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• Posted October 19, 2023

Telemedicine Could Improve Treatment for Opioid Use Disorder

Telehealth may be a powerful way to get people with opioid use disorder to take -- and stay on -- medication to treat their addiction.

Researchers report that those who started buprenorphine treatment via telehealth had an increased likelihood of staying in treatment longer compared to those who started the treatment in another setting.

“This study suggests that telehealth may increase treatment access and retention, strengthening the evidence that receiving addiction care through telehealth is to be safe and beneficial, and that it should be made available to those who need it,” said Dr. Nora Volkow, director of U.S. National Institute on Drug Abuse (NIDA).

“To quell the unprecedented loss of life from the overdose crisis, we must continue to prioritize both increasing access to treatment and providing the care and support people need to stay in treatment after they have started," Volkow said in an agency news release.

The research was part of the HEALing Communities Study, which is a large addiction prevention and treatment implementation study supported by NIDA.

Before 2020, people with opioid use disorder were required to meet in person with a health care provider to start buprenorphine treatment, but during the pandemic the U.S. government allowed more prescribing flexibility to improve access.

Clinicians could then prescribe the medication without examining patients in person. Payment for these appointments was also expanded.

To investigate how these policy changes affected outcomes, researchers used Medicaid data from 2019 to 2020 in Kentucky and Ohio.

Nearly 92,000 people ages 18 to 64 had a buprenorphine prescription in at least one quarter of 2020. Nearly 43,000 of those people started treatment in 2020.

Researchers also found significant increases in telemedicine delivery of buprenorphine after greater flexibility was allowed.

The research team also looked at a smaller subset of data from individuals who started treatment with buprenorphine in either the second or third quarter of 2020, including more than 9,000 people in Kentucky, and more than 12,000 people in Ohio.

In both states, starting treatment via telemedicine was associated with a greater likelihood of staying on treatment for a continuous 90 days.

In Kentucky, 48% of those who started buprenorphine treatment via telehealth remained in treatment for 90 continuous days compared to 44% whose treatment began in non-telehealth settings. In Ohio, 32% of those who started treatment during telehealth continued for 90 days compared to 28% who started in other settings.

Receiving buprenorphine treatment via telehealth was not associated with an increased likelihood of nonfatal overdose, the study found. This provided additional evidence suggesting that patients were not harmed by having increased access to buprenorphine treatment through telemedicine.

“This study shows that telehealth is another important tool for increasing access to this lifesaving medication,” said Miriam Delphin-Rittmon, assistant secretary for mental health and substance use at the U.S. Department of Health and Human Services.

Groups who were less likely to received treatment via telehealth were Black individuals, men and those who had experienced a prior overdose involving opioids.

The findings were published Oct. 18 in the journal JAMA Network Open.

Additional research is needed in areas beyond Medicaid populations in Kentucky and Ohio and in other years, the authors said.

“Our study suggests that people who have access to telehealth treatment for addiction seem to do better than those who do not. Our hope is that these findings can help inform future policy,” said study author Lindsey Hammerslag, an assistant professor at the University of Kentucky.

“In addition, the findings also emphasize that the benefits of telehealth are not reaching all populations equitably," she said in the release. "As we continue to integrate telehealth into standard care, we must also investigate and address the barriers that are preventing people from accessing this helpful and effective form of treatment for opioid use disorder.”

More information

The American Psychiatric Association has more on opioid use disorder.

SOURCE: U.S. National Institute on Drug Abuse, news release, Oct. 18, 2023