Psy-Q: How can mobile telemedicine unit improve opioid use disorder treatment? Eric Weintraub, MD, answers.

Dr Weintraub

Eric Weintraub, MD

Answer: This type of unit, called a telemedicine mobile treatment unit (TM-MTU) can be used in rural areas to improve access to opioid use disorder (OUD) treatment. A team recently demonstrated success with a TM-MTU in rural Maryland (see the report).

Barriers to accessing treatment, including a lack of personal and public transportation, a lack of childcare, or inability to get time off of work, prevented people from visiting a brick-and-mortar treatment facility, explained Eric Weintraub, MD, professor of Psychiatry, and director of the Division of Addiction Research and Treatment at the University of Maryland School of Medicine, in a conversation with Psycom Pro. His team led the study.

With the TM-MTU providing MOUD treatment, patients have said that they felt normal again and that they no longer think about using illicit drugs. Dr. Weintraub’s team is working on a qualitative study of the data, but anecdotally, he said that patients often tell his team “that it’s been a lifesaver for them, that they wouldn’t have been able to access treatment otherwise.”

“We also heard that people liked coming to the van because we are a specialized unit that understands addiction, and there isn’t a lot of stigma or judgment,” he says.

Dr. Weintraub explained that the TM-MTU project started in 2015 while the opioid epidemic raged through the country, hitting suburban and rural areas in Maryland. Dr. Weintraub’s team had experience coordinating and providing treatment in the Baltimore area, and they set up a telehealth program in rural areas that was shown to be as effective as in-person treatment.

While working in the Caroline County health department, the team found that even with the telemedicine program for addiction treatment, there were individuals who could not access treatment, which led to the idea for a mobile telemedicine unit. Funding for the project came in part from a grant from the federal Health Resources & Services Administration (HRSA), and support from the state of Maryland’s Department of Behavioral Health helped pay for the program’s vehicle.

“It’s really a true partnership between federal, state, and county governments and an academic medical institution all working together on this project,” Weintraub says.

The program’s next steps will be to expand the unit’s hours and its reach by servicing a neighboring county. The team also plans to purchase a bigger vehicle so they can integrate primary care and infectious disease services into their MOUD program to provide integrated care in one location.

When brick-and-mortar treatment facilities shut down during the pandemic, patient access became even more difficult – particularly in rural areas, which often have few options to begin with. Dr. Weintraub says that his team was able to continue operating throughout the pandemic and at one point became the sole provider of MOUD treatment in Caroline County. The public health emergency relaxed telehealth prescribing rules under the Ryan Haight Act of 2008, and this helped expand access to people who needed MOUD treatment. “We’re hoping that a lot of the allowances we’ve had during COVID-19 will continue, but we’re not sure,” Dr. Weintraub says.

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Last Updated: Sep 10, 2021