Closing the distance to recovery

Executive Summary

For people living with opioid use disorder (OUD), access to treatment can depend on whether care is close enough, private enough, and flexible enough to fit into everyday life. North Carolina continues to face a substantial OUD burden while expanding treatment infrastructure and opioid-response investments. Bright Heart Health (BHH) provides OUD services through telemedicine, allowing patients to connect with care without making every treatment interaction dependent on a physical clinic visit.

This case study combines North Carolina public-health data with a de-identified BHH OUD cohort of 277 records represented in the supplied patient dataset. The BHH cohort includes patients from 70 reported counties and 150 reported cities, illustrating the geographic reach of a virtual model. Patient interviews further highlight why access matters: patients described the convenience of connecting by phone, the privacy of telehealth, supportive care teams, and the ability to fit treatment into daily life.

The North Carolina Context

SAMHSA's 2023–2024 National Survey on Drug Use and Health estimated that approximately 163,000 North Carolinians age 12 and older had opioid use disorder in the past year, representing 1.77% of that population. Among adults age 18 and older, the estimate was approximately 156,000 people, or 1.86%. These are modeled state estimates based on combined 2023–2024 NSDUH data.

The treatment-access picture is broader than prevalence alone. SAMHSA's 2024 N-SUMHSS profile reports 179 clients receiving medication for opioid use disorder (MOUD) per 100,000 population at opioid treatment program facilities in North Carolina on March 29, 2024. This figure describes clients at reporting OTP facilities on a specific reference date; it should not be interpreted as the total number of people receiving MOUD statewide.

North Carolina has also directed significant policy attention and funding toward opioid response. State appropriations have supported evidence-based OUD treatment for uninsured and underinsured residents, while the state's broader opioid-response strategy emphasizes timely access to evidence-based substance-use services, particularly in geographies with lower service penetration.

• Estimated North Carolinians age 12+ with OUD, 2023–2024: 163,000
• Estimated prevalence of OUD, age 12+: 1.77%
• Estimated North Carolinians age 18+ with OUD: 156,000
• Estimated prevalence of OUD, age 18+: 1.86%
• MOUD clients per 100,000 at NC OTPs, Mar. 29, 2024: 179
• BHH OUD records in supplied NC dataset: 277

Why Telemedicine Matters

Telemedicine does not remove every barrier to OUD treatment, but it can change the practical cost of showing up for care. A patient may not need to arrange transportation, spend additional time traveling, or enter a treatment facility for every interaction. For patients balancing work, family responsibilities, recovery, and other obligations, those differences can influence whether care is realistically sustainable.

The patient interviews supplied for this case study reinforce that point. One patient described the service as convenient because they could connect from a phone and avoid having to go out. Another emphasized that telehealth allowed care to fit alongside family life. A third focused on privacy, reduced fear of judgment, and the ability to reach the care team when questions or problems arose.

What the BHH North Carolina Data Show

The supplied dataset contains 1,147 North Carolina patient records across multiple programs. Of these, 277 records (24.1%) are categorized as OUD. Because the case study is specifically about OUD services, the analysis below focuses on those OUD records rather than combining them with other program categories.

The dataset also contains appointment and prescription fields. These are operational measures, not direct measures of clinical success. For example, the number of checked-in appointments in the last 120 days describes documented utilization during that period; it should not be used alone to conclude that a patient did or did not improve.

Geographic Reach

Patients in the OUD cohort were represented across 70 reported counties. The largest reported county concentrations were Wake (22), Cleveland (13), Cumberland (12), Catawba (10), and Gaston (10). Seven records did not contain a county value. County counts are presented to illustrate geographic reach, not to estimate county-level prevalence.

Age and Sex Distribution

The cohort is concentrated in adulthood. The largest age band is 35–44, followed by 45–54 and 25–34. Age was calculated from the supplied date-of-birth field using September 2, 2026 as the reference date; the underlying patient-level dates are not reproduced in this publication-facing case study.

Program Status and Documented Utilization

In the supplied dataset, 56 of 277 OUD records (20.2%) had at least one checked-in appointment documented in the prior 120 days, while 31 (11.2%) had four or more. These figures reflect the dataset's recorded utilization field and should not be interpreted as adherence, retention, or clinical outcome measures.

• OUD records analyzed: 277
• Reported counties represented: 70
• Reported cities represented: 150
• Female patients: 189 (68.2%)
• Male patients: 87 (31.4%)
• Active in program: 50 (18.1%)
• Not active in program: 227 (81.9%)
• OUD records with an F11 ICD-10 code present: 251 (90.6%)

What Patients Say: Access, Privacy, and Support

The accompanying patient-feedback document contains recorded interviews in which participants explicitly consented to the potential use of their words as anonymous website feedback. The quotations below are selected verbatim from those interviews and have been shortened only where needed for focus. No patient names or identifying details are used.

“I like how convenient it is, and how I can just call in from my phone, and I don't have to go out and be around other people necessarily.”

Convenience and recovery, Bright Heart Health patient

“It actually allows me to live my life.”

Family and everyday life, Bright Heart Health patient

“It's very private. Everything's telehealth, so, you don't have to worry about going out and filling judgment from an actual facility.”

Privacy and reduced judgment, Bright Heart Health patient

“It just makes it so much easier to reach out for the help because it's literally all done from your phone.”

Phone-based access, Bright Heart Health patient

“They've done a really good job just giving me the support and help that I've needed through the time that I've been needing it.”

Support, Bright Heart Health patient

“It's very, like I said, it's confidential, it's private, and it's right from your phone.”

Whole-person connection, Bright Heart Health patient

Across the interviews, the themes are consistent: patients value the ability to connect from a phone, the privacy of a virtual setting, respectful and nonjudgmental care, and support that can be incorporated into ordinary life. These statements do not prove that telemedicine produces better clinical outcomes, but they provide direct patient perspective on the access and experience dimensions of care.

Connecting the Data to the Patient Experience

The public data establish the scale of the need; the BHH data show the reach of one telemedicine program; and the interviews explain why that delivery model can matter to the people using it. North Carolina's estimated OUD population is substantial, while treatment infrastructure remains dependent on where services are located and how easily people can engage with them.

The BHH cohort's geographic distribution, 70 reported counties and 150 reported cities, illustrates one way telemedicine can extend a treatment relationship beyond a single clinic location. The interviews add the human dimension: patients repeatedly described convenience, privacy, and the ability to receive support without disrupting family and daily responsibilities.

For someone deciding whether to seek OUD care, the first barrier may not be willingness. It may be whether care can fit into the life they already have. Telemedicine can reduce some of the logistical friction between wanting help and actually accessing it.

Implications for Access

• Bring care closer without requiring every encounter to occur in a physical treatment setting.
• Reduce transportation and travel-time barriers that can make recurring treatment difficult.
• Offer a private option for people who are concerned about stigma or being recognized at a treatment facility.
• Make treatment easier to integrate with family, work, and other daily responsibilities.
• Pair convenience with reliable clinical support, clear communication, and pathways for escalation when in-person or higher-acuity services are needed.

Limitations and Privacy

This case study is descriptive, not an outcomes study. The BHH dataset is an operational patient dataset and is not a representative sample of all North Carolinians with OUD. It does not support statewide prevalence estimates, causal conclusions about telemedicine, or direct comparisons with other treatment models.

The patient quotations come from a small set of recorded interviews supplied for this case study. They are used to illustrate patient experience and are not intended to represent every BHH patient.

For publication, patient-level identifiers should remain excluded. This version does not include names, dates of birth, addresses, phone numbers, email addresses, medical record numbers, or other direct identifiers. County and other demographic information are presented only in aggregate. Final website publication should continue to follow Bright Heart Health's privacy, consent, and HIPAA review processes.