Coronavirus Crisis Spurs To Online Treatment for Opioid Addiction

The ongoing coronavirus pandemic has affected various aspects of life in the . People with substance use disorder (SUD) already face obstacles to receiving treatment.

Certainly, safety precautions such as social distancing and self-quarantine are necessary strategies to slow down and stop the spread of COVID-19. But for people struggling with addiction, these are great inconveniences.

The inability to get the necessary types of addiction treatment services is a risk factor for relapse. Access to strictly regulated but crucial medications, such as methadone and buprenorphine, is impeded. Their use for opioid withdrawal management is mandatory. Abrupt cessation of opioids may lead to strong cravings, and/or acute withdrawal syndrome which can end up with relapse, overdose, and death.

In times of COVID-19 / coronavirus, the US simplifies the system of access to addiction treatment medicine. There’s a federal law that states clearly that an individual has to consult with a physician in-person before receiving a prescription for pharmaceutical drugs. This law is temporarily waived. Currently, patients can do these via video conferencing.

Medical specialists have been urging for reforms in drug addiction treatment for years. They emphasize the importance of improving access for patients in those parts of the U.S. that are understaffed with doctors eligible to prescribe controlled medications.

According to a recent report by the U.S. Department of Health and Human Services, 40 percent of the counties in the U.S. don’t have a single healthcare provider with a waiver permitting them to prescribe buprenorphine in an office setting. Even more concerning, waivered providers are absent in some areas with high treatment needs.

President Trump signed the “Special Registration for Telemedicine Act of 2018” into law. The Drug Enforcement Administration was required to expand physicians’ and nurse practitioners’ ability to prescribe controlled substances via telemedicine, without an in-person examination. But regulations remained on the paper until now.

Dr. David Kan, a medical director of Bright Heart Health, Walnut Creek, California, wishes there were other circumstances to provoke these changes besides a coronavirus pandemic. Bright Heart has recently begun collaborating with healthcare providers and insurers to help people receive substance abuse treatment and therapies while staying at their homes. Kan hopes that the growth of virtual treatment won’t slow down after the period of national emergency.

An addiction specialist Dr. Miriam Komaromy defines two aspects in determining the effectiveness of virtual care:

  1. whether it allows reaching the same degree of patient’s engagement in healthcare;
  2. whether it is possible to assess the patient’s honesty and desire to recover over a camera.

Some experts don’t see much difference between in-person and virtual care. Dr. Alyson Smith, an addiction medicine expert in Boulder Care, says it’s quite possible to evaluate a physical and emotional health of the patient via a video screen. She can recognize the signs of drug withdrawal (like pupil dilation), ask them about their feelings, and diagnose them just like in the office.

Dr. Dawn Abriel from Bright Heart finds one benefit in distant consultation. He thinks that people are more sincere with the doctor when they don’t have to leave their comfort zone and may stay at home during consultations. Abriel says that he can draw a lot of information about a patient from the real-time video by interpreting their body language.

A vice president of Premera (belongs to Blue Cross Blue Shield Association), Rick Abbott, thinks that telemedicine is an ideal option for people who keep their substance use in secret and want to undergo a treatment program discreetly.

A 2018 study found out that after one year of treatment, adults with OUD who participated in telehealth-delivered opioid therapy were more willing to continue treatment than those who received in-person opioid treatment.

Bright Heart Health officials report that 90% of their patients remain engaged in a treatment program after 3 months, which is way higher than with traditional SUD treatment. The explanation is simple – it’s convenient.

Nathan Post was a Bright Heart Health’s patient. He used their online addiction medical services in 2018.

Addicts often make up different excuses not to visit scheduled meetings. But it is easy when all you may stay at home and just need to turn on your computer. Nathan didn’t have any reasons “to blow it off”.

Telemedicine has its disadvantages. Komaromy says that telemedicine can’t replace intensive residential care. Also, some addicts may lack Internet access.

Nevertheless, telemedicine is predicted to grow due to the incredible need to increase the availability of SUD counseling. Telemedicine gives new opportunities. For example, Premera (belongs to Blue Cross Blue Shield Association) provides addiction treatment to the citizens of rural Alaska.

Highmark, another Blue Cross Blue Shield company, provides virtual treatment for substance abuse in West Virginia, the state with the country’s highest death rate from opioid addiction. The company’s representatives say that because of a small number of health providers, especially in rural areas, the insurer’s members struggle to find the needed help. Only one in three members with SUD is receiving treatment.

Regulatory changes aimed at loosening restrictions on opioid addiction treatment during COVID-19 / coronavirus can help decrease the number of overdose deaths and raise the standard of care in addiction medicine in general.

Providers specializing in opioid addiction medicine that have already switched to telemedicine say that this form of care is becoming a common reality both for them and their patients. There may be a time when you need to be supported in recovery, to hear the words of encouragement. And telemedicine helps to connect addiction therapists and patients and provide support to the latter.

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