There are many reasons to utilize telemedicine in the battle against the deadly and tenacious opioid epidemic, according to Mark Plaster, M.D., founder of Emergency Physicians Monthly and Telemedicine Magazine, but it could be the “human factor” where it will have the greatest impact.
“We are at the beginning, we are climbing up that cliff to engage the enemy,” he said during his session “The Skyrocketing Opioid Crisis: Fighting an Uphill Battle with Telemedicine,” at the Telemed Leadership Forum 2018 in Washington D.C., March 28. Telemedicine will help address the “stigma” too often associated with the addiction, he said. “We’re just opening the doors to being able to prescribe online, and being able to counsel online,” he added.
Click here to access Plaster’s on-demand webcast session.
The opioid statistics are chilling. According to a January 2018 report from the Department of Health and Human Services (HHS), 116 people died every day in 2016 from opioid-related drug overdoses, totaling 42,249 fatalities. More than 11 million people misused prescription opioids. Perhaps most frightening of all, 170,000 people tried heroin for the very first time in 2016, HHS’s latest figures.
In an interview with CNN in April, Food and Drug Administration (FDA) Commissioner Scott Gottlieb declared the opioid epidemic to be the single greatest challenge to the agency. In early 2018, the Trump Administration unveiled a new program designed to help address the threat.
Telemedicine shows great promise to help turn the tide, Plaster said. “The patient who would never, never admit [they are addicted], will be able to talk to their doctor, to talk to their counselor,” and feel a sense of privacy, Plaster said. “I’m all about removing that stigma, but if we’re waiting for that stigma to go away [on its own], we’re going to be waiting for a long, long time.”
He cited studies that have found many patients are more comfortable talking to a caregiver via a computer screen, “they can sometimes be more honest with them than they would be if they were face to face.”
Telemedicine can also offer online Narcotics Anonymous (NA) meetings where no participant is visible to others unless they want to be. In a physical NA meeting “somebody can go in” and it may be someone a patient knows or otherwise doesn’t want to see, Plaster noted.
As a physician, Plaster is excited about how telemedicine can help healthcare practitioners, too. “Telemedicine allows us to work on this issue of diversion [from a treatment plan],” he said. For example, telemedicine can make it easier for doctors to ensure patients are taking their medication. The doctor “can spin the camera around and show that nobody else is in the room,” which can decrease a patient’s anxiety level. While there are a number of etools to help, Plaster is enthused about telemedicine’s contribution to what he calls “observation methodology.”
In December the American Medical Association (AMA) expressed an interest in working with the FDA to help educate physicians about the impacts of overprescribing the medication, among other thorny issues contributing to the opioid crisis.
Telemedicine is also a great way to enhance the all-important counseling component of treatment, too. “We know that counseling and support are the keys to inpatient rehab,” he says. Unfortunately, outpatient treatment is often ineffective without ongoing support and continuity. Telemedicine can help. Patients can be seen several times throughout the day, either live or with prerecorded messages, as part of a program to “create that environment of support that they have in in-patient rehab, but now they can walk out in the street,” Plaster said.
The opioid epidemic is “a huge and deadly problem,” Plaster said. “But it’s solvable, we can make some giant strides in this. We have the tools. We have the money. We have the knowledge,” he asserted. “Do we have the moral will to successfully attack this problem?” Plaster asked the audience. “If we do, we can make some significant headway.”