The American nightmare that is the opioid epidemic affects everyone. More than 130 people die of an overdose every day; every 25 minutes a baby is born suffering from opioid withdrawal. The costs are staggering for both the healthcare industry and the nation, which Centers for Disease Control and Prevention estimates is $78.5 billion a year.
Despite the dogged attempts of government and healthcare leaders to find solutions, the crisis continues to escalate. U.S. overdose deaths involving opioids jumped from 8,048 in 1999 to 47,600 in 2017 – a stunning increase.
Anyone who’s faced addiction personally or professionally knows that it’s different from treating appendicitis or a sprained ankle. Beyond resisting the siren’s song of heroin, fentanyl or oxycodone, patients struggling with opioid use disorders (OUDs) must triumph over multiple barriers. Often they need to overcome their own denial and any fears of stigma in seeking treatment. Their addiction may have impacted their employment, finances and healthcare coverage; when they do have insurance, it may not cover costly treatment options. Their circle of influence may also struggle with addiction and friends and family members who try to encourage treatment are often met with resistance.
For these reasons, seeking treatment isn’t as simple as a 28-day rehabilitation program. These patients must make lifestyle changes and receive ongoing support both in and out of the doctor’s office. They also frequently require a multidisciplinary approach. Substance abuse is associated with higher rates of tobacco use, heart disease and other chronic conditions and infectious diseases; half of people with OUD have other mental illnesses.
As actor Russell Brand said of addicts, “Unless they have structured help, they have no hope.” One reason the opioid crisis has raged unabated is that “structured help” has been hard for many addicts and their families to find. Fortunately, telemedicine is closing several treatment gaps.
Dead End Options in Rural Towns
Underserved and rural communities have been hit hard with the opioid epidemic. Between 1999 and 2015, overdose deaths increased 325 percent in rural counties – and nonfatal prescription opioid overdoses are highest in states with large rural populations. Yet most specialized treatment centers are located in urban areas. When small town addicts seek treatment, they often learn the nearest substance abuse counselors and tailored treatment options are hundreds of miles away.
The problem intensifies when it comes to medication-assisted treatment (MAT). Able to reduce the risk of death by nearly 50 percent, MAT treatments can involve either methadone, naltrexone, or buprenorphine. But 88.6 percent of rural counties lack enough centers offering MAT treatment. 29.8 percent of rural Americans live in a county without a buprenorphine provider, compared with only 2.2 percent of urban Americans.
This forces patients to travel farther for treatment, absorbing the higher costs and logistical challenges. Payers that offer patient transportation services can also feel the sting. In one example, Washington’s Medicaid program reported spending $3 million a year to transport rural enrollees to urban treatment centers.
Bringing Virtual Care to Isolated Addicts
Just as telehealth can reach underserved patients treating other conditions, it can give addicts new options in multiple ways:
- When patients overdose or experience withdrawal symptoms, local providers can immediately connect with experienced specialists – something especially useful in prisons, university campuses, rural areas and other locales.
- Patients in treatment facilities can have virtual group sessions with their primary care providers and family members back home.
- Addicts still waiting for a facility bed can receive counseling and monitoring in their home environment – keeping them on the road to recovery.
- Patients worried about the lack of privacy in a small town or the stigma of addiction treatment, can engage with behavioral specialists from their living rooms.
- Providers can monitor patients recently released from detox or rehab, helping them combat cravings and avoid relapse triggers.
- On-site treatment professionals can collaborate with social workers, family members and therapists for better care coordination and insights into the patient’s challenges.
- Addicts can connect to peer support groups and other resources from home to prevent relapse and abstain from gateway behaviors.
- Wearable medical devices can deliver timed doses of pain medication to help users avoid drug misuse and overdose; they can also monitor a patient’s vitals and alert providers in the event of an emergency.
Expanding the Road to Recovery
It’s worth noting that The Centers for Medicare & Medicaid Services (CMS) recently increased reimbursement for substance abuse treatment. CMS has created new bundled episodes of care for treatment of opioid use disorders, services that include overall management, care coordination, psychotherapy and substance use counseling. It’s another indication that virtual care is already a respected component of addiction treatment – and a ray of hope for addicts searching for new avenues to recovery.