Telehealth reduced risk of overdoses in COVID-19 pandemic, study finds

Researchers found Medicare beneficiaries who received treatment via telehealth were less likely to suffer an overdose, suggesting a greater need to expand services and treatment.

Expanded telehealth services reduced the risk of overdose for those struggling with opioid use, researchers have found.

Researchers with the Centers for Disease Control and Prevention and the National Institutes of Health conducted the study, which was published in JAMA Psychiatry on Aug. 31. The study suggests the need to expand treatment and services.

Wilson Compton, deputy director of the National Institute on Drug Abuse, was the senior author of the study. He said the study shows the benefits of expanded access to treatment services via telehealth, if they are continued.

“The expansion of telehealth services for people with substance use disorders during the pandemic has helped to address barriers to accessing medical care for addiction throughout the country that have long existed,” Compton said in a news release accompanying the study. “Telehealth is a valuable service and when coupled with medications for opioid use disorder can be lifesaving.”

Lawmakers are pushing a bill to continue telehealth waivers that began during the COVID-19 pandemic.

The House overwhelmingly approved a bill that would expand telehealth waivers for hospitals and healthcare providers through 2024. The Senate still must approve the bill, and while there is strong support for it, telehealth advocates say Senate passage isn’t a sure thing. (Kyle Zebley of the American Telemedicine Association talked about the bill in this video. The story continues below the video.)

The bill is lacking a key provision telehealth advocates are seeking. It doesn’t include a measure to extend a waiver for remote prescriptions of medications, which expires at the end of the year.

More likely to get treatment

Nonetheless, the new study offers more evidence of the value of virtual care and further illustrates how telehealth has helped change healthcare.

Researchers examined 175,778 Medicare beneficiaries from September 2018 to February 2021, so the study took into account behaviors before the COVID-19 pandemic, the Centers for Medicare and Medicaid Services said.

Those who received telehealth services were more likely to obtain medication for opioid use disorder (12.6%) than the pre-pandemic group (10.8%). The study found the pandemic group was far more likely to obtain telehealth services for opioid use disorder than the pre-pandemic group (19.6% to 0.6%).

Patients who received telehealth services for opioid use had a lower risk of medical treatment for an overdose, the study found. Those using telehealth services were also more likely to continue medication treatment for opioid use, the CMS said.

Strategies to expand access to medication for opioid use and ensure people continue treatment “are urgently needed,” said Christopher M. Jones, acting director of the CDC’s National Center for Injury Prevention and Control and lead author of the study.

“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),” Jones said in a statement.

'Ongoing challenges'

While the study uncovered promising results for the use of telehealth, only a small number of individuals received medications for opioid use disorder on 80% or more of the days they were eligible.

“This finding underscores the ongoing challenges in engaging and retaining patients in treatment,” the authors wrote.

Researchers also uncovered issues with access. Black patients and those living in the south were less likely to receive those telehealth services, the study found.

In addition, Black, American Indian or Alaska Native, and Asian and Pacific Islanders had greater odds of requiring medical treatment for overdose.

“Tailored and culturally appropriate policy and programmatic interventions are needed to address disparities in accessing (opioid use disorder) treatment, overdose prevention, and recovery support services given recent sharp increases in overdose deaths among these groups,” the authors wrote.

The federal government has previously found some members of minority groups had less access to video telehealth services.

The authors of the new study pointed to the need for more work to eliminate the digital divide in healthcare. They also called for more study to examine the effectiveness of telehealth in treating other areas of substance use and addiction.

“Future research should examine the outcomes of telehealth services on other health outcomes, such as continued illicit opioid use and overdose deaths. In addition, research is needed to understand barriers and facilitators of clinician and patient use of telehealth,” the authors said.

Many of the patients in the study also suffered from other health challenges, including chronic medical conditions and mental health issues.

“Our results highlight the continued need for a well-coordinated and comprehensive health system that integrates physical and behavioral health care,” the researchers wrote.