The Availability of Treatment
1 in 7 adults over the age of 12 have a substance abuse problem. That is over 40 million Americans but only 1 in 10 people who need treatment will find it. This is due in part to the availability of substance abuse treatment centers. A large population struggling with substance abuse live in rural areas and low-income urban areas. There are limitations to the availability of drug and alcohol rehabs. Therefore, they tend to centralize in urban areas to maximize their help. Because of this, people in rural areas are often subjected to travel long distances in order to receive the care they need. This generally adds to expenses as they must now spend money on flights and stay.
A larger problem arises after the completion of treatment. Because of the lack of access, people in rural areas can no longer continue care through outpatient sessions. The chances for long-term success dramatically declines without ongoing care.
Life Responsibilities Make it Hard to Attend Treatment
While lack of availability may be a contributing factor in people not receiving treatment, it is not the only one. In areas like Florida, where treatment centers are relatively available throughout the state, people may still have barriers that prevent them from receiving care. This is in part because a full treatment program can take up to 90 days or longer. Most people cannot afford to take off 3 months of work. FMLA can help keep a person’s job safe while on medical leave, but it does not help with providing income. The only way to receive income while on leave is if your company offers short-term disability; and even in these cases, it will typically only cover a percentage of income.
Treatment is therefore reserved for individuals who can afford a 90-day inpatient treatment program, have both the physical and financial means to travel and all while also being able to financially and logistically afford to take 3 months off of work and family responsibilities. For this reason, not everyone is lucky enough to attend a full treatment program.
Here’s where Telehealth (or Telemedicine) comes in. Telemedicine can offer an alternative mode of treatment from an in-person treatment program. This opens up treatment options for individuals who are unable to attend treatment due to the multitude of life constraints.
What is Telemedicine for Addiction Treatment?
Telemedicine for addiction treatment has both benefits and a few potential drawbacks. The typical treatment process for substance abuse involves a process of detox, therapy, and aftercare. Often times individuals may be reluctant to this process as it involves both a time and cost commitment. Also, many people feel embarrassed about attending a treatment center due to the lingering stigma associated with being in rehab. For this reason, Telemedicine can help reduce these obstacles and therefore bridge the gaping participation gap in addiction recovery programs. Patients have greater flexibility, privacy, and accessibility with addiction telemedicine programs, increasing the chances of successful recovery.
Very simply, telemedicine is the process of receiving medical care services over the internet, usually by speaking with a physician or counselor through a live video call. As long as a person has access to a computer and the internet, they have access to addiction treatment. According to the Pew Research Center, 84% of US households own a computer and 73% have a computer with internet. This technique can bridge the treatment gap by reaching people in areas where treatment is not readily available, like rural areas. This can also provide an accessible alternative for working people and parents.
Telemedicine is also a great option for people who tend to travel frequently. Many psychiatrists require an initial one-time, in-person physical examination, but after this initial physical, psychiatrists can easily communicate with their patients through various telecommunications to virtually diagnose, prescribe medication and monitor progress. For people who travel, this can be a great way to maintain the same doctor or therapist despite continual relocation.
Privacy regulations and strict HIPAA laws protect patient confidentiality while in treatment. These laws require special video connection software ensuring patient security. These software programs are as simple as setting up any other video conferencing program but offer encrypted coding and cybersecurity protecting a person’s private information.
If you have ever been to treatment before, you understand how rigid each program can be, from inpatient to PHP, to IOP, and even outpatient. Having to work late one day may mean rescheduling your counseling session which may take up to a full week to reschedule. Because of the convenience and readiness of addiction counseling through telemedicine, patients will be able to maintain their recovery during their lunch break all without having to leave their office.
Telemedicine scheduling is typically done through an online scheduler making it easier for you and your counselor to schedule and reschedule. Life can get in the way sometimes, but consistency is a driving factor in maintaining one’s sobriety. Telemedicine adapts to people’s busy lifestyle to work around their schedule instead of the other way around.
Telemedicine is a relatively new mode of treatment. There are a few studies showing the effectiveness of telemedicine in the general healthcare field, but limited data when it comes to substance abuse treatment specifically.
One small sample study displayed the effectiveness of telepsychiatry. According to the study, “Patients showed no significant differences in level of satisfaction…” Another study raised concerns towards initial setup themselves rather than the overall treatment experience.
Remote analysis and monitoring services and electronic data storage significantly reduce healthcare service costs, saving money for you and insurance companies.
Millennials—who have statistically shown opt for high-deductible health plans—also have an opportunity to save money. According to a study conducted by Red Quill Consulting Inc., the average cost of a virtual visit is $40 to $50, while in-person care can cost as much as $176 per visit. Addiction treatment often requires care 5 days a week for the first 3 months. Therefore, for people without insurance, telemedicine for substance abuse can save people thousands of dollars.
The Drawbacks of Telemedicine for Substance Abuse
While there are obvious benefits to addiction telemedicine treatment, this therapy mode does come with some shortcomings. Medication-Assisted Treatment (MAT) through telemedicine is more complicated. Talk therapy performed entirely through telecommunication is possible, but not with MAT requires an in-person physical examination.
It is still unknown if the lack of face-to-face treatment will impact the overall experience of therapy treatment. The lack of personal communication could create an unwanted barrier between the therapist and patient, but this has still yet to be determined.
A barrier for many is the cost of telemedicine. Under the affordable care act, insurances do not cover mental health and substance use disorders at the same rate they cover medical and surgical benefits. Unfortunately, this does not include telehealth. Currently, only 22 states have passed laws that require insurers to provide some form of reimbursement for these services.
Other shortcomings involve the accessibility of telemedicine for providers. Currently, there are strict barriers in order to provide telemedicine care. Data analyzed from state Medicaid programs revealed psychiatrists as the behavioral health provider most commonly authorized to perform telehealth, followed by social workers, psychologists, and finally, addiction counselors being the least likely to have authorization.  Despite having great potential for assisting recovery and treating patients with substance use disorders, telemedicine is underutilized in addiction treatment centers because of these barriers. 
Getting Help for a Substance Abuse Issue
At the current moment, telemedicine programs are far and few in between, especially when it comes to substance abuse treatment. Over time, the benefits of telehealth will prove and test the effectiveness, but for now, the barriers of entry both on the patient side and provider side will limit the availability of telemedicine care. Although, once telemedicine becomes more mainstream, it will not be a means to replace drug and alcohol rehabs. Telemedicine cannot compete with a comprehensive residential, inpatient, PHP, or IOP treatment program. but it can help maintain an established relationship between healthcare providers and their patients. It can also be a final option for individuals in remote rural areas or people who cannot leave their family or work.
At Coalition Recovery™ our drug rehab customizes a program for each individual client, often incorporating medication-assisted detox services that progress into drug treatment programs and finally aftercare that extends our care far beyond treatment. Our multidisciplinary approach to addiction treatment includes care for co-occurring disorders as well as family therapy. Contact us now to learn about admissions from one of our addiction specialists. They can help walk you through our available options and choose a path that best fits your needs.
1. Page, C., Beck, A.J., & Buche, J. (2017). An analysis of behavioral telehealth authorization in scopes of practice. Retrieved from behavioralhealthworkforce.org/wp-content/uploads/2017/11/Y2FA3P1_Telehealth_-Full-Report.pdf
2. Molfenter, T., Brown, R., O’Neill, A., Kopetsky, E., & Toy, A. (2018). Use of telemedicine in addiction treatment: Current practices and organizational implementation characteristics. International Journal of Telemedicine and Applications, Volume 2018, Article I.D. 3932643.
Content Creator for Coalition Recovery