Expanded access to OUD medication during pandemic proved beneficial

Abstract

Several federal agencies in 2020 relaxed restrictions on medication treatments for opioid use disorder (OUD) to ensure continued access to treatment during the COVID‐19 pandemic. In order to examine the long‐term impacts of these measures, investigators conducted a longitudinal cohort study using Medicare data to compare use of OUD‐related telehealth services, use of medications to treat OUD, and incidence of overdose requiring medical treatment before and during the pandemic. Several Centers for Medicare & Medicaid Services data sources documenting behavioral health disorders and use of related treatment services were accessed. The cohort consisted of adult Medicare fee‐for‐service beneficiaries. Two mutually exclusive groups of individuals initiating OUD treatment before and after the pandemic were identified. The groups were followed for 6 months after their 6‐month index treatment periods in order to evaluate retention in OUD treatment. The primary outcomes were receipt of telehealth services, receipt of medication for OUD, and medically treated overdose. More individuals in the pandemic group compared with the pre‐pandemic group received telehealth services, with 19.6% of the pandemic group and 0.6% of the pre‐pandemic group receiving telehealth care related to OUD. Receipt of any medication for OUD was more prevalent in the pandemic group (7.5% vs. 4.4%). The percentages of patients receiving buprenorphine or medications from an opioid treatment program were higher in the pandemic cohort. Rates of medically treated overdose were similar in the two groups. Within the pandemic cohort, receipt of telehealth services was associated with increased retention in medication treatment. Those receiving OUD‐related telehealth services were also less likely to experience a medically treated overdose. The researchers suggested that future studies should examine the effect of telehealth availability on other outcomes, such as illicit opioid use and overdose deaths. [Jones C, et al. JAMA Psychiatry 2022; published online Aug 31; doi: 10.1001/jamapsychiatry.2022.2284]