Telehealth Buprenorphine Model in Maryland

An innovative telehealth model implemented in rural Maryland that has the potential to expand the capacity of buprenorphine in rural and underserved areas

A collaboration in 2015 between an addiction treatment center in rural Western Maryland and the University of Maryland’s Division of Addiction Research and Treatment resulted in a pilot program to prescribe buprenorphine through telemedicine in conjunction with psychosocial services provided by the treatment center.

Program coordinators are present at both sites to ensure protocols are followed. Initially, patients are screened by trained counselors for the telemedicine program. They are referred to the telemedicine program if they meet criteria for opioid use disorder (OUD) and are willing to participate after informed consent.

An initial appointment, consisting of a full diagnostic patient evaluation, is scheduled through an addiction psychiatrist at the university. A treatment plan is then developed and buprenorphine is initiated if indicated. Updated medical logs and notes from each encounter are placed in charts at both sites.

Evaluation of this model suggests that buprenorphine can be prescribed remotely via telemedicine and yield the same results as buprenorphine prescribed in person, in conjunction with a comprehensive treatment plan. 

This program model has evolved to now provide mobile telehealth-delivered MOUD through the Eastern Shore Mobile Care Collaborative (ESMCC).

Of patients still engaged in treatment at 3 months, 86% had opioid-negative urine toxicology.

Continuum of Care
Treatment
Type of Evidence
Peer-reviewed
Response Approach
Medications for Opioid Use Disorder
Peer-reviewed Article

Evidence of Program Effectiveness

“This study evaluated a program that began providing buprenorphine treatment to patients at a drug treatment center in rural Maryland via telemedicine in August 2015. A chart review was performed of the first 177 patients who were enrolled in the program. Data were extracted to examine retention in treatment and rates of continued opioid use. Retention in treatment was 98% at 1 week, 91% at 1 month, 73% at 2 months, and 57% at 3 months. Of patients still engaged in treatment at 3 months, 86% had opioid-negative urine toxicology. Our findings suggest that treatment with buprenorphine can be effectively delivered by telemedicine to patients with opioid use disorders in a rural drug treatment program.” (Weintraub et al., 2018)