Learn / Is Telehealth Effective for Substance Use Disorders?
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Many people hesitate to start rehab because residential treatment programs feel inaccessible. Fortunately, they’re not the only option. More and more luxury rehab programs now offer treatment via telehealth.
The popularity of telemedicine1 has skyrocketed in the past few years. It’s clear to see why this type of treatment became important in 2020: online appointments allow people in recovery to get the care they need, without taking unnecessary risks. Online treatment programs also limit the number of people on-site at a rehab facility, protecting both staff and clients.
However, online mental health treatment isn’t just for times of quarantine. Even before COVID-19 made social distancing a primary concern, “telehealth initiatives provided a platform to combat the shortcomings of cost, quality, and access ingrained in American health care.”2 Online therapy is a vital component of accessibility. Oftentimes, those who most need treatment also have the hardest time traveling to see a healthcare provider. For these clients, telemedicine makes it possible for them to get much-needed care.
Telehealth, or online medical care, is an especially valuable resource for vulnerable populations. Substance use disorders can affect anyone, including elderly and immunocompromised clients, those with mobility issues, and people whose schedules make in-person therapy impossible. For example, a CEO or high-level executive might be able to take an hour-long break for a therapy session, but unable to take 3 hours off so they can commute to and from the office.
When you think of online addiction treatment, you may imagine something like a Zoom call, with the client and provider talking through a screen. That’s certainly a big part of telemedicine, and most talk therapy sessions do fall into this category. But there’s much more to online healthcare than video chat.
Telemedicine can include any type of online health management.3 For example, you might track your daily caloric intake through an app and share it with your nutritionist, or you might communicate with your psychiatrist via email. Many patients opt in to text message reminders about upcoming appointments. All of these fall under the umbrella of online healthcare.
Many clients are rightfully concerned with their privacy, and the confidentiality of the therapy they receive. And of course, any kind of online communication has an inherent security risk. A hacker is unlikely to get their hands on any information you share in person, behind closed doors, with no recording devices in the vicinity. Thankfully, several regulations control the privacy of clients’ health history.
Most of the time, healthcare providers are legally obligated to protect any client data obtained during treatment, whether that treatment occurs online or in person. However, some of these rules have changed since the pandemic. In the U.S., for example, the government has allowed more flexibility to healthcare providers who are moving their practices online. In some cases, lawmakers may be more lenient regarding HIPAA regulations for telehealth.4 This is intended to make virtual treatment accessible for clients whose providers may not have been set up for online healthcare prior to COVID. It gives doctors and counselors a little more leeway, so they don’t have to stop seeing patients entirely while they learn how to use various online platforms.
It’s likely that these regulations will change over time, as we continue to adjust to this new era. Clients engaged in online addiction treatment programs should stay apprised of this. Ideally, you’ll check in with your providers on a regular basis to make sure that their specific practices meet your needs for confidentiality.
Feeling safe with your therapist is paramount; a lack of trust will almost certainly interfere with your recovery. Step one, as always, is to find the right type of treatment and the right provider for you. After that, there are still a number of factors to consider as you decide if telemedicine is a good fit.
Like any other form of communication, online rehab has its pros and cons—it’s certainly not appropriate for everyone. However, the very act of considering online therapy is an opportunity for you to evaluate your own priorities. By deciding whether online therapy is right for you, you’ll likely learn more about what you need out of any treatment program.
Online therapy is one of the most accessible forms of healthcare. All you need is an internet connection and a computer, tablet, or even a phone. You’ll be able to contact your medical team from home, from the office, or from the other side of the world. You won’t have to cancel appointments if you’re sick, or if the weather is bad. It also allows for more flexible scheduling, because it completely eliminates travel time.
Some clients, especially those who are new to recovery, may struggle to make and keep their appointments. This can be especially true if in outpatient treatment. If your appointments happen virtually, you’ll have fewer excuses to cancel. If you forget an appointment, some therapists will call or text you a reminder. Then, instead of having to reschedule or pay for unused time, you’ll be able to hop on the call within just a few minutes.
Online mental health treatment makes it possible for clients to engage in group therapy with people who are physically distant. Clinical Director Brenna Gonzalez explains how The Hope House Scottsdale uses technological tools for long-distance family therapy:
“The theatre room is equipped with telehealth equipment, so we can include family members in a client’s treatment program. Returning home to family support is really important, so it’s key to ensure family members understand what’s going on with their loved ones during treatment.”
Virtual therapy appointments often allow you to stay in contact with the same treatment team even when you move from one location to another. This is especially important for clients who travel to residential rehab in another state or country, and want to proceed to an aftercare program at the same rehab center when they return home.
At some rehabs, online treatment is a routine component of aftercare. Ryan Soave, the Director of Program Development at All Points North Lodge, describes the role telehealth plays in their continuing care:
“In our full continuum of care, people come out of detox into our residential facility, then they step down to the partial hospitalization program, all the way through into intensive outpatient and the telehealth program.”
Not every rehab facility offers this. Some programs may suggest you engage in online aftercare with the same facility, but a different medical team. If you live in the U.S. and travel to another state for rehab this can get especially complicated, as the U.S. has strict laws governing therapy for out-of-state clients.5 Make sure to learn what your options are before you begin inpatient therapy, so you’ll know what to expect going forward.
Virtual therapy can address many serious issues, and may be appropriate for some physical exams. However, it has noteworthy limitations when it comes to physical care, especially in the treatment of substance use disorders. For example, it’s not an effective way to perform medical detox. That process should be closely supervised by an in-person team of doctors and nurses.
Even clients who have already completed detox may still benefit from in-person care. One major drawback of online treatment is that online appointments don’t allow doctors to monitor your vital signs or perform daily drug testing.6 This aspect of accountability can be very important for people who are new to treatment, and losing access to it can severely impact the recovery process.
Although providers are ethically obligated to protect their clients’ data, breaches can and do occur. In telehealth appointments, you may be responsible for some aspects of online security.7 Your device or your home network may not be entirely secure, even if your therapist’s data is.
Online therapy is an effective way to talk to a therapist or other provider. However, there are many powerful and effective types of therapy that can only happen in person. During on-site or inpatient treatment, you may have access to art therapy, group activities, and even massage or acupuncture. Experiential therapy can greatly benefit your physical and mental health. These opportunities invite clients to learn about healthy social dynamics while creating happy memories. And it’s just not possible to go whitewater rafting via video chat!
Because of its physical limitations, some clients may benefit from telemedicine as part of a combination approach to recovery. You may choose to see some providers online and others in person. You may plan to maintain long-distance therapeutic relationships after complete inpatient treatment. If you’re interested in online therapy, be sure to talk to your medical team and ask whether they think it might be right for you.
Before you begin this type of online treatment, take some time to understand your own interest in it. Recovery is a time to reconnect with yourself and to start building healthy relationships. For some people, virtual treatment programs are appealing mostly because it allows you to stay in isolation. If that’s true for you, it might not be the best fit.
If you have other concerns—such as physical health issues, scheduling, or various forms of accessibility—don’t let the perfect be the enemy of the good. For many people, online appointments are the only way to access high-quality care. If in-person treatment just isn’t an option for you, telehealth may make it possible for you to begin recovery.
View and connect with rehabs that offer online services to find out if this format is a good fit for you.
Telehealth is an effective option for addiction treatment, providing accessible and convenient care via online platforms. It offers a safe and private way to receive therapy, making it especially beneficial for vulnerable populations and those facing travel constraints.
Online therapy ensures privacy through legal obligations and regulations, and most healthcare providers strive to maintain confidentiality. Clients should stay updated on specific practices and communicate their concerns to their therapists to ensure their privacy needs are met.
Online rehab has advantages such as accessibility, accountability, group dynamics, and continuity of care. However, it has limitations in physical care, potential confidentiality risks, and the lack of certain experiential therapies. Assessing personal priorities and consulting with your treatment team can help determine if online treatment is a suitable choice.
Koonin, L. M. (2020). Trends in the use of telehealth during the emergence of the covid-19 pandemic—United states, January–March 2020. MMWR. Morbidity and Mortality Weekly Report, 69. https://doi.org/10.15585/mmwr.mm6943a3
Roberts, N. T.-L., Jack Karsten, and Jordan. (2020, May 6). Removing regulatory barriers to telehealth before and after COVID-19. Brookings.
Managing your health in the age of Wi-Fi. (n.d.). Mayo Clinic. Retrieved September 2, 2021, from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878
Legal considerations | Telehealth.HHS.gov. (n.d.). Retrieved September 2, 2021, from https://telehealth.hhs.gov/providers/legal-considerations/
“What to Know about Doing Telehealth in a Different State.” Https://Www.Apaservices.Org, https://www.apaservices.org/practice/legal/technology/telehealth-different-state. Accessed 12 May 2023.
Knopf, A. (2020). Addiction telemedicine comes into its own with COVID-19. Alcoholism & Drug Abuse Weekly, 32(13), 5–6. https://doi.org/10.1002/adaw.32673
Hale, T. M., & Kvedar, J. C. (2014). Privacy and security concerns in telehealth. AMA Journal of Ethics, 16(12), 981–985. https://doi.org/10.1001/virtualmentor.2014.16.12.jdsc1-1412
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