Telemedicine along the cascade of care for substance use disorders during the COVID-19 pandemic in the United States

Chunqing Lin; Huyen Pham; Yuhui Zhu; Sarah E Clingan; Lewei Allison Lin; Sean M Murphy; Cynthia I Campbell; Tanya R Sorrell; Yanping Liu; Larissa J Mooney; Yih-Ing Hser

doi:10.1016/j.drugalcdep.2022.109711

Telemedicine along the cascade of care for substance use disorders during the COVID-19 pandemic in the United States

Drug Alcohol Depend. 2023 Jan 1:242:109711. doi: 10.1016/j.drugalcdep.2022.109711. Epub 2022 Nov 23.

Authors

Affiliations

¹ Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA.
² Department of Psychiatry, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, USA; VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2800 Plymouth Rd, Ann Arbor, MI 48109, USA.
³ Department of Population Health Sciences, Weill Cornell Medical College, New York, NY 10021, USA.
⁴ Center for Addiction and Mental Health Research, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, 401 Parnassus Ave, San Francisco, CA 94143, USA.
⁵ University of Colorado College of Nursing, 13120 E. 19th Ave., Aurora, CO 80045, USA.
⁶ Center for Clinical Trials Network, National Institute on Drug Abuse, 301 North Stonestreet Avenue, Bethesda, MD 20892, USA.
⁷ Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA; VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.
⁸ Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA. Electronic address: yhser@ucla.edu.

Abstract

Background: The COVID-19 pandemic has changed the landscape of healthcare service delivery. This review aims to describe telemedicine-delivered substance use disorder (SUD) treatments and services along the cascade of care in the U.S. after the start of the COVID-19 pandemic.

Methods: A literature review was conducted on PubMed, Embase, Web of Science, and Cochrane Library (Wiley). English-language articles that describe any healthcare services for patients with SUDs using telemedicine in the U.S. since the onset of the COVID-19 pandemic were identified (N = 33). We narratively summarized telemedicine-based service provision along the cascade of SUD care, such as screening/assessment, prescription, monitoring, recovery support, and other services.

Results: Soon after the onset of COVID-19 and mandated restrictions, cadres of healthcare providers from different specialties mobilized to ramp up video- and audio-based services to remotely treat patients with SUDs. Medication prescription (48.5%) and individual counseling (39.4%) were the most frequently reported services delivered via telemedicine. Other steps of SUD care delivered by telemedicine characterized in our review included SUD screening and assessment (30.3%), induction (21.2%), medication management (27.3%), monitoring (27.3%), recovery support (15.2%), and referral (24.2%). Feasibility issues and challenges to implementing telemedicine included patients' lack of access to technology and health insurance coverage, providers' capacity limits and concerns, and clinics' financial and office-space constraints.

Conclusion: The COVID-19 pandemic has offered a window of opportunity to advance telemedicine expertise by formalizing clinical guidance and routinizing provider in-service training in virtual SUD treatment. Findings suggest enhanced efforts to reduce disparities in telemedicine-based services.

Keywords: COVID-19, Healthcare services; Substance use disorder; Telemedicine.

Publication types

Review
Research Support, N.I.H., Extramural

MeSH terms

COVID-19*
Delivery of Health Care
Humans
Pandemics
Substance-Related Disorders* / therapy
Telemedicine*
United States

Abstract

Publication types

MeSH terms

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