Despite Room for Improvement, Telehealth Assists Incarcerated Patients

A report from the Bureau of Justice Assistance (BJA) described the various state-level efforts to expand access to telehealth that benefited justice-involved and incarcerated patients with substance use disorders (SUDs) throughout the pandemic, along with the lessons to guide future use.

During the COVID-19 pandemic, people with SUDs experienced many adverse outcomes, including healthcare access barriers along with buying drugs off the street and using them alone. According to the report, overdose deaths were a contributing factor to over 100,000 deaths in the 12 months prior to April 2021.

On top of this, justice-involved individuals often battle these conditions and struggle to access care. However, research indicates that telehealth can benefit this population by mitigating stigma, increasing safety, and reducing costs.

To address these issues, federal and state governments took action to remove telehealth access barriers and support those with SUDs.

New Mexico, for example, authorized intensive outpatient (IOP) services to be provided through telehealth during the pandemic. After observing that the number of patients accessing IOP services increased by 14 percent in 2020 compared to 2018, the state deemed this change successful.

Other state-level changes were specifically directed toward increasing SUD treatment access within correctional facilities.

In Virginia, the Department of Corrections used mobile equipment to increase telehealth access. This led to a reduction in external transfers while allowing providers and nurses to remotely care for patients free of virus exposure.

Many targeted pilot programs also aimed to enhance treatment for justice-involved individuals.

The Department of Public Safety, UNC Health, and the University of North Carolina School of Medicine added a telehealth program for incarcerated patients. Following implementation, 94 percent of participants reported a positive experience with the program.

Among states that used telehealth to treat justice-involved patients, various benefits were observed. These included lower costs, fewer racial barriers, higher attendance, and more flexibility, among others.

Meanwhile, several takeaways also emerged from these experiences. Governments learned the importance of ensuring access to evidence-based medication and treatment as well as the vital bond between justice systems and health partners. Developing tailored treatment plans, lowering treatment barriers following release, staff training, and program evaluation plans were also noted as necessary for the future.

Based on these lessons, the report detailed various considerations for future telehealth use in treating justice-involved populations. These included the provision of general support for telehealth, enhancing the collaboration between justice systems and health officials, and sustaining the availability of treatment options. Others included investing in telehealth infrastructure, ensuring the efficacy of technologies used, and evaluating performance.

Lawmakers are increasingly weighing changes in regulation to support the use of telehealth in treating SUDs.

In December 2022, the US Department of Health and Human Services (HHS) proposed updates to federal regulations to allow the use of telehealth in treating opioid use disorder (OUD).

The proposal details updates to federal regulations encompassing OUD treatment standards as an aspect of the HHS Overdose Prevention Strategy. Updates include allowing Americans to receive 14-to-28 days’ worth of methadone to take home and letting providers initiate buprenorphine prescriptions through telehealth.