Telehealth for Opioid Use Disorder: One Year Retention during the US COVID-19 Pandemic

Abstract

Objective: To determine retention in care for opioid use disorder when treated solely via telehealth with a harm reduction, low-threshold model. Methods: Retrospective cohort analysis of aggregated, anonymized data from 991 patients in telehealth-based buprenorphine treatment. The cohort consisted of patients with commercial or governmental insurance who enrolled between May 17, 2019 andSeptember 28, 2021. Analysis was extended to a maximum of one year for each patient. Results: At one year, retention in care was 55% overall. When analyzed separately, retention at one year was 62% for patients with commercial insurance and 53% for those with governmental insurance. Conclusions: Telehealth-based treatment of opioid use disorder can achieve retention in care for patients—with governmental or commercial insurance—that is superior to inperson treatment as usual. Policy implications: Telehealth for opioid use disorder can be effective for patients over a range of incomes. Regulatory action allowing telehealth-only care

Characteristics of Mental Health Specialists Who Shifted Their Practice Entirely to Telemedicine

“…It is unclear how telemedicine-only clinicians will navigate new Medicare and Medicaid requirements for in-person care. While clinicians and patients may prefer in-person care, introducing in-person requirements for visits and prescribing could cause care interruptions, particularly for conditions such as opioid use disorder …”

“…While clinicians and patients may prefer in-person care, 5 introducing in-person requirements for visits and prescribing could cause care interruptions, particularly for conditions such as opioid use disorder. 6 …”

Article Commentary: Confronting COVID, Racism, and Addiction: The Association of Multidisciplinary Education and Research in Substance use and Addiction (AMERSA)

“…While some regulations around buprenorphine were lifted 4 , unchanged was the requirement for qualified providers (i.e., physicians, physician assistants, advanced practice nurses) to obtain a waiver from the Drug Enforcement Agency to be able to prescribe that medication. Activists have called for these exemptions to be sustained and expanded to permanently remove these regulatory barriers to life-saving treatment 5 – 7 and policy advocates have documented how such barriers are in conflict with principles of social justice 8 .…”