Telemedicine and Addiction Treatment
Telemedicine and Addiction Treatment
Table of Contents
What is Telemedicine?
For years, you had to hop in your automobile and drive to a brick-and-mortar location if you wanted your doctor to see you.
Sure, you could harness the internet’s incredible power to help you with medically related things; look up diseases and conditions you’re curious about online, order prescription medications from an online retailer, or check out websites for the latest healthcare technology advances.
But that’s where the convenience ended. Until now.
With virtual medicine, trips to the doctor’s office might become a thing of the past! But, does telemedicine work for addiction treatment outside of a recovery center?
Boosting Access to Health Care
Telehealth helps patients be more engaged with their care, dramatically boosts access to treatment, and makes medical care more cost-effective.
People living out in the country who have had difficulty getting medical care can now do some of it virtually. Patients and physicians can share medical information on a screen in real-time.
There are three types of virtual medicine:
Interactive: physicians and patients communicating in real-time
Store and forward: sharing a patient's medical information with a provider in a different location
Remote patient monitoring: using mobile devices to collect medical data
More About Therapies
Telehealth vs. Telemedicine
There are real differences between telehealth vs. telemedicine.
Telemedicine is clinical medical care. Telehealth covers a broader spectrum and includes not only clinical services, but non-clinical services such as continuing medical education, physician training, and administrative meetings between medical professionals.
Both things can include:
Video chat
Text messages
Phone calls
Telehealth can be a convenient option for just about anyone, but it’s especially useful for:
Those who live in rural areas, far from a nearby doctor's office
Have limited mobility
Have a busy schedule
Don't have a vehicle
Need medical care on vacation
Individuals and companies looking for assistance in delivering telemedicine healthcare solutions can call The National Consortium of Telehealth Resource Centers, a federally funded organization dedicated to helping those providing medical treatment at a distance.1
Who Can Provide Virtual Medicine?
Practitioners who can legally provide remote medical care include:
Physicians
Physician assistants
Nurse practitioners
Nurse-midwives
Clinical nurse specialists
Clinical psychologists and social workers
Registered dietitians
Virtual Appointments
These days, an increasing number of doctors schedule virtual appointments on Zoom or other video conferencing platforms.
For example, your doctor can remotely check in on you to see how you’re recovering from cataract surgery.
If you have sinus pain, he can have you press your nose and face, so you can tell him exactly where the tenderness is. Then, he might be able to remotely tell you whether you have chronic sinusitis, a TMJ disorder, or something else altogether.
Although telemedicine can replace some doctor’s visits, it can’t replace them all.
For example, if you have a sore throat, you might need a throat culture, which can’t be done over the internet (at least not yet).
Of course, there’s currently no way to do a surgical procedure in cyberspace, so this is yet another reason you might have to schedule an in-person visit.
Telemedicine Visits for Substance Use Disorders
21 million individuals in this country suffer from a substance use disorder. What’s particularly tragic about this is that fewer than 20% of people with SUD seek out treatment. One major cause of this is there’s a shortage of treatment providers.
Virtual medicine seeks to fill this gap.
One encouraging development is the availability of VA telehealth for substance use disorder. This makes sure veterans can access care when and where they need it.
Effectiveness of Telemedicine Addiction Treatment
Early research has shown that telemedicine addiction treatment is at least as effective as conventional methods.
The Journal of Psychosocial Nursing and Mental Health Services recounted a study that found that traditional alcoholism treatment and telemedicine programs were equally effective in keeping people sober.
Other studies have arrived at similar conclusions.
History of Telemedicine
The history of telemedicine is an interesting one.
Technology in medicine isn’t a recent development. Virtual medicine began way back in the 1800s with the development of the first telecommunications infrastructure. Field doctors first used the telegraph during the Civil War’s bloody battles to order medical supplies, consult with other physicians, and report casualties.
In 1922, Hugo Gernsback, who published the first science fiction magazine, wrote about a device called the teledactyl. This would not only allow physicians to see their patients from miles away but also to diagnose their ailments using a television screen and a robot with gangly arms.
Thus, Hugo predicted the advent of telemedicine.
In 1948, the first radiological images were transmitted by telephone between health centers 24 miles apart.
In 1959, physicians at the University of Nebraska relayed a bunch of neurological exams to medical students across campus using a two-way interactive television. And then, half a decade later, at the same institution, medical practitioners constructed a closed-circuit television setup. This allowed psychiatrists to do consultations with more than 100 miles separating them from their patients.
Gaps in Telemedicine Coverage for SUDs
In 2018, less than 1% of all substance use treatment providers offered telemedicine options, which is an appallingly low number.
The coronavirus made seeing your doctor a much riskier undertaking. Because of that, insurance companies, individual states, and the federal government moved swiftly to allow for more telemedicine options.
Here are some of the changes:
All out-of-pocket costs waived for remote visits
Reimbursement is required for audio-only telephone communications
Virtual medical care expanded beyond rural populations
Providers no longer have to be licensed in the state where the patient lives
Parity Laws
Currently, 31 states and the District of Columbia have enacted so-called “parity” laws that require private insurance companies to reimburse doctors for telemedical services. These laws say that location cannot be a factor when deciding to cover a physician’s visit.
This means that even if a patient is in his living room while remotely being seen by a practitioner, the private payer must compensate the doctor. However, there are exceptions for some insurance plans, such as worker’s compensation and small group plans. These types of medical coverage can opt-out of telehealth coverage.
In many states, those allowed to provide addiction treatment services via telemedicine have been expanded to include more than just doctors. This means that licensed alcohol and drug counselors can remotely offer therapy and rehabilitation in lots of places.
Federal Policy Changes
Since March, the DEA has allowed telemedicine to be used as an alternative to in-person visits. This even includes prescribing medication remotely—something that wasn’t allowed before the change in federal law.
This change will remain in effect as long as Alex Azar, Secretary of Health and Humans Services, declares the COVID-19 pandemic a public health emergency.
Doctors will be able to prescribe controlled substances for medication-assisted treatment programs providing these conditions are met:
The medication is something the physician would prescribe during his ordinary course of treatment
The telemedical consultation is done so that the doctor can see the patient in real-time
All applicable federal and state laws are adhered to
The result of this regulatory change?
A massive expansion in the availability of medication-assisted drug treatment uses medications in tandem with counseling and behavioral therapies.
If you want to keep up with the all rapidly changing policies and laws, check out the Center For Connected Health Policy’s website.2
Benefits of Telehealth During the Coronavirus Crisis
During the coronavirus crisis, the benefits of telehealth are that it lets you be seen by your doctor virtually.
This means that social distancing is automatically enforced, minimizing the risk of virus exposure to both patients and medical professionals.
Digital Tools to Support Recovery
Virtual 12-Step Meetings
Millions of people all over the planet attend 12-step meetings to stay sober. However, in the coronavirus era, most of the in-person ones have been put on hold.
That’s a huge problem, seeing how many people use substances when they feel isolated and depressed.
Fortunately, online meetings seem to be filling the void. Most of them are done on Zoom, a video conferencing platform that’s attractive to many because it’s so straightforward and uncomplicated. You don’t even need to have internet access to connect to it, because you can use your telephone.
What’s more, you don’t have to use your real name or any name because the platform lets you remain anonymous.
Telehealth Therapy
Telehealth therapy works much like conventional sessions. However, you can meet with your therapist anywhere on the planet that’s most convenient for you.
This also allows you to have your session in a location where you feel most comfortable talking about sensitive topics.
The Role of New Technology in the Medical Field
These days, technology and healthcare are closely linked.
Technology has brought far-reaching changes to the medical field. Patients now have access to world-class diagnostic tools and cutting-edge procedures, resulting in better outcomes.
Storing healthcare records in the cloud means they can be accessed remotely—even in areas far off the beaten track. There’s a dizzying array of health and fitness apps that keep people in the best shape of their lives by tracking how much food they eat and their activity level.
Telemedicine is part of this technological trend that’s radically transforming the relationship between technology and healthcare. One organization that’s helping to accelerate this phenomenon is the American Telemedicine Association.
According to their website, they’re “committed to ensuring that everyone has access to safe, effective, and appropriate care when and where they need it, and that providers can do more good for more people.”
Telemedicine Pros and Cons
Pros
There are lots of wonderful things about telemedicine.
Doctors can see more patients without needing to hire more staff or even increase their office square footage. Since fewer patients are in waiting rooms, contracting deadly diseases like the coronavirus is minimized. Physicians have tremendous cost savings because seeing patients on a more flexible schedule means seeing more patients.
Of course, it’s not only doctors who benefit from the extraordinary advances in telemedicine. Patients do too.
A patient can have his appointment at home or another favorite location, without having to brave traffic or spend money on gas. They don’t have to miss a day of work either because they can conveniently schedule a consultation during a work break.
Telemedicine is a boon for rural populations, where there is a shortage of specialized providers.
Cons
Many rural communities don’t have high-speed internet yet, which is a significant barrier to telemedicine adoption. Also, it requires access to equipment that might be too expensive for small country clinics.
The data generated during a virtual visit is more vulnerable to hacking, which means you could lose it to third parties trying to sell it.
There are still some conditions you will need to see a doctor in person to get a complete diagnosis or treatment.
