Medications such as methadone, buprenorphine, and naltrexone can be highly effective for treating opioid use disorder. But these are heavily regulated in the United States, which can impede their use.
During the COVID-19 pandemic, health agencies used emergency authorities to allow opioid treatment programs to provide care via telehealth and to remotely prescribe medications for opioid use disorder. Knowing whether patients benefited from these changes could affect whether they will remain in place. But studies addressing this question have thus far been limited in scope.
A team of NIH and other federal researchers examined telehealth use, treatment engagement, and overdoses under the emergency authorities. To do so, they studied data for two groups of Medicare beneficiaries treated for opioid use disorder. One was followed from September 2018 to February 2020, before the COVID-19 pandemic. The other was followed during the pandemic, from September 2019 to February 2021. Data from more than 175,000 people were included. The results appeared in JAMA Psychiatry on August 31, 2022.
The team found that about 69% of the people in the pandemic group received any telehealth service. About 20% of the group received telehealth service for opioid use disorder. By contrast, less than 3% of the pre-pandemic group received any telehealth service, and less than 1% received opioid use disorder-related telehealth. A greater share of the pandemic group also received medications for opioid use disorder treatment.
The researchers looked at how well the people receiving medications continued their treatment. They found that those who received telehealth service were more likely to keep getting their medications. Importantly, those receiving telehealth service also had a lower risk of overdose.
The results show benefits from expanded access to telehealth and medications for opioid use disorder. They support keeping expanded access to these services after the pandemic ends.
“The expansion of telehealth services for people with substance use disorders during the pandemic has helped to address barriers to accessing medical care for addiction throughout the country that have long existed,” says senior author Dr. Wilson Compton, Deputy Director of NIH’s National Institutes on Drug Abuse (NIDA). “Telehealth is a valuable service and, when coupled with medications for opioid use disorder, can be lifesaving.”