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Does Telepsychiatry Hold Answers to the Opioid Crisis?

Parker Brown December 20, 2018

With nearly 50,000 deaths from opioid overdoses in 2017 in the United States, it’s evident that the need for increased access to behavioral healthcare is upon us. As healthcare providers and policy-makers search for answers, telepsychiatry has emerged as a solution to increase access to mental health and substance abuse care for patients across the country.

In the midst of this national crisis, the federal government has taken steps to increase availability of treatments, with an eye on telepsychiatry as one modality to get there. This summer, the U.S. Department of Health and Human Services released a report championing the use of telepsychiatry: “Access to substance use disorder treatment providers remains a challenge for states and, appropriately, the President’s Commission supports leveraging telemedicine and telepsychiatry to facilitate more coordinated care,” they stated.

In addition, the Senate passed the Opioid Crisis Response Act, which includes several measures designed to increase access to telepsychiatry services for patients suffering from opioid addiction. The bill would also change certain Medicare practices—such as lifting restrictions on telemedicine reimbursement for patients seeking treatment from their homes.

A key benefit of telepsychiatry is its ability to increase access for underserved patient populations, helping mollify the “pressing shortage” of buprenorphine prescribers in the country as noted by a study in Addiction Science & Clinical Practice from 2015. Those who need can see prescribers who can implement MAT programs through treatments such as Suboxone.

“The lack of physician-prescribing capacity for buprenorphine is preventing this evidence-based practice from achieving higher penetration rates among specialty treatment providers,” concluded the researchers. “Telemedicine provides one solution to re-allocate the distribution of this scarce resource.”

In the case that medication management is vital, face-to-face visits may not be necessary, rendering telepsychiatry a viable solution. A two-year retrospective data analysis from 2017 found that telepsychiatry-issued prescriptions led to similar rates of 30 and 90-day abstinence compared to those issued in face-to-face consultations.

Once telepsychiatrists are connected with community health centers to provide care, infrastructure to support the program can be fairly straightforward. Autumn Clark, DO, who is a telepsychiatrist in Springfield, Missouri, echoed the studies’ findings noting that in rural areas, any building can serve as a health center, as long as there are professionals on-site to set it up.

“This is really just a question of access more than anything else,” she said. Clark said that when she was seeing patients in a traditional setting, some traveled three hours to see her. “The easier you make access to treatment, the more likely they are to access it.”

Parker Brown is a freelance writer based in New York City with years of experience writing for healthcare professionals in the endocrinology, oncology, and psychiatry spaces. He has created professional-facing content for Bristol-Myers Squibb, Takeda, Pfizer and other pharmaceutical companies; he’s also worked with numerous others to create speaker decks, white papers, narrative stories, and more. Before freelancing he was a journalist at MedPage Today, where he gained extensive experience writing for and working with healthcare professionals across the spectrum. He has attended numerous professional healthcare symposiums and conferences.