A missed opportunity: Telemedicine use for treating substance use disorder remains low, despite unmet need
Despite the enormous unmet need for treatment of substance use disorders and the promise of telemedicine to fill some of the gaps in care, the tool remains woefully underused, according to research led by investigators from the Blavatnik Institute at Harvard Medical School.
The study, published in the December issue of Health Affairs, analyzed patterns of telemedicine use and showed that overall use remains low despite some increase in the use of this tool.
In what is thought to be the first study of telemedicine for the treatment of substance use disorder, the researchers used insurance claims from 2010 to 2017 to identify characteristics of telehealth users and patterns of use.
Specifically, the analysis showed that the rate of telehealth visits for substance use disorder increased quickly during the study period: from 0.62 visits per 1,000 diagnosed (97 visits) in 2010 to 3.05 visits per 1,000 diagnosed (1,989 visits) in 2017. Despite this increase, telehealth visits for substance use disorder remained dismally low, representing just 1.4% of telehealth visits for any health condition. The number of telehealth visits for substance use disorder accounted for only 0.1% of all substance use disorder visits.
Approximately 21 million Americans have a substance use disorder related to alcohol, opioids or other drugs, according to the 2016 National Survey on Drug Use and Health. Deaths from opioid overdose nearly quadrupled from 1999 to 2016, according to the U.S. Centers for Disease Control. There are several treatment options for substance use disorder, including medications and psychotherapy or counseling, but fewer than one in five people struggling with the disorder receive treatment, the researchers said.
Experts have deemed telemedicine to be one way to improve access to substance use disorder treatment, particularly for people in remote and underserved communities. While telehealth is not a substitute for in-person care, its use could increase treatment engagement and outcomes by helping patients overcome transportation, distance or stigma barriers to treatment for substance use disorders, the study authors said.
The study also showed significant geographic variation in use of telemedicine for substance use disorder. While per capita rates of telehealth for substance use disorder treatment were higher among rural residents, the vast majority of people receiving telecare were in urban areas. Targeted interventions to increase access to telehealth in rural areas are needed to address the significant unmet need for substance use disorder treatment options outside urban areas, the researchers noted.
