November 19, 2021
On November 3, the Friends of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), of which FABBS and the American Psychological Association (APA) serve on the executive committee, hosted the webinar titled “Telehealth and eHealth for the Treatment of Alcohol Use Disorder during the COVID-19 Pandemic and Beyond” to discuss research examining alcohol misuse and digital health technologies as a modality for treatment, before and during the pandemic. FABBS is a member of Friends of NIAAA to advocate for supporting research in the Institute’s wide range of scientific areas, including neuroscience and the behavioral sciences, among others.
Dr. Robert Huebner, Chair of the Friends of NIAAA, moderated the panel of five speakers, which included prominent research scientists and medical practitioners in the field of alcohol use and substance use disorders.
Dr. George Koob, Director of the National Institute on Alcohol Abuse and Alcoholism, started with his presentation, Telehealth Now, During the Pandemic, and Beyond, wherein he defined telehealth as a broad category of delivery options, including mobile health, and remote patient monitoring. Prior to the rapid expansion of telehealth use during the pandemic, there have been strategies using the psychological and behavioral sciences to assess an individual’s health-related behavior. Screening Brief Intervention and Referral to Treatment (SBIRT), for example, uses motivational interviewing to help the patient reflect on their alcohol use. Though preliminary research shows promising results in ameliorating reports of heavy drinking among those who received a session of SBIRT, the treatment is not used enough. Among people with alcohol use disorder (AUD) who saw a doctor in the past year, only 1 in 10 reported receiving advice to reduce their drinking (whereby SBIRT employs elements of personalized feedback about risks of AUD and advice to change). Nonetheless, this kind of intervention is easily implemented by computer or videoconferencing.
Dr. Koob also introduced one of the Institute’s excellent resources, the NIAAA Treatment Navigator, which explores telehealth services and online options (such as online support groups) for adults and adult loved ones who are seeking access to treatment for AUD. The Navigator simplifies the search for high quality, evidence-based approaches based on findings from more than 45 years of scientific research at NIAAA.
Next, Dr. Haiden Huskamp, Professor of Health Care Policy, Harvard Medical School, underscored the importance of telehealth use – which was significantly greater for behavioral health services in December 2020 than for other specialties. She also emphasized that telehealth allows accessibility for underserved, rural populations, wherein there may be a shortage of health providers specializing in substance use disorder. However, questions remain on how reimbursement policies can properly support patients who opt for telehealth appointments for AUD treatment, and how restrictions in practitioner licensure can create obstacles to its accessibility.
Dr. Stacy Sterling, Research Scientist, Kaiser Permanente, then presented on leveraging the relationship between a primary care provider (PCP) and a patient to assess and deliver appropriate levels of care, including pharmacotherapy, for AUD. There are multiple facets of treatment services that eHealth can provide, including assessment, psychoeducation, and motivational interventions, among others.
Dr. William Campbell, Research Scientist, CheckUp & Choices, presented on the role of telemedicine consultation in primary care. NIH small business research and development programs (SBIR & STTR), which provides support for any biomedical or behavioral research area which shares the NIH mission to improve human health, has helped fund and facilitate wider digital health adoption. However, the wide implementation of eHealth has revealed barriers to access due to factors such as the digital divide and a lack of support for physicians to adapt to the digital platforms.
Lastly, Dr. Douglas Novins, Chair in Child and Adolescent Psychiatry, University of Colorado, Anschutz, has worked within American-Indian and Alaska-Native Communities to provide psychiatric care for adults with comorbid mental and medical illnesses, who are also experiencing compounded socioeconomic challenges and substance use disorder. His research, supported in part by NIH, spans 20 years in operating a telepsychiatry clinic for the Alaska native population. He shared promising outcomes showing that adults in telepsychiatry remained engaged in treatment for longer periods and were more likely to complete the treatment. He also shared key administrative lessons for optimizing telepsychiatry services for populations of diverse cultures and traditions.
The briefing featured evidence-based strategies and techniques to better serve patients whose physical and mental wellbeing has been severely impacted by alcohol use disorder and its comorbid conditions. Promising insights into the field from researchers and clinicians, who are supported in part by NIH and NIAAA funding, show that much research is needed to assess how to deliver the highest quality care to underserved populations.
