matthew Collins, lead peer support for the men’s unit at Healing Transitions, said he thinks will lead to higher treatment retention rates.
The van also serves people not enrolled in a Healing Transitions program; anyone in the area seeking medications for opioid use disorder can get help there.
Morse has another mobile unit in the works that will serve Granville and Franklin counties — areas that currently lack an Opioid Treatment Program.
“I’m really excited about making it easier for our patients,” Morse said. “I want everybody who has opioid use disorder to be able to get this life-saving medication.”
Mobile units are less cost-prohibitive than building a brick-and-mortar clinic, Shaheen said. Plus, he explained, though some areas of the state don’t have patient volumes to sustain a building, they nonetheless have people in need of medications for opioid use disorder that could be well-served by a mobile unit.
Going mobile
While mobile opioid treatment programs are new to North Carolina, they date back to the 1980s.
The U.S. Drug Enforcement Administration approved the first mobile clinic in 1988, with the goal of increasing access to methadone treatment — particularly in rural areas. But in 2007, the agency issued a moratorium on approving new mobile units because of concerns about people stealing and misusing the drug.
In 2021, the DEA started approving new mobile units once again, citing the need to reduce overdose deaths amid the opioid epidemic by increasing access to programs.
Since then, the number of mobile units has steadily increased. In August 2022, eight mobile medication clinics operated in six states, according to a U.S. Department of Health and Human Services report on mobile medication units published in January 2025. By September 2024, that had ballooned to 54 mobile units across 17 states — and the total is continuing to grow.
Greensboro-based Mission Mobile Medical is the top provider of mobile opioid treatment units in the United States. Jacki Giarratano, the company’s director of behavioral health, said there are now 73 Drug Enforcement Agency-approved mobile units operating across the county, and more than 40 have been outfitted by Mission Mobile Medical.
“The opportunity to open doors into communities, to truly meet people where they are — mobile does that,” Giarratano said.
North Carolina leaders saw the potential of mobile units and went to work to make them possible, including by changing state regulations.
“This is a big deal,” Crosbie said, speaking at the Sept. 10 ribbon-cutting ceremony for the Greensboro mobile clinic. “The fact that this is our second truck in North Carolina, and that so many people are going to get life-saving medication, is absolutely incredible.”
Combatting stigma
Even as mobile units expand access to medications for opioid use disorder, state officials and health providers say stigma is still one of the biggest barriers preventing people from getting addiction treatment.
Despite research showing that medications for opioid use disorder are highly effective, their use is often met with judgment because some people consider them “substituting one drug for another” and lack understanding of how they help in recovery.
Crosbie said taking medications for opioid use disorder should be thought of like any other medication prescribed for a health condition, such as depression or diabetes. But a May 2025 statewide survey found that only one in five adults in North Carolina recognizes that opioid use disorder is a medical condition, she said.
The same survey found that 57 percent of North Carolinians know someone with opioid use disorder. Despite this prevalence, only 34 percent of North Carolina residents said they know how to find quality treatment for themselves or their loved ones. And 35 percent of people said abstinence is the only acceptable form of treatment.
To change those perceptions, state leaders launched a statewide campaign called Unshame NC in July to combat stigma related to substance use.
“We need more access to medications for opioid use disorder across the state — and we need a whole lot less stigma,” Crosbie said during the unveiling of the first mobile unit in Raleigh.
Morse said he believes the mobile units can be a part of that change.
“I think every time this van moves, every mile it takes, it reduces stigma,” Morse said. “It’s like a really expensive, mobile billboard … It has a lot of purpose behind it. We want to make it easier for you to get on this mobile unit and not feel like you shouldn’t.”
