Telemedicine and Telehealth for Addiction And Recovery

Before the pandemic, it was very hit or miss whether a local psychiatry or mental health clinic offered telemedicine, but now almost every practice has made the transition, in some cases literally overnight, says Anna Lembke, MD, an associate professor and medical director of addiction medicine at Stanford University School of Medicine in Palo Alto, California.

According to Dr. Lembke, "Many HIPAA [Health Insurance Portability and Accountability Act of1996) and prescribing rules have been waived in an effort to enable us to treat individuals remotely." Telemedicine is a simpler transition than for other medical specialties. Although the physical exam can still be very important, Dr. Lembke says it makes it easier to use telemedicine in psychiatry or mental health.

In the addiction and recovery world, there is a distinction between telehealth and telemedicine:

Telemedicine is a way to offer patient care via telemedicine. These services are usually billed directly to the insurance company or patient. Telehealth however, offers online support resources and can be used as part of patient treatment.

Addiction and the Pandemic: A Range of Responses

Lembke states that he is seeing all kinds of COVID-19 reactions in his clinic. I have many patients experiencing anxiety, depression and increased cravings for drugs. "I've seen people who have fallen back on their addictions," she said.

Lembke says that COVID-19 is also helping patients recover. "It has muffled all their noises and eliminated many of the triggers they used to make."

Telemedicine and Telehealth Can Help Remove Barriers To Getting Help

Welsh says that telemedicine or telehealth has proved to be a benefit for many patients. It allows them overcome barriers they might not have faced otherwise. She says that transportation can pose a problem, especially in rural areas where there isn't enough treatment for substance abuse.

Patients can travel up to 90 minutes or more to get treatment. This reduces their ability to attend appointments as often. Welsh said that patients can have more frequent appointments via telehealth and don't need to travel for transportation or gas money.

Telemedicine and Telehealth are popular options for many.

Lembke says that there has been an increase in patients who have come to the hospital since the beginning of the pandemic. It almost seems that COVID-19 was a sort of reset for those who are trying to put their houses in order. Maybe because they have had a bit more time to think about it.

"We refer a lot of patients to Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), and we've had some patients be more willing to try them than they were prior to COVID-19, because all of the AA meetings are now online instead of in person," says Lembke. People were worried about being anonymous at meetings. It was not something they wanted to do with their friends. You can sign up online with Zoom using a pseudonym to join meetings without revealing your face. She says that people can now have an AA experience online in a more private way.

Welsh states that it has been positive for them to have online recovery tools at their disposal. Welsh adds, "I believe we are seeing more patients involved in them, either because they have more time or because the groups are more easily accessible due to people’s schedules. So that's been positive."

Here are some resources to help you get support and assistance for substance abuse

Online Meetings of the AA and Group Meetings Online

AA, or Alcoholics Anonymous, is a place where men and women come together to share their experience, strength, and hope with each other to stop drinking and recover from alcoholism. The AA program is set forth in 12 steps as a way to help people have a fulfilling life without alcohol. There are email, chat, audio, and video options.

Recovery Dharma Online meetings

Recovery Dharma (peer-led community) uses Buddhist techniques of meditation, self inquiry, wisdom, compassion and community to help people heal. The movement welcomes anyone who wants to heal from addiction and addictive behavior that creates suffering, including substance use.

Live Support in the Rooms

In the Rooms is a free online recovery tool that offers 130 weekly online meetings for those recovering from addiction and related issues. It was founded to offer recovering addicts an opportunity to connect and have fun online, even when they can't attend face-to-face meetings. There are many paths to recovery that In The Rooms supports, such as all 12 step, non-12-step, wellness and mental health options.

Al-Anon Electronic Meeting List

Al-Anon is a support program for people whose lives have been affected by someone else's drinking. The group is now meeting electronically to share their hope and help in the spirit the 12 traditional traditions.

Substance Abuse and Mental Health Services Website

SAMHSA's National Helpline (800662-HELP 4357) also called the Treatment Referral Routing Service, or TTY 800-487-4889 is confidential, free and available 24 hours a day, 365 days a year in English and Spanish to individuals or their families who are suffering from mental illness and/or substance misuse disorders. You can get referrals for local support groups and treatment facilities. The service also allows callers to order information and publications for free.

Virtual Narcotics Anonymous, Narcotics Anonymous by Telephone

Based on the 12-step recovery process of AA, this program includes 12 traditions and 12 steps. It also incorporates all drug use. Meetings can be held via videoconference or telephone. Participants share ideas and reads. There are two types of meetings: open and closed. Closed meetings can only be attended by those with an addiction. Open meetings are for all but those with an addiction.

SMART Recovery Online

Welsh says that SMART Recovery's online presence has been strong for a long time. Instead of being based solely on 12 steps, it is cognitive behavioral therapy that teaches coping strategies and management skills to deal with substance abuse. "I have had a lot of patients use SMART Recovery, even before COVID-19. I highly recommend it to them.

Marijuana Anonymous Online Meetings

Marijuana Anonymous is a group that shares experiences, strength, and hope to help people recover from marijuana addiction. All are welcome to join the phone and internet meetings.

Herren Project Recovery Meetings

The Herren Project began in 2011 by former pro basketball player Chris Herren, with the stated goal of helping people navigate the road to recovery from the disease of addiction. Online support groups for addiction and meetings to help with recovery are free and moderated by qualified clinicians.

Apps for Addiction and Recovery Apps are a popular tool in the recovery world, says Lembke. "I have lots of patients who use these, especially those who have an abstinence goal - there are some apps that can count the number of days a person has been without drugs or alcohol," she says.

Apps are available that can help people reduce their alcohol consumption. Lembke states that these apps "can help track how often a person uses their drug to ensure that it stays within certain limits."

The Connections

This app from the Addiction Policy Forum and CHESS Health can help people track their sobriety, access e-therapy to learn new recovery skills, connect with trained counselors and peers, and access a variety of resources, including videos and testimonials.

Loosid

Loosid connects people with like-minded individuals. It also offers access to curated experiences such as travel and events.

For support, stay open to receiving it.

Welsh suggests that you embrace your virtual community during times like these. It could be your recovery group, family or friends you can connect online with. She encourages people to be open-minded and willing to try new things. Welsh notes that many patients were reluctant to use online resources prior to COVID-19. However, this gave them the chance of trying something different.