Opioid epidemic gets a helping hand from telehealth

All too often we hear the grim account on the evening news – another life lost in the opioid use crisis. Over 33,000 people died in the United States in 2015 alone, of opioid overdose and the impact is devastating on families and communities. But it is not all bad news – increasingly, states and organizations are mobilizing to help improve treatment options for people suffering from substance use disorder and telehealth is playing an important role.

Project ECHO (Extending Healthcare Community Outcomes) is among the technology assisted-tools being used to increase treatment options for opioid use disorder. The ECHO model uses telehealth technology as a vehicle to teach primary care providers specialty skills so they can treat patients themselves, rather than having to refer patients out to services that may not even be available in their community.

HTRC partners, University of Kansas Center for Telemedicine & Telehealth and Missouri Telehealth Network have on-going ECHOs for chronic pain management. Chronic pain is the number one reason opioids are prescribed, but the pain management ECHO teams have focused on providing other tools for pain management to try to limit over-prescribing of opioids.

In addition to Chronic Pain Management ECHO, Missouri’s ECHO project, dubbed Show-Me ECHO, will debut a new ECHO in September called Opioid Use Disorder ECHO.

Dr. Doug Burgess, an addiction psychiatrist at Truman Medical Center, will lead the Opioid Use Disorder ECHO. According to Burgess, treating opioid addiction can be a daunting prospect for busy providers, but in many ways, they are already treating the effects of opioid use.

“It is easy to get into the mindset of saying ‘I’m busy. I don’t want to take on one more thing,’ but every provider is already treating this in some way, whether he or she knows it or not,” said Burgess. “The difference is do you want to have the tools to be able to treat opioid use disorder effectively? That is what this ECHO group hopes to provide. We want to decrease the morbidity and mortality associated with opioid use disorder by giving providers the tools to treat something they are already seeing in their everyday practice.”

Burgess said patient opioid use disorder can manifest in different ways, including personal injuries, ineffective pain management, patients going from doctor to doctor, and even spread of infectious diseases like hepatitis C.

In addition to the physical manifestations, opioid addiction has a lasting impact on society as a whole. Children in families with addiction may continue to suffer throughout their lifespan. This generational effect is illustrated in a June Kansas City Star article that describes the harrowing story of two of Burgess’s patients, a mother and a daughter, who are now recovering from their addictions.

The mother and daughter described in the article are benefiting from Medication-Assisted Treatment (MAT), which combines behavioral therapy and medication to treat addiction. Opioid Use Disorder ECHO will support participants who have been MAT trained.  Burgess said this treatment can be very effective and it is a misconception that Suboxone, one of the most common medications used to treat opioid addiction, is somehow more difficult to prescribe than other medications.

“The training for administering [Suboxone] is thorough and makes it less daunting to prescribe. Once you use it, within a short period of time you realize that it is not difficult to prescribe,” explained Burgess.

HTRC will continue to provide updates on these ECHO projects. For more information about joining a chronic pain ECHO or Opioid Use Disorder ECHO, please call 573-884-3753 in Missouri or 913-588-2081 in Kansas.

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