Provider warns that telemedicine may prevent detection of drug abuse


According to a new study, three-quarters of doctors said they believe that telemedicine access limits their ability to determine whether a patient is at risk or is currently abusing prescription drugs.

According to the 2021 Quest Diagnostics Health Trends, providers are concerned that as patients suffer more stress and mental illness, the problem of drug abuse is disappearing from the cracks in virtual care report Released in November.

“Telemedicine is very important,” said Dr. Harvey Kaufman, senior medical director and head of the health trend research project at Quest Diagnostics. “It promotes participation that does not happen when the office is closed, and it can also play a role in allowing easy communication between doctors and patients. But it cannot replace everything that happens during face-to-face visits.”

The number of deaths from drug overdose, mainly caused by fentanyl use, rose to 96,779 – 30% Soaring— From March 2020 to March 2021, US Centers for Disease Control and Prevention Learn Said.

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This led the Government Accountability Office and other agencies to urge the federal government to pay attention Solve the problem of drug abuse Except for COVID-19 measures.

In a survey commissioned by Quest Diagnostics of more than 500 prescribing state-licensed doctors, 71% said that the pandemic had made the prescription drug crisis worse, and 76% predicted that even if the pandemic subsides, the number of deaths from drug overdose Will continue to rise.

Almost all (94%) primary care doctors surveyed reported that more patients are facing stress, anxiety or other mental health problems due to the pandemic.

Only half of doctors believe they can identify signs of prescription drug abuse based on telemedicine interactions, while 91% of doctors believe they can detect abuse based on interactions with patients in the office.

Due to the lack of in-person visits, 67% of doctors report that they are afraid of missing one or more patients signs of drug abuse or use disorder during the pandemic.

Nevertheless, some health systems have introduced their own Telemedicine Drug Abuse Program In the pandemic wave, and Payer’s investment There has been an increase in virtual drug abuse treatment.

Krista Drobac, executive director of the Connected Healthcare Alliance, said that even before the pandemic, telemedicine had made a huge contribution to the treatment of mental health and substance abuse disorders.

In 2018, Congress passed legislation for the first time allowing the use of telemedicine to treat Medicare members with substance use disorders.

Although going to the laboratory in person is necessary to formally confirm that someone is abusing drugs, Drobac says that doctors can ask patients the same questions about their medical history and current activities through telemedicine, as they did in person, to detect possible Drug abuse. They can also provide necessary consultation and support services for patients dealing with drug abuse problems in a virtual way.

“The preconceived idea of ??telemedicine is that you can’t get as much benefit from telemedicine visits as in-person visits,” she said. “But once people have a telemedicine visit, their perception will change. They like it more and believe they can get more from the virtual visit.”

In the first few months of the pandemic, Quest Diagnostics’ clinical drug testing volume dropped by 70%, which contradicts the response of most doctors, who believe that clinical drug testing is essential to prevent drug abuse.

Kaufman said that doctors and patients need to communicate with each other to decide when to use telemedicine and when to switch to face-to-face consultations, especially when it comes to detecting and testing drug abuse.

“There is a difference in visualization between people on the screen and people facing each other,” he said. “To perform a drug test, an evaluation is required, usually a urine drug sample. It cannot be virtual.”

Data from more than 475,000 unidentified test results in 2020 showed that nearly half of all patients tested by Quest Diagnostics showed signs of drug abuse, and a quarter showed signs of drug combination.

Kaufman said doctors need guidance to find a balance between remote care and office care in order to provide patients with compassionate care. Approximately 80% of survey respondents said they want more information on how to monitor prescription drug addiction.

Kaufman said: “They are seeking educational support to understand how to best use the different resources available to them, whether it is telemedicine, in-person visits or urine drug testing, to better respond to this pandemic. sick.”



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