A lifeline on wheels: perspectives of stakeholders on the implementation and impact of a mobile medications for opioid use disorder unit

INTRODUCTION: Mobile health units (MHUs) providing medications for opioid use disorder (MOUD) have emerged as a critical strategy to address gaps in opioid treatment access, particularly for marginalized populations. Research has yet to explore stakeholder perspectives on MHUs' implementation, challenges, and long-term sustainability. METHODS: We conducted semi-structured interviews with 15 stakeholders, including MHU staff, administrators, community partners, and policymakers. Interviews explored experiences with the MHU, barriers and facilitators to patient engagement, and operational challenges. Data were transcribed, coded, and analyzed using a template thematic approach to identify key themes related to implementation and sustainability. RESULTS: Stakeholders endorsed the MHU as a highly accessible and flexible intervention that reduces barriers for people experiencing homelessness, economic instability, and transportation limitations. The MHU facilitated strong patient-provider relationships and access to harm reduction, primary care, and social services. Challenges included staffing shortages, inconsistent funding, limited clinical space, and environmental barriers. Additionally, stigma, political resistance, and law enforcement interactions affected service delivery and patient engagement. DISCUSSION: Findings highlight the importance of policy and funding mechanisms to ensure the long-term viability of MHUs. Stakeholders recommended expanding outreach, increasing staffing, and integrating additional services. Addressing these challenges is essential to sustaining MHUs as an effective public health intervention for opioid use disorder.