The short answer is yes; in many cases you can start methadone treatment using telehealth. However, accessing methadone treatment depends on where you live, the laws in your state, and the policies of your local opioid treatment program (OTP).
At Community Medical Services (CMS), our goal is to remove as many barriers as possible so people can start recovery quickly and safely. Telehealth is one of the many tools we employ that helps us do just that. In this guide, we’ll discuss what telehealth methadone treatment is and how you can get started at CMS.
Why is Medication Important in Opioid Use Disorder Treatment?
For people living with an addiction to opioids, often called an opioid use disorder (OUD), life can feel like a constant cycle of intoxication and withdrawal. Each day becomes focused on preventing painful withdrawal symptoms and avoiding sickness.
Fortunately, there is hope. Medication for opioid use disorder (MOUD) can help people:
- Stabilize their bodies
- Reduce cravings
- Step out of the constant cycle of opioid use
- Rebuild relationships, work, and daily life
However, once someone is ready to accept help, they need to get started right away. Motivation and readiness to change can be fragile. If treatment is not available quickly, that commitment to start recovery may fade. That’s why MOUD via telehealth plays such a critical role. Telehealth can help people connect with a medical provider sooner, begin treatment faster, and avoid unnecessary delays.
The Importance of “Treatment on Demand”
Studies show that when someone decides to seek help for an OUD, there is a “golden 48 hours” in which they are most likely to follow through with starting treatment. After this window, many people encounter obstacles, lose hope, or feel discouraged and give up on the idea of getting help.
The best way to support individuals who are ready to begin recovery is to meet them where they are, both physically and emotionally. That means:
- Making treatment available near where they live
- Offering services quickly, ideally the same day
- Minimizing wait times, paperwork, and unnecessary steps
What Needs to Happen Before the First Dose of Medication?
There are many regulatory requirements that providers of MOUD must follow. At CMS, we work hard to make the process of starting care as simple as possible. A lot of the detailed paperwork can be completed over the first few days of treatment. However, before a dose of medication can be dispensed, a few things must occur:
- The patient must meet with a medical provider (in person or via telehealth, depending on state law).
- Basic information about the person’s health, substance use, and medical history must be collected.
- The provider must determine an initial dosing regimen that is safe and appropriate.
The goal of this first visit is to choose a starting dose that protects the patient’s safety, allows the dose to be increased to a therapeutic level as quickly and safely as possible, and reduces withdrawal and cravings. Telehealth can make that first medical provider visit faster and more accessible, especially when an on-site provider is not immediately available.
Methadone vs. Buprenorphine: Why the Rules Are Different
When it comes to MOUD, methadone and buprenorphine (often known by the brand name Suboxone) are both highly effective medications. However, the regulations surrounding them are not the same.
Buprenorphine has less restrictions than methadone, meaning medical providers can prescribe buprenorphine through a telehealth visit. A provider can enter orders for the OTP nurse to dispense doses at the window or in some cases send a prescription to a local pharmacy for the patient to pick up. On the other hand, methadone faces higher restrictions and retail pharmacies are not allowed to dispense methadone for the treatment of OUD. This means that all methadone for OUD must be provided through opioid treatment programs.
There are more than 2,000 OTPs in the United States. Many communities have an OTP within driving distance, though some rural areas still lack nearby access. If buprenorphine does not work well for you, or if methadone is otherwise the most appropriate medication, you will need to be able to travel to an OTP. In most cases, this involves coming to the clinic several times per week at the beginning of treatment, and then less frequently as you stabilize and qualify for take-home doses under applicable regulations.
How Does Telehealth Work for Methadone Treatment?
When a patient comes into an OTP requesting help, the priority is to have that person seen by a medical provider, get them started on medication (ideally that same day, if possible), and provide the first dose within an hour or two of them walking in.
All OTPs have medical providers available, but at smaller programs, the provider may not always be physically on site. They may be scheduled at another location, be on vacation or out of office, or may have several patients arrive at once, making it hard for everyone to be seen in a timely manner. This is where telehealth becomes extremely valuable.
Telehealth allows a patient at the clinic to meet virtually with a medical provider who is located somewhere else. As long as state and federal regulations are followed, the provider can complete the intake evaluation, develop an initial treatment plan, and authorize a safe starting dose of methadone.
What Does a Telehealth Intake Look Like?
If there is no on-site medical provider available to perform the intake, the clinic staff can still begin the process:
- Paperwork and Initial Questions: Staff will help you complete the usual intake forms. They will ask about your health history, substance use, current medications, and other background information that will help the medical provider understand your situation.
- Connecting with a Remote Medical Provider: Once basic information has been collected, staff will connect you with a remote medical provider through a secure audio and video connection.
- The Telehealth Visit: You will sit in front of a computer screen or tablet in a private area of the clinic. During this visit, the provider will review your history, discuss your goals for treatment, and ask follow-up questions. The provider will explain methadone treatment, including the benefits, risks, and what you can expect. Together, you and the provider will use shared decision making to create an initial treatment plan.
- Determining the Initial Dose: Based on your history, physical findings obtained through the visit, and current symptoms, the provider will select an initial methadone dose that is safe and designed to move you toward a therapeutic level as quickly as appropriate.
- Receiving Your First Dose: After the telehealth visit is complete and the provider has entered the order, clinic staff can then dispense your first dose on site, in accordance with all regulations.
Please note that telehealth does not replace the need to come into the OTP for medication, but it can speed up the medical evaluation so you start feeling better sooner.
How Else Can Telehealth Support Methadone Patients?
Methadone treatment is most effective when it is combined with supportive services, such as counseling and case management. Telehealth can help here, too.
Counseling Sessions
All methadone patients at CMS are assigned a counselor and encouraged to engage in counseling sessions as part of their treatment plan. These sessions can help you build coping skills, address triggers and stressors, and support your mental and emotional health. Counseling can be done in person at the clinic or over telehealth, depending on your needs and clinic capabilities. However, patients also have the right to receive medication even if they decline counseling.
Follow-Up Medical Appointments
After you begin treatment, you will have follow-up visits with a medical provider to adjust your dose, monitor your progress, and address any side effects. When appropriate and permitted, these visits can sometimes be done via telehealth while you are at the clinic.
Staying Connected Between Visits with Recovery Connect
A powerful way to stay in touch with your care team between visits is through our smartphone app, Recovery Connect. The app keeps you connected and supported, even when you are not physically at the clinic. With Recovery Connect, you can:
- Message your counselor any time and receive responses during office hours
- Access educational modules about addiction, recovery, and wellness
- Review scheduling information, appointment details, and clinic updates
Frequently Asked Questions About Telehealth Methadone Treatment
Can I do telehealth methadone treatment at home on my own device?
For methadone treatment, you must come into the OTP to receive your medication. Because of that, at Community Medical Services we have patients complete telehealth appointments in the clinic, rather than at home.
CMS is not currently providing telehealth methadone visits directly to patients’ personal devices. This may be considered in the future for certain counseling visits if regulations and clinic policies allow.
Are there any limitations on telehealth for methadone?
Telehealth for methadone treatment is governed by a combination of federal rules and state-specific regulations. Because of this, availability can vary by location.
At CMS, you can call or walk into one of our clinics, and staff will do everything possible to help you start medication as soon as we safely can. In many states, we can use telehealth to complete your initial medical assessment. However, if you live in Texas, telehealth intakes for methadone are not allowed, so your first medical evaluation must be done in person.
You may end up seeing a medical provider or counselor in person or via telehealth, depending on clinic staffing and state regulations. Our experience shows that patients who have their initial assessment done by telehealth are just as likely to be successful in their recovery journey as those who are seen in person.
Am I a good candidate for telehealth-supported methadone treatment?
Telehealth may be especially helpful if you:
- Live a long distance from the clinic
- Have transportation challenges or a tight work schedule
- Need to start treatment quickly but the on-site provider is unavailable
- Prefer to minimize time spent waiting in the lobby for a provider
You will still need to come to the OTP for your medication, especially early in treatment, but telehealth can shorten delays and make it easier to connect with a medical provider or counselor.
Get Started with Methadone Treatment at Community Medical Services
If you are wondering whether telehealth-supported methadone treatment is right for you, the first step is simple: call your nearest CMS clinic or walk in during open hours. Our team will explain what to expect on your first day, review your medication options, and help you begin the process of starting care as quickly and safely as possible, whether through a telehealth intake or a standard in-person visit.
If you or someone you love is ready to start treatment for opioid use disorder, Community Medical Services is here to help. Reach out to a CMS clinic near you to learn more about methadone treatment, telehealth options, and the support available as you begin your recovery journey.
