The need for private, safe and accessible substance and mental health treatment during times of national crisis.
Our group of experienced physicians and psychologists at iRecovery, had already been working on a large scale roll out of comprehensive telemedical services for our patients suffering with substance use and co-occurring mental health disorders, when reports of the COVID-19 virus pandemic began to surface. The outbreak has accelerated the need for our services, and we are forging ahead more determined than ever. As people across the United States contend with Corona virus disease, transmission, and the need for social distancing; care and treatment in a telemedical virtual environment for the millions of Americans facing substance use and mental health disorders has never been more vital.
According to the 2018 National Survey on Drug Use and Health (NSDUH), 164.8 million people aged 12 or older in the United States (60.2 percent) were past month substance users (i.e., tobacco, alcohol, or illicit drugs), 20.3 million people age 12 or older had a substance use disorder (SUD) and 9.2 million adults ages 18 or older had co-occurring mental health and substance use disorder. According to the Center of Disease Control and Prevention (CDC), in 2013 accidental drug overdose surpassed motor vehicles accidents as a leading cause of death. Recent statistics from the CDC and the National Center for Health Statistics reported over 69 thousand drug overdose deaths in 2019; 7 out of 10 due to opioids. Over 770,000 Americans have died from drug overdoses since 1999 and the country remains in an opioid epidemic at this time.
Treatment of substance use disorder during COVID-19
Prior to the pandemic that has spread throughout the United States, only about 10% of those diagnosed with a substance use disorder received any form of treatment. Given the issues associated with COVID 19 transmission, access to substance use treatment has become even more elusive and difficult. Traditional approaches to treating substance use disorder have primarily involved abstinence only models in detoxification or residential treatment facilities. While inpatient services are imperative for those requiring a high level of care and supervision, recovery rates at one year have been historically low. Additional concerns in accessing inpatient treatment include cost, insurance coverage, and the personal commitment necessary to enter a program and separate from family, work and other life obligations for 30 days or more.
The need for evidenced based practices with better outcomes has been extensively discussed as the opioid epidemic has continued to grow and overdose deaths rates remain high. While the FDA approved medication to treat opioid and alcohol use disorders have been effective, they have not been widely available. Less than 20% of patients with an addiction to opioids receive Medication Assisted Treatment services (MAT). According to the FDA (2019) “MAT is evidence-based treatment that includes FDA-approved medication combined with counseling and psychosocial support.” These medications, including Suboxone and Naltrexone, help people recover, but providers of MAT services have not been readily available until now. Additionally, among those who do offer MAT services, many fail to incorporate counseling and case management components of treatment that are imperative to successful recovery.
The successful treatment of substance use disorders has suddenly become far more complex with the introduction of COVID-19 into our society. According to an article recently published on March 12, 2020 by the National Institute on Drug Abuse (NIH), COVID-19 “could hit some populations with substance use disorders (SUDs) particularly hard”. Coronavirus deaths appear to be concentrated around those with underlying health conditions, including respiratory problems. People with opioid use disorder may be more vulnerable and at risk of death due to the impact these drugs have on our patients respiratory and immune systems.
Not only is the risk of opioid overdose a constant area of concern in the United States, but we must now contend with challenges regarding transmission of the COVID-19 virus among this vulnerable population. Individuals with substance use disorder tend to have higher rates of homelessness and incarceration then the general population. Individuals addicted to substances already face many obstacles to recovery, including the tendency to utilize extensive rationalizations to avoid treatment due to the compulsive nature of the disease. Financial and other barriers for receiving help may be further complicated at this time. Even if treatment is accessible and affordable, are individuals and their families going to be comfortable admitting to inpatient treatment facilities, or even in seeking face to face outpatient services? Fear of transmission may be a substantial impediment to seeking help from others.
The role of telemedicine in addiction treatment
Having overseen treatment services at the inpatient level of care for nearly twenty-years, I made the decision to forge a path to developing a telemedicine platform to drastically increase accessibility to affordable comprehensive substance abuse care with superior long-term success rates. We have dedicated countless hours to building a model for online treatment that includes assessment by a physician and psychologist, as well as ongoing re-assessment, individual therapy, group therapy, case management and medication management services from the comfort and safety of your home. When we began this mission, we felt there was enormous need in the general community and underserved areas where access to medical and psychological services is sparse. As I write this today, sitting in my home awaiting the next update by the CDC, the need for medical and behavioral healthcare utilizing telemedicine has just increased exponentially.
About the author – Jeffrey Huttman, PH.D.
Dr. Huttman is the Chief Clinical Officer for iRecovery. He oversees clinical care and is responsible for therapeutic programming, development, and areas of the company’s overall operations. He has been in practice for nearly twenty years.
If you would like more information about our addiction services, including online drug counseling, online alcohol counseling and more, get in touch with us today by visiting our website, or calling 855-791-1592