In contrast to other fields in healthcare, substance abuse disorder treatment lacks a significant technology component. Telehealth technologies have yet to be implemented on a universal scale in addiction recovery programs. However, studies show that telehealth has the potential to transform and improve the way we rehabilitate substance abuse patients and can help to reduce the number of people impacted by the opioid crisis in the United States.
Background: Drug Abuse and the Opioid Crisis in the U.S.
In recent years, drug addiction has increasingly become a deadly epidemic that is continuing to negatively impact many Americans. The abuse of opioids, such as prescription pain killers and illegal “street drugs” like heroin and fentanyl, has plagued the lives of many. According to CNN, 66.4% of the 63,600 overdose deaths in the U.S. were caused by opioids in 2016, and drug overdoses continue to be the leading cause of accidental death. With more than 2 million Americans currently dependent on or abusing opioids, measures must continuously be put in place to combat this lethal issue.
Private and government-owned addiction recovery and treatment clinics, overdose-combative medication, and other substance abuse recovery solutions have been, and are continuing to be, implemented across the country. Politicians, healthcare professionals, and drug abuse advocates alike are working hard to spread awareness. The various initiatives currently in place are leading us in the right direction towards a safer and healthier society. However, according to a recent 2018 research article, telehealth, despite having great potential for assisting recovery and rehabilitating patients with substance abuse disorders, is severely underutilized in substance abuse treatment and rehabilitation centers.
The Telehealth Patient-Provider Gap
According to the article, the adoption of telemedicine technologies in substance abuse care was found to be less than 1%, which is a devastatingly low percentage in comparison to other fields in recovery care. In the study, 11 telehealth technologies were assessed for patient interest, including computerized screening and assessment tools, texting appointment reminders and motivational messages, video and telephone-based therapy, support chats, and other helpful treatments and tools. Patient interest was analyzed on a 1-5 scale; a 5 represented “very high” interest and a 1 represented “very low” interest.
In the 8 states and 363 substance abuse treatment facilities tested in this study, the percentage of patients that had a very high interest in the telehealth technologies was always significantly higher than the percentage of facilities that were currently using the technology. For example, 68.40% of patients indicated that they were highly interested in texting appointment reminders, while a mere 13.22% of the facilities were actually utilizing this feature. Additionally, 54.82% of patients were highly interested in video-based therapy, while only 20.39% of facilities offered teletherapy.
On average, the difference between high patient interest and the use of technology was 37.32%. This study identifies the large gap between patient interest and clinician use of various telemedicine techniques. The results also exposed an area in addiction recovery service that is lacking.
Telehealth Implementation: Moving Forward
The findings from this study are transformative. It gives insight into how telemedicine can not only increase patient access to treatment options, but also improve the quality and frequency of care for patients. Patients who live in remote and/or rural locations may not have easy access to their healthcare providers, but telemedicine would provide a means of communication and motivation. This is especially valuable, since rural states, such as Oklahoma and West Virginia, are currently plagued by the highest averages of opioid use in the US. Telehealth would allow clinicians to target the substance abuse disorder patients in places that need it the most.
Additionally, further telemedicine implementation would allow patients to stay on track and be reminded of their progress outside of the physical doctor’s office, giving patients the opportunity to consistently be reminded of their goal and path toward sobriety. Some of the main reasons for patient relapse is a lack of support and the premature dismissal from a treatment facility. Telehealth technology combats both issues by offering continuous support via options such as recovery support chats and motivational text messages, while also providing a way for clinicians and patients to interact outside of in-person sessions. These initiatives have a high probability of resulting in increased program success rates and can lower the amount of people effected by substance abuse overall.
In-person patient and provider interactions seem to be the primary way clinicians have approached substance abuse treatment and behavioral therapy, and although it has proven to be fairly effective, telehealth offers a new perspective in the scope of treatment for substance abuse disorders. Not only have patients expressed interest in using telehealth during the course of their treatment, but the substance abuse treatment facilities and clinicians have as well. This is exciting news, since telehealth technology represents a unique opportunity to help tackle the drug crisis in the United States. Telehealth provides a promising solution to a public health issue with no clear-cut solution. Diversifying treatment options for substance abuse disorders with telehealth is something that treatment facilities across the country should strongly consider as a supplemental way to ensure patient recovery and well-being.
Molfenter T, Brown R, O'Neill A, et al. Use of Telemedicine in Addiction Treatment: Current Practices and Organizational Implementation Characteristics. Int J Telemed Appl. 2018 Mar 11;2018:3932643.