Patients with opioid use disorder are significantly more likely to stick with their treatment plan when offered buprenorphine via telemedicine, according to a new study in The American Journal of Drug and Alcohol Abuse.
The study was supported by Ophelia, a startup that provides prescriptions to manage opioid addiction via telehealth.
Conducted between April and September of last year, the study involved 1,378 patients. About 58% of the patients lived in Pennsylvania, and about 42% lived in New York. Across all participants, about 21% lived in rural communities, and about 79% lived in urban areas. The mean age of the patient population was 35.6 years.
Patients in the study received buprenorphine via telemedicine, and their 180-day treatment retention rate was 56.4%. The researchers also studied a subset of these patients for 365 days, and found that their treatment retention rate was 48.3%. These rates are higher than retention rates for OUD patients receiving buprenorphine in-person, the researchers said.
The research team hypothesized that retention rates would be lower among racial and ethnic minorities, as well as rural patients. However, the study found no significant associations between treatment retention and factors like sex, race, ethnicity, state or rurality.
These results are especially poignant in light of the Drug Enforcement Administration’s proposed rules, which were released in late February. The DEA’s proposal seeks to roll back some of the flexibilities allowed during the pandemic for the prescribing of controlled substances via telemedicine.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Under the DEA’s proposed rules, patients can receive only a 30-day initial supply of prescriptions for Schedule III-V drugs via telemedicine. After that, patients will need an in-person visit. This includes drugs that treat substance use disorder like buprenorphine, as well as some common psychiatric drugs like Xanax, Ambien and Prozac.
These rules have been met with mixed reviews. Some people agree with the DEA, which is touting the change as a way to ensure patient safety. But many telehealth advocates argue it will greatly disrupt access to treatment for many Americans — especially at a time when the mental health and substance use crisis is growing.
Ophelia CEO Zack Gray is among the telehealth leaders vocally opposing the proposed rules. He founded his company in 2019 after losing his girlfriend to an overdose from drugs meant to treat her accidental opioid addiction. Due to a number of reasons, she had to turn to the black market to get buprenorphine and suboxone to treat her addiction. These reasons included convenience, stigma, her inability to take time off work and the fact that she was a private person.
Many Americans face the same situation and are forced to self-administer life-saving drugs that are too difficult to obtain through legal means. But this often leads to more overdoses and deaths — self-treatment for OUD without guidance from a medical professional can be extremely dangerous.
As the DEA’s proposal looms, Gray said he hopes this study shines a light on how important it is to increase the availability of telehealth-based, medication-assisted treatment options for patients with OUD.
Photo credit: Sorbetto, Getty Images
