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Study finds more patients sought addiction treatment for drug use during early pandemic

Telehealth was particularly well-used by young adults, according to Kaiser Permanente analysis

More Kaiser Permanente Northern California patients sought out addiction treatment during the early months of the COVID-19 pandemic, compared with a similar period in 2019. The study’s authors suggest their findings could reflect an increase in problem drug use as well as patient preference for telehealth treatment by phone or video.

Vanessa Palzes, MPH

“This is the first study of its kind, showing trends in addiction treatment utilization after the shelter-in-place orders changed the way services were delivered,” said lead author Vanessa Palzes, MPH, data consultant with the Kaiser Permanente Division of Research and its Center for Addiction and Mental Health Research. “We found that younger adults aged 18 to 34 had some of the greatest increases in telehealth use. That is interesting because this age group has historically had lower rates of entering addiction treatment.”

The study was published May 19 in JAMA Health Forum. It reflects similar findings of an earlier analysis by the study team that found patients identified with alcohol use problems also initiated treatment more often during the early pandemic months. The authors concluded that the shift to telehealth could also be a factor in that increase, with younger patients being more comfortable with the format, or finding it more convenient.

Asma Asyyed, MD

The new study also examined factors such as race, ethnicity, and socioeconomic status, and found no evidence that the shift to telehealth affected any disparities in addiction treatment use that may have existed before the pandemic.

The researchers looked at medical records for Kaiser Permanente Northern California adults with drug use problems, comparing 19,648 patients diagnosed from March to December 2019 with 16,959 patients diagnosed between March and December 2020.

Overall, 25.2% of patients identified with problem drug use engaged in treatment in 2019, while 27.7% engaged in treatment in 2020. Odds of telehealth treatment engagement for addiction rose from 7.4% in 2019 to 45.9% after the pandemic began.

“It was comforting to know that there was increased utilization even with the pandemic shift to telehealth for some addiction care,” said co-author Asma Asyyed, MD, KPNC chair of addiction medicine and recovery services. “We know in addiction medicine that when patients initiate and engage with care they have better outcomes and are less likely to relapse. With opioid use, relapse can be deadly. This study starts the conversation to understand the impact that virtual care has and helps us design a hybrid in-person and telehealth addiction medicine program.”

Cynthia Campbell, PhD, MPH

The research team has funding to carry out similar analyses over a longer period of time, to understand how addiction treatment is being accessed as pandemic conditions evolve, said senior author and DOR research scientist Cynthia Campbell, PhD, MPH.

The study was funded by the National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism.

Co-authors also included Felicia W. Chi, MPH, Verena E. Metz, PhD, Stacy Sterling, DrPH, MSW, and Kathryn K. Ridout, MD, all with the Division of Research.

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About the Kaiser Permanente Division of Research

The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 600-plus staff is working on more than 450 epidemiological and health services research projects. For more information, visit or follow us @KPDOR.


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