Telemedicine Mediated Service Delivery for Substance Use Disorders

Telemedicine in addiction service delivery- Dr. D Basu For around last two decades, telepsychiatry has been practiced in India to reach the unreached population with variable degree of success. COVID-19 pandemic limited healthcare access due to travel and face to face consultation restrictions. It warranted an urgent and widespread expansion of telepsychiatry practice, and application of the same in management of patients using substance. In spite of the advantage of increased access, there are some inherent limitations in the form of inability to perform detailed physical examination and restriction of medication prescriptions. Dr. Basu will discuss the opportunities and challenges in telemedicine-based service delivery for substance use disorders. Telemedicine and Opioid substitution treatment (OST)- Dr. A. Ghosh Opioid substitution treatment (OST) was significantly affected during pandemic, as there was a strict requirement of face-to-face consultation. Only United States shifted the buprenorphine-naloxone assisted OST induction through teleconsultation. Many other countries including India has allowed preliminary assessment for OST through teleconsultation, but induction and dispensing were essentially through in person consultation. The dispensing of OST has been mechanized in some other countries. Dr. Ghosh will review the adaptations and challenges in OST delivery during the pandemic. Telemedicine mediated service delivery in the Drug Deaddiction & Treatment Centre (DDTC), PGIMER, Chandigarh- Dr. T. Mahintamani In DDTC, PGIMER, a synchronous, stepwise (telephonic, video, and in-person consultation) direct-care model has been adopted for provision of teleconsultation. A psychiatrist with post-graduate qualification performs initial assessment through telephonic or video-consultation. The prescriptions are sent through WhatsApp platform. If there is a felt need for in-person care, the patient is called in the OPD. Whenever required the feedback of consultant is sought after. Patients were found to experience stronger therapeutic relationship and physician empathy with in person consultation. Difficulty in telephonic registration, privacy and connectivity issues were commonly faced by the service users. Dr. Mahintamani will discuss the experience from DDTC, PGI, Chandigarh.