Buprenorphine and Telehealth: A New Era in Opioid Use Disorder Treatment

Buprenorphine, the most frequently prescribed medication for opioid use disorder (OUD), is used to treat an estimated 1 to 2 million individuals annually. It’s a first-line treatment for OUD, highly effective at reducing opioid use, overdose, and all-cause mortality, and improving quality of life.

However, routine urine drug screening (UDS) to test for adherence to treatment and illicit substance use is inconsistent, despite its commonality in addiction treatment settings. There is a lack of consensus about testing schedules and how to respond to results, leading to great variation and inconsistencies.

The COVID-19 pandemic has catalysed federal policy changes, allowing for expanded telehealth-based opioid treatment (TBOT). Studies have found that TBOT may be associated with improved patient outcomes relative to in-person treatment. However, there’s an urgent need for rigorous studies exploring UDS in remote care settings.

A recent study found that most patients completed a UDS in the first 30 days of care, and an overwhelming majority within the first 90 days of care, suggesting that drug testing is feasible over a telehealth treatment platform.

Findings suggest that buprenorphine delivered in TBOT settings is an effective treatment for OUD, with low rates of opioid use across all time points in care.

However, the digital divide could exacerbate existing disparities related to health care access. It’s crucial for TBOT platforms to consider the complex interplay between clinical suitability for remote care and socioeconomic and digital barriers.

This is the first study characterising UDS administration and results in an exclusively TBOT setting, a significant step towards identifying the optimal processes for UDS in remote care settings.