Increased use of telehealth services, medications during pandemic associated with reduced risk for f

The COVID-19 pandemic has led to an increase in substance abuse, particularly opioid abuse, and overdose deaths. However, a new study published in JAMA Psychiatry suggests that the expanded availability of telehealth services and medications for opioid use disorder (OUD) during the pandemic has been associated with a reduced risk of fatal drug overdose among Medicare beneficiaries.

Study Design

Researchers analyzed data from two cohorts of Medicare beneficiaries with OUD to explore the receipt of OUD-related telehealth services, medication for OUD, and fatal overdoses before and during the pandemic. The first cohort included 105,162 Medicare beneficiaries with OUD from September 2018 to February 2020 (pre-pandemic), while the second cohort included 70,479 Medicare beneficiaries with OUD from September 2019 to February 2021 (pandemic). The researchers also examined the demographic and clinical characteristics associated with fatal overdose in the pandemic cohort.

Key Findings

The study found that Medicare beneficiaries who began a new episode of OUD-related care during the pandemic and received OUD-related telehealth services had a 33% lower risk of a fatal drug overdose. Furthermore, Medicare beneficiaries who received medications for OUD from opioid treatment programs and those who received buprenorphine, one of the medications for OUD, in office-based settings also had reduced odds of a fatal drug overdose of 59% and 38%, respectively.

Mortality rates, including drug overdose mortality, were higher in the pandemic cohort compared to the pre-pandemic cohort. However, the percentage of deaths due to drug overdose was similar between the two cohorts.

Implications

The study's findings highlight the benefits of expanding telehealth services and medication treatment for OUD during the pandemic. The authors note that only 1 in 5 Medicare beneficiaries in the pandemic cohort received OUD-related telehealth services, and only 1 in 8 received medications for OUD. Therefore, the authors emphasize the need to continue expanding access to these interventions across clinical settings, particularly in underserved communities.

Journal Information: Christopher M. Jones et al, Association of Receipt of Opioid Use Disorder–Related Telehealth Services and Medications for Opioid Use Disorder With Fatal Drug Overdoses Among Medicare Beneficiaries Before and During the COVID-19 Pandemic, JAMA Psychiatry (2023). DOI: 10.1001/jamapsychiatry.2023.0310