Telehealth is a promising tool
for treating and supporting people with substance use disorders (SUDs). Rural populations can use
telehealth to overcome shortages of specialized behavioral health providers and resources. Telehealth uses
technology to provide access to services for treating SUDs across a distance. It connects patients and providers
and makes it possible for patients to receive screenings, counseling, and other services without traveling to a
provider's office. The Rural Telehealth Toolkit provides comprehensive information about models for increasing access to
behavioral and mental health treatment, including opioid use disorder.
Some screening, brief intervention, and referral to
treatment (SBIRT) and behavioral
therapy models have tested computerized or web-based versions with promising results. A
computer-assisted or web-based version of behavioral therapy could be beneficial to rural communities where
transportation and access to care are barriers to treatment.
While more research is needed to explore the effectiveness of telehealth in treating substance use
disorders, early research
promising. A study in the Journal of
Substance Abuse Treatment found that participants in an internet-based methadone
treatment program preferred the internet-based service because of its convenience and
confidentiality. Another study from
the Journal of Psychosocial Nursing and Mental Health Services found improved abstinence
from alcohol among rural women, with no significant differences between standard and web-based
treatment groups, suggesting that web-based treatments may be as effective as traditional treatment
approaches. While the use of technology has been promising, a recent study
from the National Institute on Alcohol
Abuse and Alcoholism found that telehealth is still most effective when used in conjunction with
Example of Rural Telehealth Models
Considerations for Implementation
Telehealth treatment of SUD is quickly evolving. A major component needed in order to pursue this
model is access to high-speed internet, which remains a barrier in many rural communities. Telehealth
requires access to equipment that may be costly to rural clinics with few resources. In addition to
the costs of equipment, agencies that develop telehealth programs may need to establish new policies
and procedures as well as training on the use of new equipment.
Telehealth programs must adhere to the Health Insurance Portability and Accountability Act (HIPAA)
regulations and federal confidentiality rules. For example, healthcare providers need to consider
using private networks on encrypted software if choosing to use videoconferencing. And while a large
percentage of the population is using traditional short message service (SMS) text messaging, this
format is not secure and therefore would not be compliant with HIPAA regulations.
Reimbursement for substance abuse related telehealth services varies by state. The Center
for Connected Health Policy maintains a collection of telehealth-related laws and reimbursement
policies by state.
Resources to Learn More
Center for Technology and Behavioral Health
Supports the development, evaluation, and implementation of technology-based intervention tools
focused on behavioral health. Provides program reviews and current literature on digital health
technology applications for substance use disorder interventions.
Organization: Center for Technology and Behavioral Health
National Consortium of Telehealth Resource
A collaboration of 12 regional and 2 national Telehealth Resource Centers (TRCs) providing
information on operation tools used in telehealth, reimbursement information, legal issues, training,
and webinars on a variety of telehealth related topics.
Rural Behavioral Health: Telehealth Challenges and Opportunities
Discusses the acceptability, availability, and accessibility barriers to mental health and SUD
treatment and services in rural communities with a focus on how the implementation of telehealth
services can reduce these barriers.
Citation: In Brief, 9(2)
Organization: Substance Abuse and Mental Health Services Administration
Telehealth in State Substance Use Disorder (SUD) Services
Presents the results of a survey on the use of telehealth in mental health and substance abuse
treatment systems in the 37 states. Highlights key findings identifying the types of telehealth
technology used, the purpose of these technologies, and the regulations affecting their use.
Organization(s): National Association of State Alcohol and Drug Abuse Directors
Using Telehealth to Identify and
Manage Mental Health and Substance Use Disorder Conditions in Rural Areas
Examines the feasibility of using telehealth methods to address mental health and SUD in rural
communities. Addresses telehealth implementation and use, privacy concerns, barriers and challenges,
Organization(s): U.S. Department of Health and Human Services, Assistant Secretary for Planning and
Evaluation, Office of Disability, Aging and Long-Term Care Policy, RTI International