How Is Telemedicine Being Used In Opioid And Other Substance Use Disorder Treatment?

How Is Telemedicine Being Used In Opioid And Other Substance Use Disorder Treatment?

Health Aff (Millwood). 2018 Dec;37(12):1940-1947

Authors: Huskamp HA, Busch AB, Souza J, Uscher-Pines L, Rose S, Wilcock A, Landon BE, Mehrotra A

Abstract
Only a small proportion of people with a substance use disorder (SUD) receive treatment. The shortage of SUD treatment providers, particularly in rural areas, is an important driver of this treatment gap. Telemedicine could be a means of expanding access to treatment. However, several key regulatory and reimbursement barriers to greater use of telemedicine for SUD (tele-SUD) exist, and both Congress and the states are considering or have recently passed legislation to address them. To inform these efforts, we describe how tele-SUD is being used. Using claims data for 2010-17 from a large commercial insurer, we identified characteristics of tele-SUD users and examined how tele-SUD is being used in conjunction with in-person SUD care. Despite a rapid increase in tele-SUD over the study period, we found low use rates overall, particularly relative to the growth in telemental health. Tele-SUD is primarily used to complement in-person care and is disproportionately used by those with relatively severe SUD. Given the severity of the opioid epidemic, low rates of tele-SUD use represent a missed opportunity. As tele-SUD becomes more available, it will be important to monitor closely which tele-SUD delivery models are being used and their impact on access and outcomes.

PMID: 30633671 [PubMed - in process]