“She’s the best therapist I’ve ever had,” my friend told me the other day, when I casually asked how talk therapy was going.
The kicker is, my friend lives in Atlanta, her therapist is in Boston, and they meet in a virtual meeting room.
Videoconferencing for Addiction and Other Mental Illnesses
My friend was singing the praises of the online therapy app, Talkspace. For a fee of $50, she receives two monthly therapy sessions with a licensed therapist—and at no extra charge, there’s the added benefit of unlimited text messaging.
By its self-description, Talkspace serves more than half a million clients, providing them with access to a network of 1,000-plus licensed therapists from around the country. The online therapy service is one of a number of telehealth success stories from the behavioral health field that have perked my interest as an addiction clinician. That’s because in a drug abuse epidemic that is the worst on record, millions of people with substance use disorders (SUDs) are going without the treatment they need. Addiction reportedly affects one in 10 Americans, 90 percent of whom do not receive effective treatment. Meanwhile, someone will die from a heroin or opiate prescription overdose every 19 minutes, according to a report by the Centers for Disease Control and Prevention.
Expanded Access to Addiction Treatment
Telehealth applications offering secure videoconferencing like Talkspace, eVisit and others embody how telemedicine can help bridge this addiction treatment gap, by expanding access to SUD treatment for millions of Americans. (Roughly 10 million Americans already receive telehealth services, and that number will surely grow.)
And it’s possible that such technologies will be of greatest help to rural Americans. Poorer, rural communities in this country have been hit hardest by the opiate epidemic, after all—in good part because of a shortage of mental health professionals in these same areas.
That may now be changing, thanks to a new federal initiative started just last year. The piloting of five telemedicine programs that treat opiate addiction in rural, central Appalachia (comprising Virginia, Tennessee and Kentucky) is now underway. As part of the initiative, the U.S. Department of Agriculture awarded grants to the following providers: U.S. Baptist Health Foundation Corbin, Inc., Mountain Comprehensive Health Corporation, Carey Counseling Center, Carilion Medical Center, and Rectors and Visitors of the University of Virginia.
Just how much these new telehealth programs will close the addiction treatment gap remains to be seen (and quantified). There are inevitable challenges and limitations to overcome. Still, there is reason to believe the new initiative will be successful at expanding access to SUD treatment, based on the fact that similar, longer-running telehealth efforts have already enjoyed success elsewhere around the country.
One of these is a telemedicine program at the University of Arizona that was featured in a 2010 article in MedPage Today. At the time, and as part of the program, Dr. Sue Sisley, MD, was relying on videoconferencing technology to serve a clientele sprawling across several hundred square miles of territory.
Dr. Sisley recalled a patient whom she had been treating with buprenorphine (for opiate addiction). The patient was a concert pianist who, the article recounted, was “so disgraced by his addiction, that he refused to even touch the keys on his piano.”
In a video follow-up with Dr. Sisley, after she had prescribed him buprenorphine, the patient angled the camera toward the piano and began to play.
“It was amazing,” Dr. Sisley said. “It couldn’t have happened without telemedicine.”
What We Can Learn
In other words, the expansion of addiction treatment that telemedicine affords doesn’t have to sacrifice the intimacy of in-person visits. On the contrary, telehealth interactions can at times be even more intimate, depending on the client and their individual circumstances.
The reality of addiction, too, is that it still carries a stigma for those who suffer from it and for their families. For many, that stigma is itself a barrier to seeking treatment when treatment involves in-person visits to a recovery center or addiction provider. In such cases, the convenience of being able to meet with an addiction professional from the privacy of one’s own home may be “just what the doctor ordered.”
Greater access to addiction treatment. Greater ease and convenience to receiving services. Greater privacy, and potentially less-perceived stigma on the part of those who suffer from SUDs. These are some of the lessons of addiction telemedicine at a time when the stakes have never been higher.
About the Author
Candice Rasa is the clinical director of Beach House Center for Recovery, a drug and alcohol addiction rehabilitation center in Juno Beach, Florida. With more than 10 years of experience in the mental health and substance arena, Candice supports healing in the clients she serves from a perspective of spirituality and alternative Eastern methods.