Headline

While telehealth has the potential to increase access to treatment for opioid use disorder (OUD), barriers still exist for patients and providers in receiving and delivering virtual care. 

Context

Many people with OUD do not receive evidence-based treatment. During the COVID-19 pandemic, new temporary flexibilities for telehealth delivery of OUD treatment enabled more people to receive care virtually. There has been limited research on the impact of telehealth on access to care among the most marginalized populations with OUD, such as those experiencing poverty, unstable housing, or criminal justice involvement. This qualitative study explores clinician and staff perspectives on the use of telehealth within a low-barrier, harm reduction-oriented OUD treatment program in Philadelphia.

Findings

Clinicians and staff shared that telehealth for OUD can promote easier access for some patients who face barriers to in-person care, and can support immediate access to treatment when a patient decides they are ready. However, some patients struggled to engage with telehealth due to limited access to and lack of comfort with the technology. Given hybrid approaches where some patients received care virtually and others in-person, clinicians and staff questioned whether future decisions about care modality would be driven by providers or by patients. Patients varied in their preference for in-person and telehealth OUD treatment. Study participants noted that the patients who struggled the most to participate in in-person OUD care were often described as “unstable,” and some clinicians and staff reported feeling uncomfortable delivering virtual care to these patients.

Takeaways

Clinician training on harm reduction-oriented telehealth and policies supporting patient choice in care modality could address barriers to care among marginalized individuals with OUD. Future policy should address improved access to telehealth-related technology for marginalized patients.