Opioid Use Disorder Index 

Every day, thousands of Americans seek treatment for opioid use disorder online at Bicycle Health.  Our index provides quarterly insights on patients seeking treatment online. 

See OUD Index

Medication for Opioid Use Disorder (MOUD) Treatment is the gold-standard of care for people with OUD.
- When access to MOUD via telehealth opened up during COVID-19 what was the impact?

- MOUD via telehealth associated with reductions in fatal drug overdose - JAMA Psychiatry

- MOUD via telehealth improved retention and reduced medically treated overdose - JAMA Psychiatry

- Utilization of MOUD  improved for veterans after treatment shifted to telehealth - American Journal of Psychiatry.

- MOUD via telehealth improved retention and reduced no-show rates - BMJ Innovations

- MOUD via telehealth associated with decline in opioid-related deaths involving buprenorphine -  JAMA Open Network

Does MOUD reduce overdoses?

Yes, A 2019 study in the Journal of Substance Abuse Treatment found that, at six months, only 3.6% of individuals who were adherent to MOUD with buprenorphine experienced a nonfatal drug-related overdose in the ED, compared to 13.2% of individuals who were non-adherent.

Does MOUD increase access to care?

Yes, Telehealth reduces any barrier to access to addiction specialists

Does MOUD healthcare decrease costs?

Yes, A 2013 study in JSAT found that patients who were adherent to MOUD treatment saw their total healthcare costs decrease by 42 percent ($28,458 vs. $49,051) when compared to non-adherent members.

Is MOUD via telehealth associated with reduced fatal drug overdose?

Yes. A March, 2023 study in JAMA Psychiatry found an association between emergency authorized telehealth expansion and MOUD provision during the COVID-19 pandemic were associated with lower odds of fatal drug overdose among Medicare beneficiaries.

Does MOUD via telehealth improve retention and reduce medically treated overdose?

Yes. An August, 2022 study in JAMA Psychiatry showed the telehealth provision of MOUD from COVID-19 to be associated with improved retention in care and reduced odds of medically treated overdose for Medicare beneficiaries.

Does Utilization of MOUD improve for veterans when they can shift their treatment to telehealth?

Yes. A July, 2022  study in the American Journal of Psychiatry found that Buprenorphine treatment for veterans with opioid use disorder increased as care shifted to telehealth during Covid.‍

Does MOUD via telehealth improve retention and reduced no-show rates?

Yes. A 2021 study in BMJ Innovations found the retention rate for insured telehealth patients at 90 days was 80% compared to an industry average of 44% and that “no-show rate” for telehealth patients was 9.5%, compared with an average of 23%.

Is MOUD via telehealth associated with declines in opioid-related deaths involving buprenorphine?

Yes.A January, 2023 study in JAMA Open Network found that the percentage of opioid-related deaths involving buprenorphine dropped from 3.6% to 2.1% from July 2019 to June 2021, after the Ryan Haight Act was waived and telemedicine OUD care with no in-person requirement began. The same study from JAMA Open Network found that buprenorphine-involved deaths were more likely to involve other drugs (at least one), and less likely to involve illicitly manufactured fentanyl compared to other opioid-involved overdose deaths (50.2% vs. 85.3%).

Do people with opioid use disorder misuse buprenorphine to treat withdrawal symptoms or to get high?

To treat withdrawal. A 2021 study covered in JAMA Network Open, found that hydrocodone and oxycodone were far more commonly misused than buprenorphine and that when buprenorphine is misused, the reason tends to be self-medication of withdrawal symptoms and pain, not to get high. The primary reported motivation for use of diverted buprenorphine to be lack of access to legitimate treatment for OUD. The rate of use of diverted buprenorphine was highest by far in the population of patients with OUD not receiving MOUD.

Can urine drug screenings for opioid use disorder be initiated and completed effectively via telehealth?

Yes. Over 97% of patients receiving MOUD treatment via telehealth complete their Urine Drug Screenings (JAMA Health Forum)