Isolation and uncertainty, compounded with stressful changes, has affected mental health for populations across the board during COVID-19, prompting many to turn to substance use. Over the course of the pandemic, the United States has seen a dramatic increase in substance use, as well as cases of addiction and overdose.
Check out these facts:
- As of June 2020, 13% of Americans reported starting or increasing substance use as a way of coping with stress or emotions related to COVID-19 (CDC)
- More than 40 U.S. states have seen increases in opioid-related mortality (AMA)
- Nearly every state has reported an outbreak or sustained increase in drug overdose (AMA)
This uptick amid pandemic circumstances has presented unique challenges for clinicians and treatment centers, as the need for support is growing, while access to in-person help is simultaneously diminishing.
Virtual Care & Telemedicine
Prior to COVID, there were restrictions on clinicians providing prescriptions without an in-person meeting – and on treating addiction via telemedicine (Michigan Medicine). With many addiction treatment facilities forced to eliminate or decrease in-person patient contact during the pandemic, these policies were lifted, allowing the use of virtual appointments, support groups and treatment services.
Through virtual care, providers are able to check in with clients remotely, alter treatment plans, and remain in contact with those battling a substance use disorder – or who are in recovery. Additionally, crucial lifelines such as group meetings have been able to continue virtually, offering the support necessary to cope with the impulsivity and negative behaviors associated with addiction.
Insurance companies were also forced to change their policies to allow virtual treatment for behavioral health, including substance use disorder, which was previously restricted (APA). While some facilities have been able to offer these virtual services, also called telemedicine or telehealth, it doesn’t come without drawbacks or challenges.
Challenges of Telehealth in Substance Use Treatment & Recovery
Patient Access to Technology & Internet Connection
While access to devices with internet capabilities have become more affordable and widely available in the United States, some clients remain without these devices and therefore unable to engage in virtual treatment or support groups. For those who are in treatment or recovery, this dip in support could potentially lead to relapses or disrupt a treatment plan.
Frequent Technical Issues
Due to the ban on social gatherings during the pandemic, many began using the internet and associated devices for the first time and have a lack of experience navigating technical difficulties.
Similarly, treatment centers and clinicians may have adopted new technologies or software programs to conduct virtual care appointments and, as we all know, there’s a learning curve. While technical issues can usually be resolved, clients may feel discouraged from engaging with virtual care due to these frustrations.
Privacy & Security
There are two sides to privacy in virtual care. One is on the part of the provider and the telehealth software, who are concerned with HIPAA and maintaining the privacy of the patient.
Then there is also the client, who may feel their privacy is threatened while engaging in a virtual session because of being in a shared living space where others may listen in or intervene in their session. Previously, in-person support was able to better secure a client’s confidentiality within the walls of the session setting.
Psychosocial Aspects of Telehealth
Both patients and providers share concerns about whether video-based interactions can provide the same quality as in-person interaction and treatment. Previously, those providing treatment were able to visually assess patient withdrawal or intoxication, create more social cohesion in group therapy settings, or build trust in one-on-one treatment (Mayo Clinic).
Furthermore, clients who experience a more effective form of treatment in an inpatient setting may struggle without additional social support, or feel challenged when it comes to following a prescription plan (APA).
While telehealth treatment for substance use is a safe and effective alternative to in-person sessions, it could be considered of mediocre quality.
American Medical Association: Reports of increases in opioid- and other drug-related overdose and other concerns during COVID pandemic
American Psychological Association: Substance use during the pandemic
Center for Disease Control: Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic
Mayo Clinic: Substance Use Disorders and Telehealth in the COVID-19 Pandemic Era
Michigan University Medicine: Barriers to Addiction Care Fell Because of COVID-19. Now the Challenge is Keeping Them Down