Review explores telehealth for substance use disorders

The use of telehealth for the treatment of substance use disorders (SUDs) is addressed in a review and clinical practice guideline published online March 22 in the Annals of Internal Medicine.

Stacey Uhl, from the ECRI Center for Clinical Evidence and Guidelines in Plymouth Meeting, Pennsylvania, and colleagues synthesized recent findings on the efficacy of telehealth for SUDs in a review using data from 17 randomized controlled trials. The researchers found that in terms of improving abstinence from alcohol or cannabis, the evidence was very uncertain that telehealth provided as videoconferencing or web-based cognitive behavioral therapy had similar effects to in-person therapy. Based on limited evidence, adding telehealth options to usual SUD care may offer some benefit.

Christopher Perry, M.D., from the National Capital Consortium in Bethesda, Maryland, and colleagues developed recommendations that were believed to be the most clinically impactful for management of SUDs. The guidelines include a section of new recommendations in relation to telehealth. The authors suggest the use of technology-based interventions in addition to usual care for alcohol use disorder (weak evidence). For SUDs other than alcohol use disorder, insufficient evidence was found for or against technology-based interventions in addition to usual care. Use of structured, telephone-based care is suggested as an adjunct to usual care for SUDs (weak evidence).

"This clinical practice guideline also includes a new section on the use of technology in the treatment of SUD; unfortunately, evidence on this topic was insufficient to recommend for or against most novel treatment methods," Perry and colleagues write.

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