Conceptual framework for telehealth strategies to increase family involvement in treatment and recovery for youth opioid use disorder

Abstract

With opioid use at crisis levels, it is imperative to support youth ages with opioid use disorders (OUD) in taking medication and accessing behavioral services over long periods. This article presents a conceptual framework for telehealth strategies that can be adopted to increase family involvement across a four‐stage continuum of youth OUD treatment and recovery: Treatment Preparation, Treatment Initiation, Treatment Stabilization, OUD Recovery. It first identifies provider‐delivered tele‐interventions that can enhance OUD services in each of the four stages, including family outreach, family engagement, family‐focused intervention, and family‐focused recovery maintenance. It then introduces several types of direct‐to‐family tele‐supports that can be used to supplement provider‐delivered interventions. These include both synchronous tele‐supports (remote interactions that occur in real time) such as helplines, peer‐to‐peer coaching, and online support groups; and asynchronous tele‐supports (communications that occur without participants being simultaneously present) such as automated text messaging, self‐directed internet‐based courses, and digital web support.

A Qualitative Study of Patient Experiences with Telemedicine Opioid use Disorder Treatment during COVID-19

“…Some of the participants believed that the patient-provider relationship successfully translated into virtual environments and that virtual visits implied mutual trust. Videoconferencing has the additional benefit of supporting recovery by allowing access to the private home environment, leading to conversations around home life and routines for MOUD adherence 24 , 34 …”

“…Videoconferencing has the additional benefit of supporting recovery by allowing access to the private home environment, leading to conversations around home life and routines for MOUD adherence. 24,34 Ultimately, the acceptability of treatment modalities depends on the connection established between a patient and their provider in the setting in which they feel most supported and respected. While most participants indicated that virtual visits were their preferred clinical setting, others endorsed the importance of having the flexibility to choose (in-person vs. virtual).…”

Coronavirus disease pandemic and adolescent substance use

“…Telemedicine also bypasses many traditional barriers to care, including transportation, limited or constricted time due to work or childcare duties, and provider availability, and may also reduce barriers to family involvement that is often crucial for successful youth treatment [43]. However, challenges remain, including preservation of confidentiality, optimization of safety assessment, and disparities in access that may worsen inequities [41 ▪▪ ,44].…”

The comparative effectiveness of Core versus Core+Enhanced implementation strategies in a randomized controlled trial to improve substance use treatment receipt among justice-involved youth

“…This intersection of justice and health agencies is where appropriate clinical assessment and linkages to treatment services are inconsistent and fragmented at best [ 9 ]. Youth with serious SU issues are not likely to access treatment [ 10 ] and have relatively low retention after initiation, especially compared with adults [ 11 , 12 ]. Data from US samples of JJ-involved youth indicate that among youth in need of SU services, 31% receive a treatment referral, 21% initiate treatment, 10% engage for at least 6 weeks, and 6% continue in care (at least 90 days); receiving a referral significantly increases the likelihood of initiation [ 13 ].…”