Good outcomes with 'telepsychiatry' in medical treatment of opioid use disorder

January 25, 2017, Wolters Kluwer Health

For people with opioid use disorder receiving medication treatment with buprenorphine, a telepsychiatry approach—using videoconferencing as an alternative to in-person group sessions—provides similar clinical outcomes, reports a study in the Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine (ASAM).

The pilot study suggests that might help to extend the availability of medication for addiction (often known as medication-assisted treatment, or MAT) for opioid use disorder—particularly in . "Telepsychiatry may present a promising way to deliver MAT to this population and expand access to care," write Dr. Wanhong Zheng and colleagues of West Virginia University, Morgantown.

Similar Results with Telepsychiatry and Face-to-Face Visits

The researchers reviewed the records of 100 enrolled in the "Comprehensive Opioid Addiction Treatment" (COAT) program at WVU. The program included MAT with buprenorphine—an "opioid partial agonist" that is effective in reducing opioid use, promoting abstinence, and aiding recovery. As outlined in recent ASAM guidelines, psychosocial treatment is recommended alongside MAT for opioid use disorder, although evidence for the added benefit of psychosocial treatment is limited. Regardless, the limited availability of such care is sometimes a barrier to receiving medication.

The review included 46 patients treated with weekly telepsychiatry group sessions and 54 with face-to-face sessions. Telepsychiatry sessions were held at a local mental health facility, with the psychiatrist participating via a secured webcam. Both groups underwent random urine drug screening tests. The two groups had similar characteristics, although telepsychiatry patients were more likely to live in rural areas.

Substance use outcomes were similar between groups. Forty-nine percent of patients in the telepsychiatry group and thirty-seven percent in the face-to-face group achieved 90 consecutive days of abstinence during the study period—the difference was not significant. Use of other substances during the 90-day abstinence period was also similar between groups.

As is typical for opioid use disorder, relapses were common. Patients receiving telepsychiatry had shorter average times to reach 30 and 90 days of abstinence, although the difference was not statistically significant. In both groups, about half of patients remained in treatment through 90 days.

Opioid use disorder has become an epidemic. In many areas, demand far exceeds treatment capacity; the authors' program currently has a waiting list of more than 600 patients. New approaches are urgently needed to increase the availability of treatment for opioid use disorder.

The telepsychiatry approach seeks to extend the reach of WVU's successful COAT program, initiated in 2004 by study coauthor Dr. Carl R. Sullivan. "Throughout the past 12 years, we have treated more than 2,000 patients," Dr. Zheng comments. "Currently we have eight buprenorphine prescribers treating more than 500 active patients—some abstinent for over ten years."

The preliminary results suggest that, in a comprehensive treatment program using buprenorphine, outcomes are similar for patients receiving telepsychiatry as for those attending face-to-face sessions. Some findings suggest even better outcomes with telepsychiatry, although larger studies would be needed to determine whether there was a significant difference between groups.

Telepsychiatry might be especially useful for expanding access to care for patients living in rural areas. The authors note that West Virginia has the highest opioid-related mortality rates in the country. Dr. Zheng and colleagues conclude: "The hope is that this study will open further avenues for research, funding, and practical application in increasing access of psychiatric services through telemedicine, specifically in terms of substance use treatment and to populations with limited access to healthcare."

Explore further: Researchers identify factors associated with stopping treatment for opioid dependence

More information: Wanhong Zheng et al. Treatment Outcome Comparison Between Telepsychiatry and Face-to-face Buprenorphine Medication-assisted Treatment for Opioid Use Disorder, Journal of Addiction Medicine (2017). DOI: 10.1097/ADM.0000000000000287

Related Stories

Researchers identify factors associated with stopping treatment for opioid dependence

January 5, 2017
Individuals with opioid use disorder who are treated with buprenorphine, a commonly prescribed drug to treat addiction, are more likely to disengage from treatment programs if they are black or Hispanic, unemployed, or have ...

Study examines opioid agonist therapy use in Medicare patients

July 20, 2016
Few Medicare enrollees appear to be receiving buprenorphine-naloxone, the only opioid agonist therapy for opioid addiction available through Medicare Part D prescription drug coverage, according to a study published online ...

Medication-assisted treatment underused in teen opioid addicts

August 24, 2016
(HealthDay)—Resources should be increased to promote use of medication-assisted treatment of opioid addicted adolescents and young adults, according to a policy statement from the American Academy of Pediatrics (AAP) published ...

Team reports on study of waitlisted opioid-dependent adults

December 21, 2016
In rural states like Vermont, opioid-dependent adults desperate for treatment often find themselves stuck on a wait list, sometimes for eight months or more, increasing their risk of continuing to use illicit opioids, contract ...

Clinical trial for opioid therapy moves closer to market

January 24, 2017
A multi-site clinical trial led by researchers at the University of Kentucky Center on Drug and Alcohol Research (CDAR) has demonstrated the effectiveness of CAM2038, a potentially transformative buprenorphine therapy for ...

Study: Rural communities see steep increase in babies born with opioid withdrawal

December 12, 2016
The number of babies born with drug withdrawal symptoms from opioids grew substantially faster in rural communities than in cities, a new study suggests.

Recommended for you

Rapid response inpatient education boosts use of needed blood-thinning drugs

November 16, 2018
A new study designed to reach hospitalized patients at risk shows that a "real-time" educational conversation, video or leaflet can lower the missed dose rates of drugs that can prevent potentially lethal blood clots in their ...

Drug overdose epidemic goes far beyond opioids, requires new policies

November 7, 2018
Most government-funded initiatives to address the overdose epidemic in the United States have targeted opioids specifically and have neglected other drugs that are increasingly implicated in overdoses, such as cocaine and ...

Zebrafish larvae help in search for appetite suppressants

November 2, 2018
Researchers at the University of Zurich and Harvard University have developed a new strategy in the search for psychoactive drugs. By analyzing the behavior of larval zebrafish, they can filter out substances with unwanted ...

FDA OKs powerful opioid pill as alternative to IV painkiller

November 2, 2018
U.S. regulators on Friday approved a fast-acting, super-potent opioid tablet as an alternative to IV painkillers used in hospitals.

Amphetamine-related hospitalizations surged between 2003 and 2015

November 2, 2018
An analysis conducted by Hennepin Healthcare, University of Minnesota School of Public Health and University of Michigan researchers shows amphetamine-related hospitalizations increased more than 270 percent from 2008 to ...

Cocaine-fentanyl overdoses underscore need for more 'test strips' and rapid response

November 1, 2018
Penn Medicine emergency department physicians are calling for more readily available testing strips to identify the presence of fentanyl in patients experiencing a drug overdose, and a rapid, coordinated response among health ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.