Expanding access to buprenorphine treatment in rural areas with the use of telemedicine.

BACKGROUND AND OBJECTIVES: The opioid epidemic in the United States has resulted in a public health emergency. Medication-assisted treatment (MAT) with methadone and buprenorphine are evidence-based treatments for opioid use disorder. However, numerous barriers hinder access to treatment in rural areas. The use of telemedicine to deliver psychiatric services is demonstrated to be safe and effective; however, limited data exist on the novel application of telemedicine in the delivery of MAT. This report describes the results of a retrospective chart review of 177 patients in a rural drug treatment center that were treated with buprenorphine through telemedicine. METHODS: This study evaluated a program that began providing buprenorphine treatment to patients at a drug treatment center in rural Maryland via telemedicine in August 2015. A chart review was performed of the first 177 patients who were enrolled in the program. Data were extracted to examine retention in treatment and rates of continued opioid use. RESULTS: Retention in treatment was 98% at 1 week, 91% at 1 month, 73% at 2 months, and 57% at 3 months. Of patients still engaged in treatment at 3 months, 86% had opioid-negative urine toxicology. DISCUSSION AND CONCLUSIONS: Our findings suggest that treatment with buprenorphine can be effectively delivered by telemedicine to patients with opioid use disorders in a rural drug treatment program. SCIENTIFIC SIGNIFICANCE: This use of telemedicine is a potential tool to expand medication-assisted treatment to underserved rural populations. (Am J Addict 2018;XX:1-6).