Q&A: Telehealth’s role in fighting the opioid epidemic

Amid the COVID-19 pandemic, the number of overdose deaths in the US has skyrocketed. The CDC estimates that more than 107,000 people died in 2021, an increase of nearly 15% from the more than 93,000 deaths in 2020.

But the pandemic has also led to a sudden increase in the use of telehealth. Regulations surrounding telehealth regulations for controlled substances were relaxed during the public health emergency, allowing providers and startups to offer drug treatment such as buprenorphine for opioid use disorders.

One of those companies, Bicycle Health offers prescription drugs in addition to virtual care. CEO and founder Ankit Gupta and medical director Dr. Brian Clear sat down with: MobiHealthNews to discuss the treatment landscape for patients struggling with opioid use disorder and the startup’s recent $50 million Series B raise.

MobiHealthNews: Why do you think telemedicine works well for this population?

dr. Brian Clear: It’s all about access. So we know that only one in ten patients with substance use disorder is actually treated in the past year. There are many reasons for this, mostly around geographic access. Forty percent of counties in the United States don’t even have a provider registered to provide you with buprenorphine for opioid use disorders.

There is also stigma. Particularly in cities where people in their health system or their neighbors know who they are, patients are reluctant to show up to these programs, which are certified licensed programs for specialized addiction treatment, and these programs are known to provide specialized addiction treatment.

In our program, we find that 30% of patients who contact us have never been diagnosed with opioid use disorder before and have never had access to opioid use disorder care before, which is truly remarkable. That means we appeal to people who would otherwise not have access to a different level of care. We’re finally breaking that cycle of serving the same tiny, tiny subpopulation of patients over and over.

Ankit Gupta: Yes, and I’ll give you an example. New regulations recently went into effect in Alabama requiring a personal examination within the past 12 months to prescribe a controlled substance. For the past nearly two months, we’ve had an entire task force working tirelessly to help our hundreds of patients find local health care providers in Alabama.

After all that effort, we still found that less than 20% of patients actually found a local health care provider. It is because the providers were not available. They were not affordable. There was a lot of stigma as Brian mentioned. We’ve had reports that patients don’t want to be seen when they walk into clinics; they don’t want their car parked outside. So we were in heavy weather.

We literally had to fly a few providers to Alabama and spend a week there to comply with regulations so we can continue to take care of the patients we have. We are not enrolling new patients, but we will continue to care for the patients we have until we find a suitable option for them locally. And so there’s just a huge, huge lack of access.

MHN: Overdose deaths have increased in recent years. What have you heard from patients about their experiences with access to care?

Clear: It has always been bleak and access has not gotten worse in the past two years. What has happened is that fentanyl is now almost ubiquitous in the illicit drug supply. Patients who use illicit opioids are therefore much more likely to overdose than ever before.

COVID kept people in their homes for a very long time and made people even more reluctant to access resources that were already very limited. Now, I think we’re starting to get past that, and people are going back to more normal lives. So I can’t say COVID restrictions are keeping people out of care anymore.

But we’re in a place now where it’s not just fentanyl; they are new analogs of fentanyl – which are even more potent – that are in the illicit drug stash.

gupta: About four or five months ago, we sent out a survey to patients. There were about 1,000 patients and we asked them many questions, including their views on recovery and addiction treatment during COVID.

And what we learned was very different from the story out there. We learned that 77% of our patients said the pandemic has not made maintaining or achieving recovery more difficult. In fact, 42% said it made it easier. So again, it shows how telehealth can really improve access.

MHN: Bicycle Health recently raised a $50 million Series B. How do you plan to use that investment?

gupta: So far, we’ve been fairly successful in reaching patients; we have helped more than 17,000 patients in 26 states to date. But we’re still starting.

We will use this investment to continue to increase access to treatment for opioid use disorders. That includes hiring medical providers to increase the capacity to see patients, building our technology that helps us both deliver care and increase the quality of care through data analytics and patient engagement tools we built in-house. by our randomized home drug testing program.

We’ve also been quite successful in partnering with health plans. We see strong demand, from both commercial and Medicaid-administered health plans, to both increase access by lowering the cost of this patient population. So we invest in increasing those partnerships.

We are now getting incoming interest from healthcare providers who want to work with us, either by referring patients to us or co-managing patients. We want to use the investment to also increase our partnerships with medical providers, case managers and discharge planners, especially in the judicial health sector, but also with employers to reach patients.