Telehealth's Transformative Impact on Opioid Addiction Treatment for Veterans Amid Disparities
This comprehensive research, built on the experiences of over 17,000 veterans engaged in a nationwide battle with opioid addiction, sheds light on the transformative role of telehealth.
A lifeline administered through the Veterans Health Administration, buprenorphine, a gold-standard medication for opioid use disorder, is reaching more patients due to the accessibility of virtual consultations.
However, the study also unveils a harsh reality – an uneven telehealth landscape, marked by disparities across race, age, and housing conditions.
Perhaps one of the most striking revelations is the crucial role of telephone-based care, currently teetering on the brink of discontinuation.
This modality has proven particularly beneficial for patient groups that faced significant barriers to accessing buprenorphine-based care in the pre-pandemic era, according to the study published in the esteemed JAMA Network Open.
“Retaining the option of telephone-based telehealth for buprenorphine treatment could be a game-changer for veterans who struggle to access video consultations.
This includes the elderly, the Black community, and those grappling with housing instability,” advocate Madeline Frost, Ph.D., M.P.H. from the University of Washington, the spearhead behind this thought-provoking study.
The Role of Telehealth in Enhancing Opioid Addiction Treatment
“Those grappling with opioid and other addictions already face a labyrinth of obstacles in their journey to recovery, with certain subsets experiencing further disparities. It becomes paramount, therefore, to offer a wide array of options, encompassing phone and video, to simplify the process of engaging with healthcare,” emphasizes Allison Lin, M.D., M.S., a seasoned addiction psychiatrist and the senior author of the research.
Dr. Lin, an Associate Professor of Psychiatry at the University of Michigan Medical School and a research scientist at the VA Ann Arbor Healthcare System, led the extensive data analysis of veterans prescribed buprenorphine during a year-long span that began in late March 2020.
The data paints an intriguing picture. In the cohort, 38% of the veterans leveraged at least one video consultation for their addiction care. Meanwhile, 50% had at least one phone-based consultation, with no video interactions. The remaining 12% opted for traditional in-person visits.
A significant finding from the research is the correlation between telehealth usage and treatment adherence. Patients with at least one telehealth consultation were more likely to adhere to their treatment plan, a crucial factor in diminishing the risk of relapse and overdose.
Focusing on new patients who commenced buprenorphine treatment post the onset of the pandemic, the data reveals an intriguing pattern. Treatment continuation rates were higher among those who had utilized telehealth services, with video consultations leading to higher adherence than phone-only visits.
Unmasking Disparities and Potential in Telehealth for Sustained Opioid Addiction Treatment
Those who embarked on their buprenorphine treatment journey before the pandemic, and utilized telehealth services, showed an equal likelihood of maintaining their treatment, irrespective of whether they opted for video or phone consultations.
However, the study also highlighted disparities in telehealth reach and the type of telehealth services accessed.
Younger, male, Black, and Hispanic individuals or those with specific mental health or substance use conditions were less likely to use any form of telehealth.
Among those who did telehealth services, individuals over 65, male, Black, or with unstable housing were less likely to use video consultations, leaning more towards telephone consultations.
The crux of the research suggests that both video and phone telehealth services could potentially extend the duration of patients’ engagement with care.
The authors underscore the importance of enhancing access to video-based care while supporting patients to continue treatment, regardless of the chosen modality.
Frost, a recent graduate of the Ph.D. Program in Health Services from the University of Washington Department of Health Systems and Population Health focuses her research on enhancing access to and the quality of care for substance use disorders.
Lin, a veteran of numerous studies on telehealth usage in addiction treatment, is a part of the U-M Addiction Center, the Institute for Healthcare Policy and Innovation, and the VA Center for Clinical Management Research.