Telemedicine Can Successfully Help More Patients with Opioid Use Disorder

Telepsychiatry therapy can be a good add-on to buprenorphine treatment.

A face-to-face counseling approach might not be necessary for patients receiving buprenorphine for opioid use disorder, a new study found.

Buprenorphine is an opioid medication used to treat addiction to heroin or other opiates, but additional intervention can help patients. Physicians from West Virginia University (WVU) examined if telepyschiatry could take the place of in-person group sessions for this patient population. Although a pilot study, the results suggest that the videoconferencing strategy could be a plausible option as far as medication-assisted treatment (MAT) programs go.

The team collected records from 100 patients who were either in face-to-face group-based or telepyschiatry buprenorphine MAT programs. Participants in the telepsychiatry group did the therapy at a mental health facility and a psychiatrist was on the other side of the webcam.

The 54 patients in face-to-face sessions and 46 patients in telepyschiatry underwent random urine testing throughout the study period. Characteristics were similar between the two groups, but those in the telepsychiatry group were more likely to live in rural areas.

“We did not find any significant statistical difference between telepyschiatry buprenorphine MAT intervention through videoconference and face-to-face MAT treatment,” the doctors wrote in the Journal of Addiction Medicine.

Of all the participants, 37% in the face-to-face group and 49% in the telepsychiatry group achieved 90 consecutive days of abstinence. About half of the patients in both groups stayed in their programs for 90 days.

Relapses are common in opioid use disorder, and that was the case in this study as well. Other substance uses during the 90-day abstinence period were similar in both groups.

Although the average time to reach 30 and 90 days of abstinence was shorter in the telepsychiatry group, outcomes weren’t statistically significant.

Coauthor, Carl Sullivan, MD, from WVU implemented a similar successful initiative, the COAT program, in 2004. So if the results of this current project are anything like that one, many more patients can be reached.

“Throughout the past 12 years, we have treated more than 2,000 patients,” Wanhong Zheng, MD, said in a news release. “Currently we have eight buprenorphine prescribers treating more than 500 active patients—some abstinent for over 10 years.”

Treatment availability is just one challenge for the two million people with opioid use disorder in the United States. That barrier could be overcome with further implementation of telemedicine, the physicians advised.

The study, “Treatment Outcome Comparison Between Telepsychiatry and Face-to-face Buprenorphine Medication-assisted Treatment for Opioid Use Disorder: A 2-Year Retrospective Data Analysis,” was published in the Journal of Addiction Medicine.

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