A funny thing happened on the way to addiction recovery: a pandemic. The COVID-19 pandemic forced care providers to shift as much work as possible to telehealth rather than in-person visits to a treatment facility. The surprising outcome is that for some people suffering from substance use disorders, telehealth led to better results.

Those are the findings of a just-released study from Oregon Health & Science University (OHSU). The study is based on interviews with 30 people undergoing substance use disorder treatment at OHSU between March, 2020, and December, 2021. All the participants were receiving buprenorphine to help reduce symptoms of withdrawal.

Participants felt like they received more personalized care and felt a greater sense of autonomy and being trusted. Not all the feedback was positive. Some participants felt their privacy was compromised by having to talk to their medical providers within earshot of others in their environment. Also, participants were turned off by providers who did not make eye contact or try harder to make a personal connection during teleconferences.

In the midst of the pandemic, Mayo Clinic Proceedings published a survey of telehealth interventions for substance use disorders (SUDs), including recommendations for implementation. The researchers under the leadership of Dr. Tyler S. Oesterle,

Department of Psychiatry and Psychology at the Mayo Clinic in Rochester, Minnesota, cited these benefits for telehealth interventions for SUDs:

• Telehealth has been shown to improve access to care
• Telehealth improves access to care, especially for rural populations
• Telehealth interventions can produce similar results to in-person treatment
• Telehealth reduces the burden of travel
• Telehealth helps reduce the perception of stigma.

Further, telehealth achieves a higher level of satisfaction for both patients and providers. There is no doubt that it has improved access to treatment for SUDs, and there is growing evidence that when handled properly telehealth leads to improved outcomes for patients trying to recover. 

The researchers note that “regulatory barriers have been one of the biggest hindrances so far” to the growth of telehealth interventions for SUDs, “including insurance reimbursement and state licensure requirements.” Since this study was published in 2020, many states and the federal government have loosened restrictions on who can write prescriptions for buprenorphine and other addiction treatments.

The Mayo Clinic researchers provide some helpful guidelines for telehealth services best practices. These include:

• Conduct sessions over a reliable, high-speed connection
• Establish that the patient is in a private setting
• Provide a backup mode of communicating in case of difficulties
• Maintain a clean and professional visible workspace
• Always position the camera at eye level
• Work to maintain a positive attitude throughout the conference

The researchers also provide a lengthy assessment checklist for an addiction-focused telehealth intake session. While they still say that in-person visits with medical providers are “the gold standard” of care for SUDs, they also see telehealth interventions as making good care more widely available, and allowing the customer to choose:

Some patients may benefit tremendously by coming to the clinic, meeting with the counseling staff, sharing experiences with other patients in treatments, taking medication-assisted treatments, giving a urine test, and getting encouragement and feedback, whereas other patients may appreciate the convenience of virtual options.

Written by Steve O’Keefe. First published July 10, 2024.

Sources:

“OHSU study: Telehealth builds autonomy, trust in treating addiction,” OHSU News, July 8, 2024.

“Substance Use Disorders and Telehealth in the COVID-19 Pandemic Era: A New Outlook,” Mayo Clinic Proceedings, December 2020.

“Telemedicine-delivered treatment interventions for substance use disorders: A systematic review,” Journal of Substance Abuse Treatment, June 2019.

Image courtesy Wikimedia Commons, used under Creative Commons license.