Key Takeaway:
- NC STAR Network expands opioid addiction treatment by training primary care providers to deliver evidence-based care across North Carolina.
- The hub-and-spoke model now reaches 88 counties, improving access to medications for opioid use disorder, especially in rural communities.
- Providers say integrating addiction treatment into primary care reduces stigma, strengthens patient trust and supports better long-term health outcomes.
North Carolina’s NC STAR Network is expanding access to opioid addiction treatment by training primary care providers to deliver medication-assisted care through a hub-and-spoke model that now reaches 88 of the state’s 100 counties.
NC STAR Network Brings Addiction Care Into Primary Care
The NC STAR Network is broadening access to medications for opioid use disorder, or MOUD, by supporting primary care clinics across North Carolina. The initiative follows a 2023 federal policy change that removed special certification requirements for prescribing buprenorphine, a widely recognized treatment for opioid use disorder.
The network is led by the University of North Carolina at Chapel Hill, East Carolina University, and the Mountain Area Health Education Center. The academic institutions provide training, specialist support, and consultation to community health providers throughout the state.
“Addiction is the absolute essence of primary care,” said Claire West, director of the NC STAR Network. She said treating substance use disorder alongside other chronic conditions allows providers to deliver whole-person care.
Network Expands Access Across Rural Communities
The hub-and-spoke model, adapted from Vermont’s approach to opioid treatment, emphasizes collaboration between academic medical centers and community clinics. Gabriela Castro, a family medicine physician and the network’s data team lead, said communication flows in both directions, allowing providers to adapt care to local needs.
The network now serves 88 of North Carolina’s 100 counties. Between July 2024 and June 2025, academic hubs treated about 1,400 patients with MOUD, while participating community sites reported serving more than 4,000 patients.
The Foundation for Opioid Response Efforts supports the initiative through its Rural Health Transformation Program. Foundation President Karen Scott said the model offers multiple entry points for care through local health departments, federally qualified health centers, academic medical centers and rural clinics, making specialist expertise available to providers statewide.
Providers Say Model Reduces Stigma And Improves Care
Network leaders say delivering addiction treatment in familiar primary care settings helps reduce stigma and improve patient engagement. Castro said patients often feel more comfortable receiving treatment from clinicians they already know.
“Any door should be the right door when somebody wants treatment,” Castro said.
West said integrating addiction treatment into routine primary care also allows physicians to address related health needs, including HIV prevention, hepatitis screening, and housing challenges that affect recovery.
Rural providers say the approach is especially valuable where access to specialty addiction services remains limited. Zach White, opioid dependence treatment program coordinator at MAHEC, said many patients seeking treatment have not received routine medical care for years.
Foundation program director Ken Shatzkes said the NC STAR Network could serve as a model for other states investing federal rural health funding, even if their proposals do not explicitly adopt a hub-and-spoke structure.
Sandy Thomas-Montilus, a physician and community partner in the network, said stigma within the medical profession remains a barrier to expanding addiction care. She urged health care providers to take greater responsibility for addressing the opioid crisis through evidence-based treatment.
Medical Director Holly Warren, who now focuses on addiction medicine after years in primary care, said providing MOUD has reinforced her commitment to patient-centered care.
“It’s really rewarding to see people heal and recover from a chronic illness,” Warren said.
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