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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 take it up to the digital front as well?
Telehealth technologies are a rising star in the field of the healthcare system, especially during the COVID-19 pandemic, which can give patients interactive access to different mobile health services in a convenient virtual package.
How does this communication technology – telehealth work? Why should you even consider the use of telehealth? Is it helpful enough when you need urgent care? and how secure is our health records? What about care delivery? And will they accept health insurance? These are all valid questions, and this article will help you find answers.
Table of Contents
Telehealth in Addiction Recovery: Explained
As the name implies, telehealth is the use of telecommunications technologies (phones, computers, etc.) to deliver treatments and healthcare services. It could be applied to any medical care, from treating skin conditions to following up with substance misuse patients.
Telehealth vs. Telemedicine
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 the patient with treatment or diagnosis (clinical services only).
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.
Components of Telehealth: How It Works
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.
Virtual Visits
The most obvious way to apply telehealth to addiction treatments is to set up remote (video chats or video conferencing) therapy sessions in real-time.
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.
Remote Monitoring
Depending on the case, telehealth can be used to deliver computerized screenings (like the AUDIT) that help with assessments or follow-ups.
Providers may 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.
MAT Prescriptions
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, highlighting the concept’s flexibility.
Typically, practitioners cannot 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.
Integrated Care
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 provider and behavioral health professionals) need open communication channels to better get the right health information needed. Virtual care, like telehealth through virtual meetings and patient portals, can help with that.
Stats About the Growth of Telehealth in the Field of SUD Treatment
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.
Benefits of Telehealth in Addiction Recovery
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:
Assessment of Living Environment
Virtual visits or video 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 or conduct a remote patient monitoring 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.
Reduced Stigma
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.
Better Accessibility
Accessibility is perhaps the main perk to expect with telehealth services. They can boost retention and keep recovering addicts engaged by making receiving treatment and staying in the loop easier.
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.
Customized Plans and Resources
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.
Limitations of Telehealth in Addiction Recovery
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:
Coordination Issues
Depending on the situation and time, recovering addicts might have to consult with someone other than their regular healthcare provider.
With peer coordination, important details about the treatment plan and patient history can be considered.
Insurance Coverage
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.
Technicalities and Logistics
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 public. 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.
Case-by-Case Variations
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.
Ensuring Privacy and Security in Telehealth
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:
HIPAA Compliance
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.
Before you sign-up for any service, it’s vital to ask about their privacy policies. You can also look for providers who use HIPAA-compliant video communication tools.
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.
Secure Devices and Spaces
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.
Ensure you’re sitting in a private room where you can control the 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.
Expanding Telehealth Communication From Within
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.
Final Thoughts
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.