Combining telehealth with opioid use disorder (OUD) treatment leads to lower odds of death by overdose.

That’s according to a new study from three federal agencies on the expanded use of telehealth and other regulatory flexibilities during the coronavirus public health emergency (PHE) to treat OUD. Telehealth coupled with OUD treatment led to a 33% reduction in the likelihood of fatal overdose, the study states.

“The results of this study add to the growing research documenting the benefits of expanding the use of telehealth services for people with opioid use disorder, as well as the need to improve retention and access to medication treatment for opioid use disorder,” Christopher Jones, the lead author of the study, said in a news release. “The findings from this collaborative study also highlight the importance of working across agencies to identify successful strategies to address and get ahead of the constantly evolving overdose crisis.”

Jones is also the director of the National Center for Injury Prevention and Control, a part of the federal Centers for Disease Control and Prevention.

However, the same study found that telehealth-backed treatment did not reduce the likelihood of fatal opioid overdoses on par with traditional care settings.

The study, published in JAMA Psychiatry, found that treatment provided through federally qualified opioid treatment programs (OTP) saw 59% lower odds of fatal overdose. It also found the use of buprenorphine in office-based settings was associated with a 38% lower likelihood of fatal overdose.

The study compared the outcomes of Medicare beneficiaries before and during the pandemic under the regulatory flexibility the PHE offered. These flexibilities extended to OTPs and take-home doses of methadone, the most highly controlled medication used to treat MAT, as well as prescribing of buprenorphine. The two cohorts totaled over 175,000 combined.

The two other agencies involved with the study were the National Institute on Drug Abuse (NIDA) and the Centers for Medicare & Medicaid Services (CMS).

“This study shows that many beneficiaries were able to utilize opioid use disorder-related telehealth services during the pandemic, but we need to continue our efforts to broaden the use of telehealth, particularly in underserved communities,” Dr. Shari Ling, deputy chief medical officer at CMS, said in the release.

The reach of telehealth to treat OUD was limited; only 1 in 5 Medicare beneficiaries in the pandemic-era cohort received these services. Meanwhile, only 1 in 8 received medication for OUD.

Overall, the death rate among the pandemic cohort was higher than the pre-pandemic cohort. However, the death rate related to drug overdose remained similar over time.

“At a time when more than 100,000 Americans are now dying annually from a drug overdose, the need to expand equitable access to lifesaving treatment, including medications for opioid use disorder, has never been greater,” Dr. Wilson Compton, deputy director of NIDA and the study’s senior author, said in the release.

The use of telehealth in prescribing controlled substances such as buprenorphine may be severely limited should proposed rules from the Drug Enforcement Administration come into effect. Public comments on the proposals are overwhelmingly negative.