The opioid crisis has without a doubt shifted the structure of healthcare, policymaking, and the criminal justice system in our nations. As a specialized family medicine doctor who has been actively involved in the treatment of opioid use disorder (OUD) for a decade, it has long been apparent that the solution to this crisis lies in wide-reaching, easily accessible care. Interestingly, the answer may have been revealed in the form of telehealth practice shifts during the COVID-19 pandemic – telehealth proves to be an effective medium for delivering OUD care, bridging the historical gaps in accessibility between clinicians and patients.
In light of this development, promising bipartisan legislation such as the recently reintroduced TREATS Act has emerged as a beacon of hope. The primary aim of this Act is to remove regulatory barriers in telehealth-based medication for OUD (MOUD) treatment programs, thereby improving access to care for the most vulnerable patients. Essentially, the TREATS Act is set to decriminalize OUD by providing more accessible avenues to treatment.
Importantly, this change can have profound positive implications for people in custody – a group often overlooked yet highly impacted by OUD. Jails and prisons have long struggled with providing effective OUD treatment. With the aid of the TREATS Act, we can extend MOUD treatment to this underserved demographic, thus ensuring consistent access to care, especially during the critical transitions into community living.
Approximately 20% of adults in custody are grappling with OUD. The failure to provide effective care programs within the criminal justice system often leads to a revolving door – incarceration, release without treatment intervention, re-offending, repeat. However, this cycle could be disrupted by facilitating access to treatment both during incarceration and post-release.
Historically, individuals with OUD who are in custody have not been provided with widely accessible care options. For those who do receive treatment while in custody, the treatment often isn’t continued as they transition back into society. As statistics show, people in custody have a 12.7 times higher risk of death in the weeks following their release, with opioid-related overdose being the leading cause of death for released inmates.
Telehealth-based treatment programs, like buprenorphine or Sublocade, could potentially put a stop to this cycle. This is achievable through the seamless transition of care via telehealth, from incarceration to resettlement in society, and the consistency it provides in otherwise disrupted care.
This approach to care is not new. Since the start of regulatory waivers in 2020, many practices have noted tremendous success in ensuring continuity of care for hundreds of patients transitioning from custody to community life. However, these waivers are due to expire next year – this is where the TREATS Act comes in, legally cementing the continuity of telehealth-based care.
This approach, while providing an optimistic solution to a long-standing public health crisis, requires ongoing collaboration between health systems and regulators to protect and scale telehealth MOUD care models. As we continue to build on the progress made so far, we can potentially make long-lasting strides in addressing the opioid epidemic. For more details, refer to this piece.