During the COVID-19 pandemic, there was a significant increase in fatal drug overdoses. Yet pandemic-era policies led to better retention rates for opioid use disorder (OUD).
That’s according to a recent study — supported by the National Institutes of Health (NIH) and the Substance Abuse and Mental Health Services Administration (SAMHSA) — that found that telehealth intake for buprenorphine treatment increases the odds that a patient sticks with treatment.
The study analyzed Medicaid claims and enrollment data from Nov. 1, 2019, to Dec. 31, 2020, among people aged 18 to 64 years from Kentucky and Ohio, to determine whether telehealth intake impacted treatment retention or rates of opioid-related nonfatal overdose during the COVID-19 pandemic.
Retention improved with telemedicine, which the researchers correlate with more permissive telehealth regulations associated with the pandemic.
“These results offer important insights for states with a high burden of OUD looking to policies and methods to reduce barriers to treatment,” the study’s authors wrote. “This finding may be especially valuable for improving [Medications for Opioid Use Disorder] MOUD access in states such as Kentucky, which has historically had restrictive buprenorphine access policies and restrictive methadone regulations, as well as a large rural population.”
Researchers found that factors including rural status, such as race and ethnicity, sex, age and opioid-related overdose history impacted retention rates. For example, non-Hispanic Black people were less likely to stick with treatment for at least 90 days compared to non-Hispanic white people.
Researchers sought to determine if telemedicine improved rates of opioid-related nonfatal overdose but did not find an association. Other demographic factors, including age, sex, rural status and opioid-related overdose history, impacted rates of opioid-related nonfatal overdoses.
The study was limited to analyzing only medically treated overdoses, so the study may not have had the power to detect an association between telehealth and overdose, given that there were few overdoses in the sampled data.
Study authors noted that additional research is needed to determine if the study’s findings will be applicable in later years.
The study’s findings align with previous research that suggests that the use of telemedicine can improve retention rates for treating alcohol use disorder (AUD) and opioid use disorder (OUD).
“Although telemedicine visits may be more convenient, bypassing the need to take time off or find transportation to receive treatment, payers are reluctant to provide parity if telemedicine is viewed as inferior to in-person care or is associated with potential harms,” the authors wrote. “Our findings provide some support for parity requirements by demonstrating that telemedicine was associated with improved access and improved treatment retention.”
This study’s results were published shortly after the DEA extended COVID-19-era telehealth flexibilities for another year.
