Abstract
The opioid epidemic faced by the USA is a complex public health crisis, with staggering loss of life and overwhelming social, health, and economic costs. Despite the rising need for medication-assisted treatment, individuals struggling with opioid use continue to face multiple barriers hindering their access to care, particularly in rural areas. Innovative approaches to enhance access to treatment are needed. Telepsychiatry has proven to be effective and economical across multiple settings and psychiatric diagnoses, including opioid use disorder. As the implementation of telepsychiatry continues to expand, this method of healthcare delivery offers significant opportunities to overcome several barriers to access patients with opioid use disorder face. While addressing the opioid crisis will require multifaceted efforts involving multiple stakeholders and different approaches, a comprehensive strategy must incorporate the adoption of telepsychiatry as an innovative approach to overcoming barriers to treatment and enhancing access to care.
Similar content being viewed by others
References
Opioid Overdose. Understanding the Epidemic. Center for Disease Control and Prevention. Available online at https://www.cdc.gov/drugoverdose/epidemic/index.html. Accessed on February 5, 2018.
Zheng W, Nickasch M, Lander L, et al. Treatment Outcome Comparison between Telepsychiatry and Face-to-Face Buprenorphine Medication-Assisted Treatment for Opioid Use Disorder: A 2-Year Retrospective Data Analysis. Journal of Addiction Medicine. 2017;11(2):138–144.
National Advisory Committee on Rural Health and Human Services. Families in Crisis: The Human Service Implications of Rural Opioid Misuse. U.S. Department of Health & Human Services. Available online at https://www.hrsa.gov/advisorycommittees/rural/publications/opioidabuse.pdf. Accessed on February 5, 2018.
Rosenblatt RA, Andrilla CH, Catlin M, et al. Geographic and Specialty Distribution of US Physicians Trained to Treat Opioid Use Disorder. Annals of Family Medicine. 2015;13(1):23–26.
Drugs of Abuse. Opioid Overdose Crisis. The National Institute on Drug Abuse. Available online at https://www.drugabuse.gov/drugs-abuse/opioids/opioid-crisis#five. Accessed on February 4, 2018.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC: American Psychiatric Association, 2013.
Rudd R, Seth P, David F, et al. Increases in Drug and Opioid-Involved Overdose Deaths – United States, 2010-2015. Morbidity and Mortality Weekly Report. 2016;65(50–51):1445–1452.
Havens JR, Oser CB, Leukefiled CG, et al. Differences in Prevalence of Prescription Opiate Misuse among Rural and Urban Probationers. American Journal of Drug and Alcohol Abuse. 2007;33(2):309–317.
Paulozzi LJ, Xi Y. Recent Changes in Drug Poisoning Mortality in the United States by Urban-Rural Status and by Drug Type. Pharmacoepidemiology and Drug Safety. 2008;17: 997–1005.
Florence CS, Zhou C, Luo F, et al. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013. Medical Care. 2016;54(10):901–906.
Kolodny A, Courtwright DT, Huang CS, et al. The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of Addiction. Annual Review of Public Health. 2016;36:559–574.
World Health Organization. Guidelines for the Psychosocially-Assisted Pharmacological Treatment of Opioid Dependence. Geneva, Switzerland: World Health Organization, 2009.
American Society of Addiction Medicine. The National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. Chevy Chase, MD: American Society of Addiction Medicine, 2015.
Mattick RP, Breen C, Kimber J, et al. Methadone Maintenance Therapy versus No Opioid Replacement Therapy for Opioid Dependence. Cochrane Database of Systematic Reviews. 2009;(3).
Jones CM, Campopiano M, Baldwin G, et al. National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment. American Journal of Public Health. 2015;105(8):55–63.
Molfenter T, Sherbeck C, Zehner M, et al. Buprenorphine Prescribing Availability in a Sample of Ohio Specialty Treatment Organizations. Journal of Addictive Behaviors, Therapy, & Rehabilitation. 2015;4(2):100140.
Stein BD, Gordon AJ, Dick AW, et al. Supply of Buprenorphine Waivered Physicians: the Influence of State Policies. Journal of Substance Abuse Treatment. 2015;48(1):104–111.
Overview. Workforce. The Substance Abuse and Mental Health Services Administration. Available online at https://www.samhsa.gov/workforce. Accessed on February 5, 2018.
Quest TL, Merrill JO, Roll J, et al. Buprenorphine Therapy for Opioid Addiction in Rural Washington: The Experience of the Early Adopters. Journal of Opioid Management. 2012;8(1):29–38.
Medication-Assisted Treatment. Buprenorphine Waiver Management. The Substance Abuse and Mental Health Services Administration. Available online at https://www.samhsa.gov/medication-assisted-treatment/buprenorphine-waiver-management. Accessed on February 5, 2018.
National Council Medical Director Institute. The Psychiatric Shortage Causes and Solutions. Washington, DC: The National Council for Behavioral Health, 2017.
Cummings, J. Are We Doing All We Can to Stop the Opioid Crisis? U.S. News and World Report: Healthcare. Available online at https://health.usnews.com/health-care/for-better/articles/2017-08-31/are-we-doing-all-we-can-to-stop-the-opioid-crisis. Accessed on February 5, 2018.
Shore, JH. Telepsychiatry: Videoconferencing in the Delivery of Psychiatric Care. The American Journal of Psychiatry. 2013;170(3):256–262.
Chakrabarti, S. Usefulness of Telepsychiatry: A Critical Evaluation of Videoconferencing-Based Approaches. World Journal of Psychiatry. 2015;5(3):286–304.
Wilson LS, Maeder AJ. Recent Directions in Telemedicine: Review of Trends in Research and Practice. Healthcare Informatics Research. 2015;21(4):213–222.
Hilty DM, Ferrer DC, Parish MB, et al. The Effectiveness of Telemental Health: A 2013 Review. Telemedicine Journal and E-Health. 2013;19(6):444–454.
Dwyer, TF. Telepsychiatry: Psychiatric Consultation by Interactive Television. American Journal of Psychiatry. 1973;130(8):865–869.
Bastini AB, King CM, Morgan RD, et al. Telepsychological Services with Criminal Justice and Substance Abuse Clients: A Systematic Review and Meta-Analysis. Psychological Services. 2016;13(1):20–30.
Eibl JK, Gauthier G, Pellegrini D, et al. The Effectiveness of Telemedicine-Delivered Opioid Agonist Therapy in a Supervised Clinical Setting. Drug and Alcohol Dependence. 2017;176:133–138.
Cohn D, Mahmoud, H. The Evolving Landscape of Behavioral Telehealth. Becker’s Hospital Review. Available online at https://www.beckershospitalreview.com/telehealth/the-evolving-landscape-of-behavioral-telehealth.html. Accessed on February 5, 2018.
Deslich S, Stec B, Tomblin S, et al. Telepsychiatry in the 21st Century: Transforming Healthcare with Technology. Perspectives in Health Information Management. 2013;10(Summer):1f.
Simms DC, Gibson K, O'Donnell S. To Use or Not to Use: Clinicians’ Perceptions of Telemental Health. Canadian Psychology. 2011;52(1):41–51.
Cuevas CDL, Arredondo MT, Cabrera MF, et al. Randomized Clinical Trial of Telepsychiatry through Videoconference versus Face-to-Face Conventional Psychiatric Treatment. Telemedicine Journal & e-Health. 2006;12(3):341–350.
Kinley A, Zibrik L, Cordeiro J, et al. TeleHealth for Mental Health and Substance Use: Literature Review. University of British Columbia. Available online at http://med-fom-ehealth-office.sites.olt.ubc.ca/files/2013/04/TeleMental-Health-Literature-Review-FINAL.pdf. Accessed on February 5, 2018.
O'Reilly R, Bishop J, Maddox K, et al. Is Telepsychiatry Equivalent to Face-to-Face Psychiatry? Results from a Randomized Controlled Equivalence Trial. Psychiatric Services. 2007;58(6):836–843.
Jong M. Managing Suicides via Videoconferencing in a Remote Northern Community in Canada. International Journal of Circumpolar Health. 2004;63(4):422–428.
Whitacre BE, Hartman PS, Boggs SA, et al. A Community Perspective on Quantifying the Economic Impact of Teleradiology and Telepsychiatry. The Journal of Rural Health. 2009;25(2):194–197.
Molfenter T, Holloway D, Zwick J. Trends in Telemedicine Use in Addiction Treatment. Addiction Science & Clinical Practice. 2015;10(14):1–10.
Substance Abuse and Mental Health Services Administration. Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health. U.S. Department of Health & Human Services. Available online at https://addiction.surgeongeneral.gov/executive-summary.pdf. Accessed on February 5, 2018.
Kirby MJL, Keon WJ. Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada. The Senate of Canada. Available online at https://www.mentalhealthcommission.ca/sites/default/files/out_of_the_shadows_at_last_-_full_0_0.pdf. Accessed on February 5, 2018.
Smith M. The IMLC. Interstate Medical Licensure Compact. Available online at http://www.imlcc.org. Accessed on February 5, 2018.
The Center for Connected Health Policy. State Telehealth Laws and Reimbursement Policies: A Comprehensive Scan of the 50 States and District of Columbia. Public Health Institute. Available online at http://www.cchpca.org/sites/default/files/resources/50%20STATE%20PDF%20FILE%20APRIL%202017%20FINAL%20PASSWORD%20PROTECT.pdf. Accessed on February 5, 2018.
Centers for Medicare & Medicaid Services. Telehealth Services. U.S. Department of Health & Human Services. ICN 901705. Available online at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/TelehealthSrvcsfctsht.pdf. Accessed on February 5, 2018.
Centers for Medicare & Medicaid Services. Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program. Federal Register, Vol. 82, No. 139. Washington, DC: US Government Publishing Office, 2017.
Wang L, Alexander CA. Telepsychiatry: Technology Progress, Challenges, and Language and Transcultural Issues. Journal of Translational Medicine and Developmental Disorders. 2014;1(1):1–11.
Perrin, A. Digital Gap between Rural and Nonrural America Persists. Pew Research Center. Available online at http://www.pewresearch.org/fact-tank/2017/05/19/digital-gap-between-rural-and-nonrural-america-persists/. Accessed on February 5, 2018.
Author information
Authors and Affiliations
Contributions
Dr. Hossam Mahmoud developed the concept, performed literature search, performed literature review, write up, and editing. Ms. Emily Vogt performed literature search, performed literature review, write up, and editing.
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Mahmoud, H., Vogt, E. Telepsychiatry: an Innovative Approach to Addressing the Opioid Crisis. J Behav Health Serv Res 46, 680–685 (2019). https://doi.org/10.1007/s11414-018-9611-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11414-018-9611-1