The opioid epidemic in the US has worsened during the COVID-19 pandemic, leading to an increase in fatal drug overdoses. In response, telehealth services for opioid use disorder (OUD) have expanded. A recent study published in JAMA Psychiatry found that Medicare beneficiaries who received OUD-related care through telehealth had a lower risk of a fatal drug overdose. The study highlights the benefits of telehealth services for individuals with OUD and the need to expand access to medication treatment for opioid use disorder.
The opioid epidemic has been a major public health crisis in the United States, with opioid-related deaths increasing over eight times since 1999, according to the Centers for Disease Control and Prevention (CDC). In 2020 alone, nearly 69,000 people died from drug overdoses, with opioids being involved in over two-thirds of these deaths. The COVID-19 pandemic has only made this issue worse, leading to an increase in fatal drug overdoses. In response, federal emergency authorities activated during the COVID-19 public health emergency allowed for the expansion of telehealth for OUD, which has led to increased interest in the use of virtual care for this issue.
Telehealth and OUD
Telehealth is the use of electronic communication technologies, such as videoconferencing and remote monitoring, to provide healthcare services to patients. Telehealth has been shown to improve access to care, particularly for individuals who live in rural or remote areas, have mobility issues, or face other barriers to in-person care. Additionally, telehealth can be a valuable tool for individuals who may be hesitant to seek care in person due to the stigma associated with OUD.
During the COVID-19 pandemic, telehealth became an essential tool for providing care to patients with OUD. The federal emergency authorities activated during the COVID-19 public health emergency allowed for the expansion of telehealth services for OUD. This expansion led to an increase in the use of telehealth for OUD-related care.
A recent study published in JAMA Psychiatry examined the impact of telehealth services on fatal drug overdoses among Medicare beneficiaries. The study considered two separate cohorts: pre-pandemic (September 1, 2018, to February 29, 2020) and pandemic (September 1, 2019, to February 28, 2021). The former cohort consisted of 105,162 patients, and the latter consisted of 70,479 beneficiaries. All patients considered were Medicare fee-for-service beneficiaries over the age of 18.
Researchers found that the rate of fatal drug overdoses was 5.1 per 1,000 beneficiaries in the pandemic cohort and 3.7 per 1,000 beneficiaries in the pre-pandemic cohort. However, following a multivariable analysis of the pandemic cohort, researchers found that OUD-related telehealth led to a lower adjusted odds ratio and a 33 percent lower risk of a fatal drug overdose.
The receipt of medications for OUD (MOUD) and buprenorphine had a similar effect. Those who received MOUD from opioid treatment programs and those who received buprenorphine in office-based settings had a 59 percent and 38 percent lower risk of a fatal drug overdose, respectively.
Based on these results, researchers were able to conclude that OUD-related telehealth services led to various benefits for Medicare beneficiaries struggling with the disease. Furthermore, researchers noted that efforts to expand MOUD and sustain care for individuals with OUD must continue, particularly given the ongoing opioid epidemic in the United States.