Kleykamp B, Guille C, Barth K, McClure E. (2020). Substance use disorders and COVID-19: The role of telehealth in treatment and research. Journal of Social Work Practice in the Addictions. 20(3): 248-253. doi: 10.1080/1533256X.2020.1793064
Telehealth offers benefits beyond emergency use during the COVID-19 pandemic. A scalable solution that increases treatment access for individuals with substance use disorder (SUD), telehealth also supports innovation in SUD treatment and research. As COVID-19 restrictions lift and telehealth continues to augment SUD care and research, several key issues merit consideration. The future of emergency changes to state- and federal-level policies on telehealth in SUD treatment remains unclear. For instance, the U.S. Drug Enforcement Administration (DEA) has given emergency permission for clinicians to prescribe buprenorphine and naloxone via telehealth. If regulations revert to pre-pandemic restrictions, patients receiving SUD treatment via telehealth who would not otherwise seek out in-person treatment will lose access to care. Further research needs to determine whether telehealth SUD treatment produces health outcomes comparable to in-person treatment and what variables (e.g., type of technology, telehealth setting/parameters, patient characteristics, substance(s) used) predict treatment outcomes. Barriers to wide-scale adoption of telehealth for SUD treatment in health systems include lack of provider training, limited access to broadband internet, unreliable mobile network connections, and patient or provider concerns. Clinicians using telehealth must maintain treatment fidelity and ensure that patients receive optimal care, while research conducted via telehealth needs to preserve scientific integrity and prevent bias in data collection. Future research could explore strategies to increase access to telehealth care among vulnerable populations (e.g., rural with limited broadband, homeless populations). The impact of telehealth on existing models of SUD treatment and research (e.g., clinic model for methadone maintenance, biochemical verification of substance use) also warrants research attention.