Telehealth Expansion Linked to Drop in Opioid Overdose Risk During Pandemic

The expansion of telehealth during the COVID-19 pandemic was associated with an increase in the use of medications for opioid use disorder (OUD) treatment and a reduction in the odds of medically treated overdoses, according to a new study.

Published in JAMA Psychiatry, the study includes data from the Centers for Medicare & Medicaid Services. The data encompasses information on demographics, medical and substance use, and psychiatric comorbidities of adult Medicare fee-for-service beneficiaries with OUD. The data was divided into two periods: before the COVID-19 pandemic (from September 2018 to February 2020) and during the pandemic (from September 2019 to February 2021).

The pre-pandemic cohort comprised 105,240 beneficiaries, while the pandemic cohort included 70,538 beneficiaries.

A larger percentage of beneficiaries in the pandemic cohort received OUD-and behavioral health-related telehealth services, as well as medications for OUD, such as methadone, buprenorphine, and extended-release naltrexone, as compared to the pre-pandemic group.

The percentage of OUD patients experiencing a medically treated overdose was similar in the pre-pandemic cohort (18.5 percent) and the pandemic cohort (18.4 percent).

But, in the pandemic group, receiving OUD-related telehealth services was linked to increased odds of retaining patients in programs providing medications for OUD and to a lower likelihood of medically treated overdoses in this group.

It is also important to note the prevalence of health inequities in virtually enabled OUD care. Researchers found that Black people had lower odds of receiving OUD-or behavioral health-related telehealth services and lower odds of continuing to take medications for OUD. They also observed higher odds of medically treated overdoses among Black, American Indian or Alaska Native, and Asian or Pacific Islander populations.

Still, the American Telemedicine Association (ATA) hailed the study as another example of the benefits of telehealth.

"Today, we were heartened to read the significant results from this important study, demonstrating the positive impact telehealth can have on treating individuals with substance abuse disorder," said Kyle Zebley, senior vice president, public policy at the ATA, in a press release shared with mHealthIntelligence.

Zebley also noted that the study makes a strong case for permanently eliminating the Ryan Haight Act of 2008, which states that any healthcare practitioner prescribing a controlled substance must first conduct an in-person evaluation.

"We hope this sends a strong signal to policymakers that telehealth can and should be a permanent part of healthcare delivery, to effectively and safely address critical needs of patients and individuals whenever and wherever they need it most. This study is further proof that President Biden's administration should work with Congress to make permanent the current Ryan Haight in-person waiver for the remote prescription of clinically appropriate controlled substances," added Zebley, who is also executive director of the association's advocacy arm, ATA Action.

The new research adds to a growing body of evidence showing how virtual care options helped expand OUD treatment access.

For example, a study published earlier this month showed that audio-and video-based care modalities bolstered veterans' access to opioid use disorder treatment, including increased access to buprenorphine.