Escalating prescription opioid use and abuse have emerged as major public health problems in Washington. Rural communities in particular have been hit hard due to their limited access to specialists. This project allows mental health specialists in urban areas to support health care providers in rural areas using videoconferencing technology. Patient evaluations and recommendations, caseload supervision, and education are all done remotely via telehealth. This project aims to establish acceptance, effectiveness, and cost-efficacy of telehealth for delivery of mental health and pain medicine care in rural primary care.