Initiating Drugs for Opioid Use Disorders Via Telemedicine During COVID-19: Implications for Proposed Reforms to Law Ryan Haight

This article was originally published here

J Gen Med Intern. October 28, 2021. doi: 10.1007 / s11606-021-07174-w. Online ahead of print.


BACKGROUND: The Ryan Haight Act generally requires that a clinician make an in-person visit before prescribing a drug for opioid use disorder (OUD). This requirement has hampered the use of telemedicine to expand OUD treatment, and many policymakers have called for its removal. During the COVID-19 pandemic, effective March 16, 2020, the requirement has been temporarily lifted. It is not clear whether clinicians who treat patients with OUD perceive telemedicine as a safe and effective way to initiate treatment with OUD.

OBJECTIVE: To understand clinician use and comfort level in using telemedicine to introduce patients to medications for opioid use disorder.

DESIGN: National survey administered electronically via the WebMD / Medscape Online Clinician Panel in Fall 2020.

PARTICIPANTS: A total of 602 clinicians (primary care providers, psychiatrists, nurse practitioners or certified nurses, and physician assistants) participated in the survey.

MAIN MEASURES: Frequency of video, audio-only and in-person visits for initiation of treatment, level of comfort with the use of video for new patient visits with OUD.

KEY RESULTS: Clinicians varied widely in their use of telemedicine for drug initiation. About 25% used telemedicine for most initiations, while 40% only used in-person visits. The majority (55.8%) expressed at least some discomfort with the use of telemedicine to treat new patients with OUD, although clinicians with more patients with OUD were less likely to ‘express such unease.

CONCLUSION: The results suggest that a permanent relaxation of Ryan Haight’s requirement may not result in widespread adoption of telemedicine for OUD drug initiation without additional support or incentives.

IDPM: 34713386 | DOI: 10.1007 / s11606-021-07174-w

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