Using Telemedicine to Combat the Opioid Epidemic

Cross-posted from Health IT Buzz

Editorial Note: Among the hidden casualties of the nation’s opioid epidemic are outbreaks of HIV and HCV infections among people who inject drugs. Making medication-assisted substance abuse treatment more widely accessible can help people recover from substance use disorder as well as reduce the risk of HIV transmission among injection drug users.

Combatting the opioid crisis is a top priority for the Trump Administration and the U.S. Department of Health and Human Services (HHS). We are making progress. Just last week we released the 2017 National Survey on Drug Use and Health (NSDUH) data, which showed significantly more people received treatment for substance use disorder in 2017 than in 2016; this was especially true for those with heroin-related opioid use disorders. In addition, the number of people who initiated use of heroin in 2017 was less than half of the number in 2016.

While these are promising data, we know there is still much more work to be done, especially in rural areas that have been hard hit by the opioid epidemic. This is particularly true in some rural and remote areas of the country where patients with opioid use disorder (OUD must travel long distances to receive treatment; and there are too few clinicians available to provide medication-assisted treatment (MAT)—an essential component in the treatment of OUD.

HHS is committed to improving access to MAT for OUD and is working on a variety of strategies to improve access to this life saving treatment through increased funding to states and communities, payment policy changes, and education, training and technical assistance. One such area is to help providers understand how telemedicine can be used, in certain circumstances, to expand access to buprenorphine-based MAT.

Working with the Drug Enforcement Administration (DEA), HHS developed materials to help clarify how clinicians can use telemedicine as a tool to expand buprenorphine-based MAT for opioid use disorder treatment under current DEA regulations. The information, including a clinical practice example that is consistent with applicable DEA and HHS administered authorities, can help to increase access to buprenorphine by utilizing telemedicine to expand provider's ability to prescribe MAT to patients, including remote patients under certain circumstances. This especially will support access to buprenorphine in rural areas where there may be a smaller number of providers with a DATA 2000 waiver—which allows qualified practitioners to prescribe buprenorphine for the treatment of OUD in settings other than a federally regulated opioid treatment program.

Sadly, this information is not widely known among healthcare providers and other stakeholders; and many have been reluctant to utilize telemedicine for prescribing MAT. That is why we are taking this opportunity during Prescription Opioid and Heroin Epidemic Awareness Week (September 16-22, 2018) to make sure everyone knows that effective treatment is available, including via telemedicine, to help combat the opioid epidemic in the U.S. Beyond telemedicine, health information technology (health IT) can be leveraged in many ways to combat the nation's opioid crisis. The Office of the National Coordinator for Health IT (ONC) has resources for healthcare providers to learn more about health IT tools to combat the opioid epidemic through the Opioid Epidemic and Health IT chapter in the Health IT Playbook and ONC's Educational Module for Behavioral Health Providers [PDF, 5.1MB].

Please share this information with your colleagues and networks as we are hopeful that we can help eliminate this perceived barrier to treatment.