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Author Credentials

Jack C. Wang, D.O. Staff Psychiatrist Substance Use Disorder Clinic Residential Rehabilitation Treatment Program Hershel "Woody" Williams VA Medical Center Adjunct Professor Psychiatric Residency Program Marshall University

Author ORCID Identifier

0009-0004-3649-5014

Keywords

accessibility, addiction, alcohol, barrier, opioid, regulation, substance use, telehealth, telepsychiatry

Disciplines

Medicine and Health Sciences | Psychiatry

Abstract

ABSTRACT

Introduction: Prior to the COVID-19 pandemic, telepsychiatry for substance use disorder (SUD) management was generally an underutilized modality, mainly due to regulatory constraints. Through the pandemic, governmental deregulations rapidly and massively expanded their adoption, bringing out their significant potential to expand access, overcome barriers, and mitigate stigma for individuals seeking addiction care, particularly for rural and underserved populations. This narrative review consolidates the recent research on the growing adoption of telepsychiatry in the management of SUDs. It aims to explore the evidence-based benefits, identify common challenges, and underscore key considerations for its effective and equitable integration into SUD treatment paradigms.

Method: This review examines telemental health and SUD literature published between 2010 and 2025. We searched Google Scholar, MEDLINE, and EBM Reviews using keywords such as "telepsychiatry," "addiction," and "veteran." Only complete, English-language studies were included. Articles underwent a two-phase screening: first by title and abstract for relevance, then by full-text review against inclusion criteria. The analysis employed mixed methods, combining interpretive synthesis of qualitative data (barriers, accessibility) with quantitative analysis of adoption rates. Statistical analysis was performed using Python for Chi-square tests and data visualization.

Results: Telepsychiatry provides substantial advantages for SUD care, with the most significant being expanded access for rural and underserved populations; in addition, it reduces patients’ costs, transit burdens, and stigma, which improves treatment initiation and retention. It has demonstrated value across various SUD interventions, such as medications for opioid use disorder (MOUD) initiation and maintenance, individual and group psychotherapy, and psychiatric evaluations. However, implementation faces obstacles related to the digital divide, navigating evolving regulatory and reimbursement landscapes, and effectively managing acute or highly complicated cases remotely. The literature suggests that an integrated approach, combining virtual and in-person visits, may offer greater outcomes.

Discussion: While not a panacea, telepsychiatry is an integral tool that can significantly improve the accessibility and continuity of care for the SUD population. Its effective and enduring implementation calls for further research to examine its long-term outcomes, patient-centered approaches for diverse populations, and the development of supportive policy frameworks to ensure quality and equitable care.

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