Evidence That Telehealth Benefits Addiction Treatment is Thin says APA Study

A new study released by an American Psychiatric Association publication finds only a slight link between telehealth and good outcomes in the addiction treatment space.

In large part, that’s because the potential evidence to consider when comparing in-person treatment to telehealth in addiction treatment is scant. The study was conducted by researchers with RTI International and UCLA.

And the fact that there is a limited body of research was noted frequently by the authors of the study.


“In contrast, there is a large research base on the effectiveness of telehealth for treating mental disorders,” the study reads. “This research showed that telehealth mental health counseling is equally as effective as in-person counseling.”

Published last week in the APA’s “Psychiatric Services,” the new study identified and examined eight already-published studies and supplemented those findings with an online survey of addiction treatment organizations in California and interviews with 30 California treatment providers and other stakeholders.

Of the eight studies, seven found that telehealth was not more effective than in-person “in terms of retention, therapeutic alliance, and substance use.” The eighth study found that telehealth facilitated methadone prescribing and improved retention.


The Covid-19 pandemic and state and federal governments’ reaction to it turned telehealth from a luxury or half-hearted obligation into a necessity almost overnight.

The study finds that about 27% of specialty addiction treatment facilities in the U.S. reported having telehealth capabilities before the pandemic. Among the California addiction providers surveyed, more than 50% of their patients were being treated via telehealth. A study previously covered by Behavioral Health Business found that psychiatrists used telehealth at the highest rate to diagnose and treat patients.

“Telehealth may help engage patients in addiction treatment by improving access and convenience,” the study reads. “Additional research is needed to confirm that benefit and to determine how best to tailor telehealth to each patient’s circumstances and with what mix of in-person and telehealth services.”

Provide sentiment revealed in the California stakeholder survey is mixed at best. The plurality of providers found that telehealth was less effective than in-person in several instances with the exception of intensive outpatient treatment, group counseling and medication management. The majority of respondents found telehealth was less effective when considering those three aspects of addiction treatment.

The largest share of respondents who believed telehealth was less effective than in-person was in group counseling: 62% said it was less effective. At the same time, 25% said it was equally or more effective while 13% were not sure.

Survey respondents were more generous in some ways about telehealth facilitating access to addiction treatment: 64% said that telehealth mitigated access barriers almost completely or moderately. The remaining 36% responded that it had helped a little, not at all or that patient attendance wasn’t affected by Covid-19 or related barriers in almost equal measure.

“Interview participants highlighted that telehealth eliminates the transportation challenges that can prevent patients from attending counseling sessions,” the study reads. “One county official observed that telehealth ‘allows access to be a little easier when people don’t have to ride a bus for two hours roundtrip to get to their appointments.’”

But the benefits of access and convenience don’t apply evenly. People in rural areas (where broadband access is limited); people whose means limit access to technology; people facing housing security or safety issues seem to not benefit from the wider adoption of telehealth.