I09 – Novel Telehealth-Based Interventions to Increase Access and Engagement Among Veterans with Substance Use Disorders During the COVID-19 Pandemic

Summary

The COVID-19 Pandemic has significantly disrupted the delivery of traditional substance use disorder (SUD) treatment across healthcare, including the closure of residential treatment centers and disruption to community-based programs such as Alcoholics Anonymous (AA). The epidemiological implications of these changes are not yet known. However, data from the Department of Veterans Affairs (VA) suggests that engagement with SUD treatment within VA has decreased since the start of the pandemic, while overdose rates have risen. Over the past several decades, the integrated primary care (PC) setting has provided an important venue for engagement with individuals with SUDs who may otherwise not connect with traditional SUD treatment settings. There are many reasons that the PC setting provides additional access avenues for these individuals, including avoiding the stigma of traditional SUD settings and providing familiarity with the patient’s established healthcare team. During the pandemic, the need for access and treatment of SUDs has increased within PC, yet PC has faced its own challenges with service disruption from reduced face-to-face appointments and the logistical barriers with the transition to telemedicine. The utilization of technology has been instrumental to the continued delivery of effective SUD interventions within PC. In this symposium, we present three novel, PC-based interventions designed to improve access and engagement for individuals with SUDs despite these access challenges: (1) A video telehealth-based intervention for the treatment of alcohol use disorders, utilizing principles of Motivational Interviewing and Motivational Enhancement Therapy. (2) A telehealth-based group intervention for the treatment of tobacco use disorders that incorporates behavioral and pharmacological treatment delivered in tandem by a psychologist and clinical pharmacist. During the pandemic, both of these interventions transitioned from in-person encounters to a telehealth platform. Successes, challenges, and solutions to telehealth adaptation will be discussed. Additionally, to address barriers to treatment initiation and engagement, we will present: (3) A telephoned delivered, motivationally-tailored intervention to increase utilization of evidence-based treatment for tobacco use disorder. Adaptations of this intervention to promote engagement with other SUDs will be discussed and prospective outcome data collected during the pandemic will be presented. Across all interventions, best practices for team-based care that incorporates both behavioral and pharmacological interventions and integrates care from providers from multiple professions will be discussed. Additionally, approaches to implementation in non-veteran, community-based treatment settings, and adaptations to these interventions to meet the challenges of the COVID-19 pandemic will be addressed.