Telemedicine along the cascade of care for substance use disorders during the COVID-19 pandemic in the United States

Temporal association of pre-pandemic perceived social support with psychological resilience and mental well-being during the COVID-19 pandemic among people with a history of injection drug use

“…This suggests an important opportunity to incorporate novel digital recovery-specific support services (e.g., smartphone applications and online social network sites) ( Ashford et al, 2020 , Bergman and Kelly, 2021 ) into future interventions designed to build social support among PWUD even beyond the context of the pandemic. On the other hand, virtual and digital social platforms are not universally accessible due to resource and technology barriers among many PWUD ( Bergman and Kelly, 2021 , Lin et al, 2023 ), emphasizing the importance of also offering in-person recovery support programs. Future programs could also explore other ways to create safe spaces for PWUD, or environments designed to allow members of minority or at-risk groups to feel comfortable being themselves and expressing their minoritized identities ( Palfrey, 2017 ).…”

Impact of VA's video telehealth tablets on substance use disorder care during the COVID-19 pandemic

“…Nonetheless, given that telehealth has been underused and understudied among patients diagnosed with SUD 4 and because prior research has pointed to a lack of access to technology and to smart devices as a prominent barrier affecting telehealth use among patients with SUD ( Lin et al, 2023 ), our findings of an average overall increase across the study period in engagement with video services and modest increases in SUD care visits across all modalities offer promising evidence of the acceptability of and engagement with telehealth use among SUD patients.…”

“…Veterans are an important at-risk population for studying SUD care, and VA studies using strong methodology can inform the current national and state policy debates about telehealth licensure laws. Given that prior research indicates patients' lack of access to technology is a prominent barrier to delivering telehealth care to patients with SUD ( Lin, Pham, Zhu, et al, 2023 ), we focused on evaluating VA's expansion of its tablet distribution program during the COVID-19 pandemic to facilitate veterans' participation in home-based telehealth ( Zulman, Wong, Slightam, et al, 2019 ). As of November 2022, there were over 132,000 VA tablets in circulation, with 81 % of all VA-issued tablets having been distributed during the pandemic.…”

Missed Opportunities: Substance Use Hotline Operator Uncertainty of State Buprenorphine Prescribing via Telemedicine

“…Roughly 1 year after the March 2020 release of DEA guidance expanding the role of telemedicine in the use of buprenorphine in the treatment of OUD, most substance use hotline operators contacted were uncertain whether their state permitted initiation or continuation of buprenorphine via telemedicine. Telemedicine proved a powerful tool for expanding access to substance use treatment during the pandemic, particularly in rural areas 9–11 . Operator uncertainty represents a critical missed opportunity to connect people actively seeking services during a time of marked increases in opioid overdose and hotline calls to safe and effective treatment known to drastically reduce opioid overdose 1,3 …”

“…The end of the Public Health State of Emergency on May 11, 2023, brought further changes to the role of telemedicine in OAT, including reinstating in-person visits for buprenorphine prescribing 8 . In the absence of clear transition plans, these changes likely prompted a new wave of treatment disruptions, especially in areas lacking in-person treatment options or with policy uncertainty, and in turn increased utilization of substance use treatment hotlines 9–11 . The aim of this study was to examine state substance use hotline operator certainty of whether practitioners in that state (each US state and Washington, DC) could initiate or continue buprenorphine treatment of OUD via telephone or video conference 1 year after the March 2020 DEA announcement.…”