Originally published by our sister publication Pain Medicine News

By Myles Starr

A qualitative analysis of patient perceptions of stigma and their experiences with it while using telehealth for treatment of opioid use disorder (OUD) revealed that remote care might mitigate some negative experiences, but some concerns remain.

“The forms of stigma experienced by individuals with [OUD] are complex and multifaceted, as are the ways in which those experiences interact with telehealth-based care,” the study authors wrote. “The mixed results of this study support policies allowing for a more individualized, patient-centered approach to care delivery that allows patients a choice over how they receive OUD treatment services.”

A total of 30 participants were included in the study (Harm Reduct J 2024;21[1]:125). The patients had at least one telehealth visit (video/virtual or phone only) for OUD and a prescription for any formulation of buprenorphine for treatment. Participants’ mean age was 40.5 years (range, 20-63 years); 47% were women, 50% were men; and 7% were transgender, non-binary or gender diverse. The majority of the study group (77%) were white, 13% were American Indian/Alaska Native, 17% were Black and 17% were Hispanic/LatinX. Housing instability was common among participants, with nine (30%) having experienced homelessness in the preceding six months.

Patients were asked questions regarding their perceptions of and experiences with stigma and telehealth at the individual, public and structural levels.

At the individual level, it was reported that “telehealth provided [some] participants with a greater sense of agency, allowing them to seek care from within a known, safe environment or to quickly end an uncomfortable encounter.” Similarly, at the public level, telehealth allowed some patients to avoid uncomfortable situations from being seen in public seeking treatment for OUD or missing work for treatment. However, some patients expressed privacy concerns when seeking telehealth and described the clinic as “a more secure environment.”

At the societal level, researchers found that depending on the patient, telehealth alleviated or exacerbated perceptions that their clinician was discriminatory.

The study researchers concluded that “given that aspects of both telehealth and in-person OUD treatment modalities left some participants feeling judged by their clinicians, our findings highlight the need to further explore how clinicians perpetuate stigma through telehealth-based programs, and how training and clinical guidelines could mediate this.”

The authors reported no relevant financial disclosures.