Virtual opioid agonist treatment: Alberta's virtual opioid dependency program and outcomes

Area of Science:

• Digital Health
• Addiction Medicine
• Public Health

Background:

• Telehealth, including telemedicine, offers a solution to reduce access barriers in opioid agonist therapy (OAT).
• Common barriers include transportation, in-person induction, employment, and childcare challenges.
• A fully virtual OAT model was developed and implemented in Alberta, Canada.

Purpose of the Study:

• To introduce a unique virtual clinic model for OAT delivery.
• To describe the outcomes associated with this virtual care model.
• To evaluate the effectiveness of telehealth in improving OAT access and retention.

Main Methods:

• Retrospective chart review of electronic health records from Alberta's Virtual Opioid Dependency Program (VODP).
• Extracted outcome data at admission and at 3, 6, and 12 months post-admission.
• Analyzed utilization trends over three years and treatment retention rates at 6 and 12 months.

Main Results:

• 440 client records were analyzed, showing rapid utilization growth.
• Median wait days for treatment decreased from 6 to 0 days with a Same Day Start service.
• Treatment retention was high: 90% at 6 months and 58% at 12 months.
• Client satisfaction was 90%, with reported reductions in drug use and overdose, and improved social functioning.

Conclusions:

• The VODP virtual model demonstrates high client satisfaction, rapid growth, and positive clinical outcomes.
• This entirely virtual OAT delivery is a promising strategy for evidence-based opioid use disorder (OUD) treatment.
• It particularly benefits individuals in rural or underserved areas during the fentanyl overdose crisis.