Old tech but not low tech: telephone-based treatment provision for substance use

Area of Science:

• Substance Use Disorder Treatment
• Telemedicine
• Health Equity

Background:

• Telemedicine offers improved patient care access and outcomes in substance use disorder treatment.
• Recent Centers for Medicare and Medicaid Services revisions allow audio-only care, impacting future regulations.
• Audio-only telemedicine addresses technology barriers and serves specific populations with reduced telehealth utilization.

Purpose of the Study:

• To evaluate the role and effectiveness of audio-only telemedicine, specifically telephone visits, in substance use disorder treatment.
• To highlight the importance of telephone-based care for increasing access and reducing disparities.
• To advocate for patient-centered hybrid care models incorporating telephone-only treatment.

Main Methods:

• Review of existing studies on telephone visits for buprenorphine treatment and substance use counseling.
• Analysis of patient and provider acceptance of telephone-based modalities.
• Examination of the impact of telephone-only treatment on care access, costs, and stigma.

Main Results:

• Telephone visits for buprenorphine treatment are well-accepted by patients and providers.
• Audio-only telemedicine is viable for individuals lacking technology, those in rural areas, and specific demographic groups facing disparities.
• Telephone counseling is convenient, flexible, empowering, and augments therapeutic alliances.

Conclusions:

• Telephone-only treatment is essential for reducing disparities in substance use disorder care.
• Hybrid care models including telephone options enhance service productivity, reduce no-show rates, costs, and stigma.
• The telephone remains a vital resource for accessible and sustainable substance use disorder treatment.