Telehealth for Addiction: Online Support Groups in the Age of COVID-19

COVID-19, the disease caused by the novel coronavirus called SARS-CoV2, is putting tremendous strain on all of us. As of April 7, 2020, there are over 350,000 confirmed cases of SARS-CoV2 in the United States and over 11,000 deaths. Public health officials at the local, state, and national level are urging individuals to practice social distancing and, in some cases, ordering residents to shelter in place.

How can people access needed health care for chronic conditions while engaging in safe public health practices?

Individuals with substance use disorders face unique problems in accessing care during these trying times

In 2018, over 20 million Americans aged 12 or older had a substance use disorder. Only a small proportion receive recovery support services.

Recovery support services range from formal treatment to mutual aid support groups, including recovery programs like Alcoholics Anonymous and SMART Recovery. Mutual aid support groups are an integral part of the continuum of care for individuals with substance use disorders, and recent research reveals their effectiveness.

Social support is critical for both physical and mental health, especially for individuals living with a substance use disorder. Telehealth resources can help in filling that need. Unfortunately, barriers to telehealth use may include a lack of knowledge about online groups, difficulty navigating new technologies, and confidentiality or privacy concerns.

National organizations have rallied to post information. For example, the American Society of Addiction Medicine has links for online support groups and guidance on etiquette and confidentiality.

Recent changes have improved access to telehealth

State and federal policymakers have recently made changes to improve access to telehealth. The loosening of restrictions on telehealth may help address some of the barriers. For example, the guidance specifically allows consumer-facing technologies such as Skype, Zoom, or FaceTime, rather than requiring HIPAA-compliant technology. These apps are widely used and require little training.  Also, many of these apps have free versions that can adapt well to group events.

At this difficult time, moving an existing in-person mutual aid support group to a virtual group can help people receive the recovery support services they need in the comfort of their own homes. The National Association of State Alcohol and Drug Abuse Directors has recently posted examples. They link to Ohio’s guidance for providing and funding substance use and mental health services via telehealth. They also link to federal guidance for the use of telemedicine while providing medication-assisted treatment.

Online support groups could improve care for some populations

Telehealth could increase access to easily accessible, low-cost specialized support. Online support groups are free and available to individuals regardless of income or insurance status. Individuals can attend multiple groups throughout the week, or even on the same day, resulting in increased social support.

Online support groups could also improve health equity by meeting the needs of particular communities defined by gender, sexual orientation, culture, or disability. Accessing online groups based on one’s own personal affiliations may increase perceived social support and enhance recovery. Also, people with transportation issues or in rural areas might prefer online groups. Easy access to online groups could reduce the stress of arranging transportation.

Social distancing is an important piece of flattening the curve and reducing the impact of the coronavirus pandemic. However, having in-person meetings canceled may be especially hard for people with substance use disorders. Using technology to access mutual aid support groups should be encouraged during this time.