Expanding access to buprenorphine treatment in rural areas with the use of telemedicine

Abstract

Background and Objectives The opioid epidemic in the United States has resulted in a public health emergency. Medication‐assisted treatment (MAT) with methadone and buprenorphine are evidence‐based treatments for opioid use disorder. However, numerous barriers hinder access to treatment in rural areas. The use of telemedicine to deliver psychiatric services is demonstrated to be safe and effective; however, limited data exist on the novel application of telemedicine in the delivery of MAT. This report describes the results of a retrospective chart review of 177 patients in a rural drug treatment center that were treated with buprenorphine through telemedicine. Methods This study evaluated a program that began providing buprenorphine treatment to patients at a drug treatment center in rural Maryland via telemedicine in August 2015. A chart review was performed of the first 177 patients who were enrolled in the program. Data were extracted to examine retention in treatment and rates of continued opioid use. Results Retention in treatment was 98% at 1 week, 91% at 1 month, 73% at 2 months, and 57% at 3 months. Of patients still engaged in treatment at 3 months, 86% had opioid‐negative urine toxicology. Discussion and Conclusions Our findings suggest that treatment with buprenorphine can be effectively delivered by telemedicine to patients with opioid use disorders in a rural drug treatment program. Scientific Significance This use of telemedicine is a potential tool to expand medication‐assisted treatment to underserved rural populations. (Am J Addict 2018;XX:1–6)

Removing the stigma of medication for opioid use disorder

“…75,76 Evidence shows that telemedicine can be an effective method to manage buprenorphine. 77 This is especially true now during the COVID-19 pandemic. Rhode Island, for example, has developed a hotline for those wishing to start buprenorphine.…”

Reevaluating Chronic Opioid Monitoring During and After The COVID-19 Pandemic

“…This higher retention rate in patients undergoing treatment for opioid use disorder may be alluding to the social and logistical barriers patients may face while undergoing OAT that requires face-to-face interactions [ 13 , 14 ]. Furthermore, previous studies have demonstrated that telemedicine was non-inferior to in-person encounters for patients undergoing OAT, evidenced by no significant statistical differences in additional substance use or average time to abstinence [ 17 , 18 ]. Recent consensus guidelines by Shanthanna et al and Cohen et al both emphasize the use of telemedicine platforms to facilitate patient interactions for opioid therapy during social distancing restrictions in light of the COVID-19 pandemic [ 19 , 20 ].…”

TIA: a feasibility study of telemedicine in addictions

“…Telemedicine in addiction studies in the USA has shown beneficial outcomes. Telemedicine has been used for buprenorphine treatment clinically and Weintraub et al (2018) conducted a retrospective chart review of service users and found that this was effective at keeping service users within treatment at 3 months of treatment with 86.1% having opiate negative tests suggesting very good outcomes. Zheng et al (2017) conducted a similar retrospective chart review, comparing outcome measures between telemedicine and face-to-face reviews for buprenorphine treatment.…”