Studies are showing that depression and anxiety rates are increasing among individuals in the United States, access to mental healthcare is becoming more expensive, and clients are rapidly outnumbering mental healthcare professionals. As a result, telemedicine is becoming more popular in the mental health realm because it allows for easier more convenient access for clients who are in need. However, telemedicine for substance abuse is becoming a “missed opportunity” when drug overdose deaths continue to climb, and access to care remains limited.
Telemedicine delivers therapy without triggering these feelings of anxiety as this form of medical encounter can be provided through a laptop, a smartphone or a tablet as long as there is a secure Internet connection. It allows for more privacy and is an avenue for clients to seek help if they are unable to visit a therapist in person, for whichever reason. So why is telemedicine successful and sustainable for mental health disorders but not for substance abuse disorders?
Taking a look at the numbers
Telemedicine visits for substance use disorder jumped from 97 in 2010 to nearly 2,000 by 2017, but substance use disorder represented only 1% of all visits in 2017, and they made up 0.1% of all substance use disorder treatment visits. By contrast, patients diagnosed with a mental health disorder accounted for more than a third of all visits in 2017. More than 20 million adults in 2014 had a substance use disorder during the previous year, but only 2.5 million received treatment, according to research.
One of the main reasons why substance abuse is difficult to treat via telemedicine is because many individuals need to be weaned off these addictive substances and many laws require individuals to visit a treatment specialist in person before they can be prescribed medication-assisted therapy. Low dose benzodiazepines, buprenorphine, and methadone are commonly prescribed prescription medications that are used to curb withdrawal symptoms associated with benzodiazepine and opioid abuse, respectively. However, all these treatment modalities can be dangerous, and therefore there are laws in place for clinicians to properly educate, counsel and manage these controlled substances used for treatment.
Another reason this method is not as widespread for substance abuse addiction compared to mental health disorders is the disparity between the low supply of addiction medicine specialists and high demand for their services. Individuals who are struggling with substance undergo physical withdrawals which are a very different psychological and psychological process compared to mental health disorders. Although telemedicine may not be the best form of therapy for individuals who are undergoing physical withdrawals, telemedicine can be expanded for outpatient and long-term use for individuals who are overcoming addiction once they have undergone medical detox.
New law may bring hope
“Expanding telemedicine use for treating substance use disorder treatment was one of the priorities included in the massive Support for Patients and Communities Act, a large package of opioid-related bills that President Donald Trump signed in October. The law expanded Medicare coverage of telemedicine services for substance use disorder to beneficiaries in their homes and required the CMS to draft guidance for states on how they can use telemedicine within their Medicaid programs.”