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Comment
. 2022 Oct 1;79(10):981-992.
doi: 10.1001/jamapsychiatry.2022.2284.

Receipt of Telehealth Services, Receipt and Retention of Medications for Opioid Use Disorder, and Medically Treated Overdose Among Medicare Beneficiaries Before and During the COVID-19 Pandemic

Christopher M Jones  1 , Carla Shoff  2 , Kevin Hodges  2 , Carlos Blanco  3 , Jan L Losby  1 , Shari M Ling  4 , Wilson M Compton  3
Affiliations
Comment

Receipt of Telehealth Services, Receipt and Retention of Medications for Opioid Use Disorder, and Medically Treated Overdose Among Medicare Beneficiaries Before and During the COVID-19 Pandemic

Christopher M Jones et al. JAMA Psychiatry. .

Erratum in

  • Change to Open Access Status.
    [No authors listed] [No authors listed] JAMA Psychiatry. 2022 Oct 1;79(10):1048. doi: 10.1001/jamapsychiatry.2022.3186. JAMA Psychiatry. 2022. PMID: 36197441 Free PMC article. No abstract available.

Abstract

Importance: Federal emergency authorities were invoked during the COVID-19 pandemic to expand use of telehealth for new and continued care, including provision of medications for opioid use disorder (MOUD).

Objective: To examine receipt of telehealth services, MOUD (methadone, buprenorphine, and extended-release [ER] naltrexone) receipt and retention, and medically treated overdose before and during the COVID-19 pandemic.

Design, setting, and participants: This exploratory longitudinal cohort study used data from the US Centers for Medicare & Medicaid Services from September 2018 to February 2021. Two cohorts (before COVID-19 pandemic from September 2018 to February 2020 and during COVID-19 pandemic from September 2019 to February 2021) of Medicare fee-for-service beneficiaries 18 years and older with an International Statistical Classification of Diseases, Tenth Revision, Clinical Modification OUD diagnosis.

Exposures: Pre-COVID-19 pandemic vs COVID-19 pandemic cohort demographic characteristics, medical and substance use, and psychiatric comorbidities.

Main outcomes and measures: Receipt and retention of MOUD, receipt of OUD and behavioral health-related telehealth services, and experiencing medically treated overdose.

Results: The pre-COVID-19 pandemic cohort comprised 105 240 beneficiaries; of these, 61 152 (58.1%) were female, 71 152 (67.6%) were aged 45 to 74 years, and 82 822 (79.5%) non-Hispanic White. The COVID-19 pandemic cohort comprised 70 538 beneficiaries; of these, 40 257 (57.1%) were female, 46 793 (66.3%) were aged 45 to 74 years, and 55 510 (79.7%) were non-Hispanic White. During the study period, a larger percentage of beneficiaries in the pandemic cohort compared with the prepandemic cohort received OUD-related telehealth services (13 829 [19.6%] vs 593 [0.6%]; P < .001), behavioral health-related telehealth services (28 902 [41.0%] vs 1967 [1.9%]; P < .001), and MOUD (8854 [12.6%] vs 11 360 [10.8%]; P < .001). The percentage experiencing a medically treated overdose during the study period was similar (18.5% [19 491 of 105 240] in the prepandemic cohort vs 18.4% [13 004 of 70 538] in the pandemic cohort; P = .65). Receipt of OUD-related telehealth services in the pandemic cohort was associated with increased odds of MOUD retention (adjusted odds ratio [aOR], 1.27; 95% CI, 1.14-1.41) and lower odds of medically treated overdose (aOR, 0.67; 95% CI, 0.63-0.71). Among beneficiaries in the pandemic cohort, those receiving MOUD from opioid treatment programs only (aOR, 0.54; 95% CI, 0.47-0.63) and those receiving buprenorphine from pharmacies only (aOR, 0.91; 95% CI, 0.84-0.98) had lower odds of medically treated overdose compared with beneficiaries who did not receive MOUD.

Conclusions and relevance: Emergency authorities to expand use of telehealth and provide flexibilities for MOUD provision during the pandemic were used by Medicare beneficiaries initiating an episode of OUD-related care and were associated with improved retention in care and reduced odds of medically treated overdose. Strategies to expand provision of MOUD and increase retention in care are urgently needed.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Compton reports long-term stock holdings in General Electric Co, 3M Companies, and Pfizer outside the submitted work. No other disclosures were reported.

Comment on

References

    1. Substance Abuse and Mental Health Services Administration . Medications for opioid use disorder: for healthcare and addiction professionals, policymakers, patients, and families. Accessed March 17, 2022. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP... - PubMed
    1. National Academies of Sciences, Engineering, and Medicine Committee on Medication-Assisted Treatment for Opioid Use Disorder ; Mancher M, Leshner AI, eds. Medications for Opioid Use Disorder Save Lives. The National Academies Press; 2019. doi: 10.17226/25310 - DOI - PubMed
    1. US Centers for Disease Control and Prevention . Provisional drug overdose death counts. Accessed April 4, 2022. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
    1. Volkow ND. Collision of the COVID-19 and addiction epidemics. Ann Intern Med. 2020;173(1):61-62. doi: 10.7326/M20-1212 - DOI - PMC - PubMed
    1. Alexander GC, Stoller KB, Haffajee RL, Saloner B. An epidemic in the midst of a pandemic: opioid use disorder and COVID-19. Ann Intern Med. 2020;173(1):57-58. doi: 10.7326/M20-1141 - DOI - PMC - PubMed

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