Telehealth Lessened Overdose Risk Among Patients with Opioid Use Disorder

Published in JAMA Psychiatry, a recent study found that Medicare beneficiaries who engaged in opioid use disorder (OUD)-related care through telehealth during the COVID-19 pandemic experienced a lower risk of a fatal drug overdose, calling attention to the need to expand medications for OUD (MOUD).

According to the Centers for Disease Control and Prevention (CDC), the prevalence of opioid-related deaths has increased by over eight times since 1999, killing almost 69,000 in 2020.

However, federal emergency authorities activated during the COVID-19 public health emergency allowed for the expansion of telehealth for OUD, which led researchers to study how virtual care affected this issue and its prominence.

To do this, they conducted a study that considered two separate cohorts: prepandemic (September 1, 2018, to February 29, 2020) and pandemic (September 1, 2019, to February 28, 2021). The former cohort consisted of 105,162 patients and the latter consisted of 70, 479 beneficiaries. All patients considered were Medicare fee-for-service beneficiaries over the age of 18.

Researchers found that the rate of fatal drug overdoses was 5.1 per 1,000 beneficiaries in the pandemic cohort and 3.7 per 1,000 beneficiaries in the prepandemic cohort. However, following a multivariable analysis of the pandemic cohort, researchers found that OUD-related telehealth led to a lower adjusted odds ratio and a 33 percent lower risk of a fatal drug overdose.

The receipt of MOUD and buprenorphine had a similar effect. Those who received MOUD from opioid treatment programs and those who received buprenorphine in office-based settings had a 59 percent and 38 percent lower risk of a fatal drug overdose, respectively.

Based on these results, researchers were able to conclude that OUD-related telehealth services led to various benefits for Medicare beneficiaries struggling with the disease. Furthermore, researchers noted that efforts to expand MOUD and sustain care retention levels would be beneficial.

“The results of this study add to the growing research documenting the benefits of expanding the use of telehealth services for people with opioid use disorder, as well as the need to improve retention and access to medication treatment for opioid use disorder,” said lead author Christopher M. Jones, PharmD, DrPH, director of the National Center for Injury Prevention and Control at the CDC, in a press release.

“The findings from this collaborative study also highlight the importance of working across agencies to identify successful strategies to address and get ahead of the constantly evolving overdose crisis.” 

The use of telehealth to provide treatment for OUD has become common since the COVID-19 pandemic and support for the therapy has grown.

A study from the University of Michigan from August 2022 found that telehealth improved access to treatment for OUD among veterans. Researchers drew this conclusion after examining how buprenorphine access during the year before the pandemic compared to that of the first year of the pandemic. They found that the number of patients using this medication increased between the two time periods.

Additionally, they noted that although telehealth modalities varied, audio-only was the most common among the veteran population.