• Evan Jones

Telehealth for rural residents latest tool in opioid fight


Capital News Service

LANSING — Smartphones could be Michigan’s latest tool to fight a dependence on painkiller pills.

In 2018, for the first time in six years, opioid deaths declined slightly in the state. Opioid-related overdose deaths decreased by 0.8 percent from the 2017 total of 2,053 to 2,036. Overall overdose deaths declined by 3.2%, according to the Michigan Department of Health and Human Services.

“There’s no one avenue that’s going to fix this issue. You have to hit this from a bunch of different areas,” said Lynn Sutfin, a public information officer for Health and Human Services.

One of the future avenues could be smartphones, said Doug Vanderlooven, a recovery coach with Workit Health, an Ann Arbor-based treatment center with increased traction in Northern Michigan and the Upper Peninsula.

Recent state efforts already in place include:

  • No longer requiring prior authorization from a patient’s health care insurer for medications that treat opioid use disorders.

  • Launching a $1 million statewide campaign to frame opioid dependence as a health issue instead of an addiction.

  • Expanding syringe service programs from 13 to 25 agencies that provide clean needles which can reduce disease risk.

  • Creating guidelines for medical providers on safe opioid prescriptions.

  • Beginning treatment programs in three state prisons with a goal to expand to all prisons by 2023.

“This is a step in the right direction. However, there is much work to be done, particularly when it comes to disparities and access to treatment,” Joneigh Khaldun, the department’s chief medical executive, said in a prepared statement. “We have a plan in Michigan to cut opioid-related overdose deaths by half in five years and we will be using all available resources to make that goal a reality.”

Challenges remain. Rural areas may not have enough treatment providers, she said. Both urban and rural residents may lack access to transportation to get them to treatment.

Workit Health is the only telehealth provider of opioid services in Michigan, Vanderlooven said.

The clinic requires a one-time in-person visit. Subsequent services can be received through a phone app, if the patient is in the state.

Workit Health’s phone services, like traditional rehabilitation, allow patients to meet with clinicians through video chat. Patients can also receive coaching, join recovery groups, and complete addiction courses.

The company already serves many clients in northern Michigan and the Upper Peninsula as it looks for partnerships to increase enrollment, Vanderlooven said.

“We’ve been trying to reach out into those more rural areas in Michigan because essentially if you can get down here for one appointment and then have an internet connection moving forward, you can receive services from us,” he said. “There’s so much with making appointments, scheduling appointments, transportation. To take all that out of the equation its monumental.”

A remaining barrier is reimbursement for opioid-related therapeutic services through health insurance, he said.

“Unfortunately, there are currently very limited insurances that will cover this service, but that is in relation to this type of treatment, not specifically telehealth,” Vanderlooven said. “Getting what might be referred to as addiction services covered by insurances is difficult.”

The company recently received a grant to provide services to patients without insurance or with Medicaid in Lenawee, Livingston, Monroe and Washtenaw counties, he said.

“Wherever you’re at within your own recovery, we can fit in to that with you and support you, be a provider for you,” Vanderlooven said.

Alongside an increase in services, the department is beginning to change the language about the opioid crisis with its $1 million advertising campaign including billboards, internet and radio ads.

Sutfin said, “When you look at the word ‘addiction,’ it has a very negative connotation. This is not just something someone chooses to do, or they can stop at any time – it is a health issue.”

The “not-the type” stigma occurs when friends and family fail to recognize signs of opioid use disorders. Other times, people believe opioid use is an active decision as opposed to a person’s body becoming physically or chemically reliant on them, according to a department release.

“One of the things that we’ve heard is that people are ashamed of having a substance abuse disorder,” Sutfin said. “It’s a chronic medical condition and you need to seek treatment for it, just like you would diabetes or heart disease or any other issue.”

PHOTO: "Screens" by ransomtech is licensed under CC BY-NC-SA 2.0