Addiction treatment programs are hardly ever one-dimensional.
Healthcare professionals have to tackle the issue from different angles to provide well-rounded care for their patients. This could call for a blend of medication, counseling, peer support, transitional recovery residences, and more. So, why not take it up to the digital front as well?
Telehealth, a rising star in the field, can give patients access to different services in a convenient virtual package.
How does telehealth work, why should you even consider it, and how secure is it? These are all valid questions, and this article will help you find answers.
Table of Contents
- Telehealth in Addiction Recovery: Explained
- Benefits of Telehealth in Addiction Recovery
- Limitations of Telehealth in Addiction Recovery
- Ensuring Privacy and Security in Telehealth
- Expanding Telehealth Communication From Within
- Final Thoughts
Just as the name implies, telehealth is the use of telecommunication tools (phones, computers, etc.) to deliver treatments and healthcare services. It could be applied to anything, from treating skin conditions to following up with substance misuse patients.
Before we dig into the nitty-gritty details of how telehealth can help recovering addicts, we need to clear up one misconception.
Many people use“telehealth” and “telemedicine” interchangeably, but that’s not always accurate.
Telemedicine means providing treatment or diagnosis (clinical services only) to the patient.
On the other hand, telehealth is more of a wide umbrella that covers both clinical and non-clinical services. So, you can lump administrative meetings or training sessions for the healthcare providers themselves under this label, too.
We’ll be focusing on the blanket term in this post.
It can be a little hard to imagine treating substance use disorders (SUDs) virtually because many of us are used to the motion of traditional inpatient rehab. While telehealth can’t always replace in-person services, it still plays an important role.
According to a 2018 article from the International Journal of Telemedicine and Applications, SUD organizations can use telehealth in:
- Computerized screening/assessments
- Telephone-based recovery support
- Telephone/video-based therapy
- Patient web portals
- Text message appointment reminders
Let’s take a closer look at how some of these work in real-life situations.
The most obvious way to apply the concept of telehealth to addiction treatments is to set up remote therapy sessions.
Keep in mind that mental health disorders and substance misuse often go hand in hand. Experts estimate that half of SUD cases also struggle with mental health issues at some point. Tackling both aspects of the dual diagnosis is crucial for recovery.
Now, the way that these telehealth applications work means that, sometimes, healthcare providers will ask you to fill out a form before the visit so they can have up-to-date info about your case.
Regardless, it’s a great way to get in touch with your counselor when you can’t head to the facility or when your condition doesn’t really require an in-person visit.
Note that this application doesn’t stop at one-on-one meetings. It’s possible to hold virtual group sessions, too.
Depending on the case, telehealth can be used to deliver computerized screenings (like the AUDIT) that help with assessments or follow-ups.
Yet, providers might have to apply the SBIRT approach. If you aren’t familiar with it, the SBIRT starts with a quick screening to assess the severity of the case.
Then comes the “BI” in the name, which stands for “Brief Intervention.” In this step, the provider aims to increase the patient’s awareness and instill motivation for behavioral change.
Finally, the “RT” in SBIRT means “Referral to Treatment.” That part is particularly vital in telehealth since the provider can only do so much for the recovering addict on the other end of the phone.
One program in Mayland looked into using telehealth to help provide medically assisted treatment (MAT) to addicts in rural correction centers. As you’d expect, the reports show that the implementation was successful, which highlights the concept’s flexibility.
Typically, practitioners might not be allowed to prescribe certain MAT drugs without an in-person physical examination.
Back in 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) exempted opioid treatment programs (with buprenorphine) from this regulation, though.
Telehealth isn’t limited to communication between the healthcare provider and the patient.
Since many cases require integrating telehealth services with other forms of therapy and/or treatment, the different practitioners (like primary care and behavioral health specialists) need open communication channels. Virtual meetings and patient portals can help with that.
Back in 2018, one study found that the number of telehealth SUD virtual visits went from 0.62 to 3.05 (per 1000 individuals) between 2010 and 2017.
That looks like a significant improvement, but the SUD-related visits still took a tiny share (1.4%) of all telehealth visits that were reimbursed over the study’s eight-year duration.
That said, more recent reports from the SAMHSA show that the percentage of SUD treatment facilities that offer telemedicine services more than doubled from 2019 to 2020.
This rapid spread of clinical telehealth programs is probably because more and more healthcare centers had to adapt during the pandemic and expand their virtual services.
Telehealth can be an effective treatment tool.
In fact, a systematic review of telehealth (telemedicine, specifically) in cases of alcohol addiction doesn’t just help reduce consumption. It also helps with depression, patient satisfaction, and quality of life, all with reduced costs.
Yet, there are other factors that make it a convenient supportive option, including:
Virtual visits can give the counselor an insight into the recovering addict’s living situation.
Odds are, the recovering addict will log into the video session from their home, which can help the therapist/provider observe the person and gauge how they’re capable of taking care of themselves out of rehab.
Plus, it could be a good chance to get the family members involved in the treatment/follow-up plan. Keep in mind that not all families can be present for in-person visits.
Setting the meeting online offers more flexibility to encourage them to hop into the call when needed.
Having access to virtual therapy sessions and support groups can come in handy for people who fear being judged as they walk into facilities and clinics associated with SUD.
Accessibility is perhaps the main perk to expect with telehealth services. They can boost retention and keep recovering addicts engaged by making it easier to receive treatment and stay in the loop.
Here’s how telehealth can boost accessibility:
- Offers round-the-clock access to healthcare professionals.
- Reduces waiting time before visits.
- Accommodates those with limited ability to commute to the facilities due to disabilities, rural location, child-care, or other reasons.
- Sends reminders before in-person appointments to reduce no-shows.
One clinical operation specialist shared the success story of how telemedicine helped her father with his addiction. She says it gave him a chance to be heard and have a treatment plan that was built just for his needs.
This goes to show how telehealth opens the doors to customization and program tailoring.
The telehealth provider can even choose to offer services in multiple languages to help overcome barriers, but that’s not all. It would be easy to diversify the formats (visual media, text, etc.) to make addiction-related resources easier to understand, regardless of literacy level.
Despite being incredibly convenient, telehealth isn’t without its limitations and drawbacks.
Here are a few points to consider before opting for a virtual SUD treatment service:
Depending on the situation and time, recovering addicts might have to consult with someone other than their regular healthcare provider.
If there isn’t enough peer coordination, important details about the treatment plan and patient history can be left unconsidered.
It seems like more and more insurance companies are covering telehealth nowadays, but there could be limitations.
Illinois residents have reimbursement options for both live video and audio-only services. However, that’s not the case for every state.
Make sure to double-check where your state-level regulations and private insurer’s policies stand on the different forms of addiction recovery telehealth services.
Virtual meetings don’t always go as planned, and there are a whole lot of technical issues that can interrupt the session.
It’s also worth mentioning that not all recovering addicts have access to a reliable network, which means that they might have to head to public spaces for the visit/meeting.
Of course, that’s not ideal for security and privacy reasons. Plus, some people might feel uncomfortable sharing information about their mental health and substance use issues in a public space. So the session might not be as insightful as expected.
Other recovering addicts won’t be able to use personal phones and laptops all day depending on their recovery residence situation. However, this hiccup could be prevented by hiring support staff to help connect the residents to the telehealth platform.
Telehealth doesn’t work for everyone.
Sure, some reports believe that individual virtual treatments are just as effective as their in-person counterparts. However, other surveys show divided opinions.
In an online survey, around 45% of respondents found individual counseling on telehealth to be less effective than in-person alternatives. Moreover, 62% said group counseling is better in person than over telehealth platforms.
That has a lot to do with the sense of personal connectedness. This feeling could be harder to establish virtually than in a face-to-face setting.
All in all, you can expect the treatment and efficiency outcomes to change depending on a few factors, including:
- The current recovery stage and craving intensity
- Living environment and presence of adequate support systems
- The person’s comfort level with technology
Keep in mind that many people will also need to go through detox in a supervised facility before they can consider telehealth as an aftercare tool.
Not everyone jumps on the idea of using video conferences or calls as part of their addiction treatment plan. Fear of a privacy leak is a major concern, after all.
Still, there are laws and simple practices that can help keep your data protected.
Here’s what you need to look out for:
Unfortunately, it’s not unheard of for websites that target opioid addiction treatments to use third-party cookies. These cookies could pose a privacy concern for people who don’t want their sensitive healthcare information out there in the open.
Note that even popular products, like Skype, can be compliant under certain conditions. So, don’t dismiss a platform just because it looks too mainstream.
Encrypting the data and using HIPAA-compliant platforms won’t cut it if the patient is sitting in an exposed space where someone could peek into the screen or overhear critical information.
These leaks are fairly avoidable, though.
Make sure you’re sitting in a private room where you can control the amount of interruptions and intrusions coming in from the doors and windows. Going for two-factor authentication on your communication device can help, too.
These tips work both ways. So, the providers themselves need to take in video conferences or calls in a secure office.
On a side note, some patients prefer an audio-only service since they feel it’s slightly more secure than showing their face on a virtual group support video call. Either way, you can always communicate your preferences to your healthcare provider to see if it’s feasible.
There’s still work to be done before the concept of telehealth can take off within mental illness and SUD treatment organizations.
SAMHSA proposed a few strategies that can help boost internal readiness for virtual services, including:
- Selecting program champions to advocate for telehealth in the clinic.
- Training and capacity-building the staff.
- Investing in secure devices, platforms, broadband, and reliable IT support.
Telehealth can be a flexible, time-saving, and cost-effective tool for continuity of care in addiction recovery.
Please note, Telehealth for addiction treatment is not currently offered by Illinois Recovery Center. We do, however, have plans to integrate this treatment modality into our addiction care services in the near future.