The Vanderbilt Maternal Addiction Recovery Program (VMARP) is offering virtual appointments to help reach patients in Nashville’s outlying areas for treatment of Opioid Use Disorder (OUD). Telehealth appointments are particularly important during the COVID-19 pandemic — a time when many experts are predicting increased opioid overdoses and deaths as a result of isolation.
Jessica Young, MD, MPH, addiction medicine specialist, associate professor in the Department of Obstetrics and Gynecology and director of the VMARP program, has been offering telehealth visits since March 2020, alongside other members of VMARP. For Young, telehealth appointments are a silver lining in the pandemic.
She has found that many of her patients prefer telehealth to in-person appointments, especially those who live more than an hour away from Vanderbilt University Medical Center. For patients who make this drive weekly, telehealth is an easier and more convenient option. “Telehealth appointments are an incredible tool for addiction medicine,” said Young. “They increase access to care for all patients, but particularly for those who live in areas where there are few addiction medicine providers.”
In an effort to reach as many women as possible, VMARP is also partnering with the Center for Women’s Health Clinics in Columbia and Northcrest to provide medication-assisted treatment services to pregnant patients with OUD. The department currently treats women from 26 surrounding counties and is offering virtual recovery support groups, which has allowed patients from across the state to continue engaging in necessary group sessions in a safe manner.
“Our patients often want to attend multiple sessions during the week but can’t commit to in-person groups due to their distance from the clinic,” Young said. “Hosting them virtually allows for patients to get support as often as needed.”
Another helpful aspect of telemedicine is the ability to prescribe medication over the phone. Buprenorphine and Naloxone are two of the most important medications in addiction care. Now, both of these can be prescribed over the phone via telehealth.
Regulatory changes due to the COVID-19 pandemic have allowed for direct-to-patient telehealth for prescribing buprenorphine. “Buprenorhine and Narcan are medications that can prevent opioid relapse, overdoses and deaths,” said Young. She believes being able to prescribe these through telehealth increases access and saves lives as a result.
The Vanderbilt Maternal Addiction Recovery Program plans to continue offering telehealth appointments even after the pandemic is no longer a concern.
Young estimates that 20% of their patient visits will remain fully virtual in the future. Even after group therapy is safely able to return in person, VMARP will keep 25% of their groups virtual, allowing patients to receive support from their own homes.
According to the Metro Public Health Department of Nashville and Davidson County, by October 2020, more people had died from drug overdoses than all of 2019. This represented an increase of 39%. Non-fatal overdose ER visits increased by 31% in the same time period.
Young agrees that the opioid epidemic has worsened during COVID-19.
“Opioid overdoses continue to rise during the pandemic. The numbers prove that the national opioid epidemic is still a major problem,” she said. “With overdoses increasing and in-person options limited, we have had to find new ways to reach our patients, and telehealth has been a great solution.”
