Alcohol use disorder (AUD) is a widespread problem in the US, affecting millions of people. While medications for AUD (MAUD) can be effective, many individuals struggle to access them due to factors like limited access to prescribing clinicians, high costs, and societal stigma; however, telemedicine offers a promising solution to these barriers.

In a recent research letter, Haiden Huskamp, PhD, the Henry J. Kaiser Professor of Health Care Policy, and team members, including S. James Adelstein Professor of Health Care Policy, Sharon-Lise Normand, and Associate Professor of Health Care Policy, Alisa Busch, MD, MS investigated the use of telemedicine for initiating MAUD in the US. The study analyzed de-identified claims data from Optum Labs and focused on adults aged 18-64 with commercial or Medicare Advantage insurance. Findings showed telemedicine was used in 13.9% of all MAUD initiations between January 2019 and September 2023, with a peak of 26.4% in May 2020.

They found the following factors associated with telemedicine initiation:

• Psychiatrists were more likely to use telemedicine compared to primary care physicians.
• Patients with mental health diagnoses or from higher-income areas were also more likely to utilize telemedicine.
• Men, individuals with non-AUD substance use disorders, and those with alcohol-related medical conditions were less likely to use telemedicine.

The study highlighted the "digital divide" as a potential barrier to telemedicine access. Telemedicine initiation was more common in higher-income areas, suggesting that telemedicine might not be equally accessible to everyone. Limitations of the study included its focus on a specific population, lack of information on race and ethnicity, and inability to observe MAUD initiations for out-of-pocket payers.

Despite these limitations, the study suggests that telemedicine can be a valuable tool for expanding access to MAUD and addressing the challenges faced by individuals with AUD.