Telehealth addiction treatment has increased the number of people dependent on buprenorphine

A new study conducted by Oregon Health & Science University found that patients who began treatment for opioid use disorder via a telehealth mobile app persisted with treatment at a greater rate through six months, compared with those who began treatment in a physical clinic.

This study has been published in. Journal of Substance Use and Addiction TreatmentIt is one of the first organizations to compare patient retention between telehealth and traditional office-based treatment.

This comparison was only possible because of a federal waiver during the COVID-19 pandemic that allowed physicians to start treatment with buprenorphine via phone or tablet rather than in-person visits. That waiver is set to expire at the end of this year, increasing the importance of this new finding amid a crisis of illicit drug use that kills more than 100,000 Americans each year.

The lead author said, “This finding reinforces the idea that telehealth is effective in initiating and continuing treatment for people with opioid use disorders.” Brian Chan, M.D., M.P.H.Associate Professor of Medicine (General Internal Medicine and Geriatrics) at OHSU School of Medicine, Dr.

The study was conducted from September 2021 to March 2023. Buprenorphine is a partial opioid receptor agonist that prevents opioid withdrawal symptoms. It is one of three drugs approved by the Food and Drug Administration for the treatment of opioid use disorder.

The researchers studied a group of 159 patients from two groups: one group that began treatment via a telehealth-only platform and a second group that began treatment in an office-based setting with a traditional approach. Both groups experienced a relatively low rate of treatment discontinuation. However, the telehealth-only group continued treatment at a higher rate at six months. Adjusted for time, the study found that only 3.8% in the telehealth-only group discontinued treatment at six months, compared to 9.7% in the treatment-as-usual group.

The authors write, “This finding provides additional evidence that individualized assessment may not be necessary for some treatment-seeking patients to obtain buprenorphine.”

Chan said the study also raises some important caveats.

For one thing, most patients in both groups — all in Oregon and Washington — remained in treatment for six months, meaning retention was high no matter which treatment modality was used. In addition, overall rates of employment and stable housing among participants in the telehealth-only group were both slightly higher than those in the treatment-as-usual group.

“There is still a role for in-person visits for certain types of patients,” Chan said. “At the same time, telehealth reduces the risk of interrupting treatment if patients cannot travel to in-person visits.”

Boulder Care, a Portland-based company that offers telehealth treatment for substance use disorders, provided telehealth access for study participants. In-person treatment was provided through a mix of primary care, addiction clinics, and community-based clinical practices.

“We continue to learn that telehealth plays a vital role in high-quality addiction care,” the co-author said. Stephen Martin, M.D.“This study provides conclusive evidence that virtual care alone is dramatically effective in helping patients receive life-saving treatment and recover,” said Dr. , Boulder Care's medical director of research, education and quality.

“We hope policymakers will act soon to ensure that this remains a sustainable source of care for all Americans.”

This research was supported by the National Institute on Drug Abuse of the National Institutes of Health, grant awards R44DA050354, K23DA053390, K01DA055130, and UG1DA015815; and the Agency for Health Research and Quality, grant award K12HS026370. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or AHRQ.