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

Huskamp, Haiden A.; Busch, Alisa B.; Souza, Jeffrey; Uscher‐Pines, Lori; Rose, Sherri; Wilcock, Andrew; Landon, Bruce E.; Mehrotra, Ateev

doi:10.1377/hlthaff.2018.05134

Cited by 132 publications

(119 citation statements)

References 10 publications

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“…Appropriate measures may include telehealth to deliver care and medication treatment for OUD patients. 11 In addition, greater emphasis may be in order on the importance of social distancing and wearing masks and following other guidelines, as recommended by the Centers for Disease Control and Prevention (CDC).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Patients with COVID-19 in the Setting of Chronic Opioid Use Disorder

Thiesset¹,

Newman²,

Tonna³

et al. 2020

Preprint

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Background: There are no known studies regarding the effects of COVID-19 in patients with a concurrent diagnosis of opioid use disorder (OUD). Due to the rapidly developing nature and consequences of this disease, it is important to identify patients at an increased risk for serious illness. The aim of this study was to understand the disease burden of COVID-19 on patients with OUD by looking at their rates of hospitalization, admission to the intensive care unit (ICU), and receipt of mechanical ventilator support.Methods: This retrospective chart review compared clinical parameters from patients with positive COVID-19 status as identified by a positive SARS-CoV-2 PCR test and diagnosed OUD at the University of Utah Health. Descriptive statistics and prevalence ratios (PRs) were generated. Log binomial models generated PRs adjusted by age, sex, race, and comorbidities of asthma, pneumonia, and diabetes.Results: COVID-19 patients with OUD were significantly more likely than patients without OUD to have asthma (p<0.01), diabetes (p<0.01), and chronic pneumonia (p<0.01), to be hospitalized (23% vs 4%; p<0.01), to be admitted to the ICU (11% vs 2%; p<0.01), and to receive mechanical ventilation (7% vs 1%; p<0.01). After adjusting for age, sex, race, asthma, pneumonia, and diabetes, patients with OUD continued to be at increased risk for inpatient hospitalization (aPR=5.65, 95% confidence interval [CI]=2.29-13.92), intensive care unit (ICU) admission (aPR=0.69, 95% CI = 0.19-2.45), and mechanical ventilation (aPR=1.25, 95% CI =0.27-5.75). Patients with OUD averaged longer stays in the hospital than those without OUD (9.53 days vs 0.70 days, p<.001).Conclusion: Patients that have a diagnosis of OUD in the presence of COVID-19 are more likely to be hospitalized, admitted to the ICU, receive mechanical ventilation and have longer hospital inpatient stays compared to patients without OUD.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Patients with COVID-19 in the Setting of Chronic Opioid Use Disorder

Thiesset¹,

Newman²,

Tonna³

et al. 2020

Preprint

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“…Awareness and motivation campaigns against excessive opioid use are carried out in written and visual media around the world. Several studies in developed countries have recently highlighted that opioid use is an important public health problem, and stated the necessity of limiting the use of opioids [22][23][24]. D.C. Buse et al assessed opioid use and dependence and found that 16.6 % of patients with chronic opioid use for migraine treatment met the dependence criteria and that these patients had more hospital admissions with more frequent recurrent complaints [25].…”

Section: Discussionmentioning

confidence: 99%

Opioids and Migraine: Opioid Awareness and Frequency of Use among Turkish Migraineurs

Ertem

Basarir

Baran

et al. 2019

Bezopasnost' i risk farmakoterapii

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Despite the inadequate evidence of effi cacy and safety of opioid use for the treatment of migraine, it has been reported that patients with moderate to severe migraine headaches are prescribed opioids. Migraineurs may experience serious health impacts from opioids such as headache-related disability, psychiatric and cardiovascular comorbidities. The reduction of the risk of opioid abuse and prevention of an opioid epidemic are important public health challenges. The aim of this study was to assess the awareness of opioid therapy for migraine and the frequency of use among Turkish patients with episodic and chronic migraine. Materials and methods: consecutive migraine patients were enrolled in this cross-sectional study. A semi-structured questionnaire was developed and used by the researchers to assess the patients’ awareness of an opiod treatment option and the frequency of use of opioids for migraine treatment. Results. One hundred two patients were enrolled, of which 72 had episodic migraine and 30 had chronic migraine. All subjects reported that they had not been offered or prescribed any kind of opioids by general practitioners and neurologists for their headache. Besides, only 7 % of patients declared that they had heard of opioid treatment for migraine but they had never consulted their doctors about its effects. Conclusions. Our fi ndings demonstrated that opioids were not preferred as an option for acute or preventive migraine treatment by Turkish migraineurs and their physicians. The reduction of opioid prescription will help to prevent the development of medication overuse and opiate-induced headaches and drug addiction.

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“…Other studies and reports concur that MOUD saves lives and prevents relapses and other negative consequences [6; 7]. The challenge now remains how to get those affected into medical and behavioural treatment programs [3,6]. Traditional paths of entry require patients to initiate or self-present for treatment to a provider or clinic.…”

Section: Introductionmentioning

confidence: 99%

Routes of non-traditional entry into buprenorphine treatment programs

Champagne‐Langabeer

Swank

Langabeer

2020

Subst Abuse Treat Prev Policy

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Background: Excessive prescribing, increased potency of opioids, and increased availability of illicit heroin and synthetic analogs such as fentanyl has resulted in an increase of overdose fatalities. Medications for opioid use disorder (MOUD) significantly reduces the risk of overdose when compared with no treatment. Although the use of buprenorphine as an agonist treatment for opioid use disorder (OUD) is growing significantly, barriers remain which can prevent or delay treatment. In this study we examine non-traditional routes which could facilitate entry into buprenorphine treatment programs. Methods: Relevant, original research publications addressing entry into buprenorphine treatment published during the years 1989-2019 were identified through PubMed, PsychInfo, PsychArticles, and Medline databases. We operationalized key terms based on three non-traditional paths: persons that entered treatment via the criminal justice system, following emergencies, and through community outreach. Results: Of 462 screened articles, twenty studies met the inclusion criteria for full review. Most studies were from the last several years, and most (65%) were from the Northeastern region of the United States. Twelve (60%) were studies suggesting that the criminal justice system could be a potentially viable entry route, both pre-release or post-incarceration. The emergency department was also found to be a cost-effective and viable route for screening and identifying individuals with OUD and linking them to buprenorphine treatment. Fewer studies have documented community outreach initiatives involving buprenorphine. Most studies were small sample size (mean = < 200) and 40% were randomized trials. Conclusions: Despite research suggesting that increasing the number of Drug Addiction Treatment Act (DATA) waived physicians who prescribe buprenorphine would help with the opioid treatment gap, little research has been conducted on routes to increase utilization of treatment. In this study, we found evidence that engaging individuals through criminal justice, emergency departments, and community outreach can serve as non-traditional treatment entry points for certain populations. Alternative routes could engage a greater number of people to initiate MOUD treatment.

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

Cited by 132 publications

References 10 publications

Outcomes of Patients with COVID-19 in the Setting of Chronic Opioid Use Disorder

Outcomes of Patients with COVID-19 in the Setting of Chronic Opioid Use Disorder

Opioids and Migraine: Opioid Awareness and Frequency of Use among Turkish Migraineurs

Routes of non-traditional entry into buprenorphine treatment programs

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