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Fighting the opioid epidemic and COVID-19 pandemic

Using innovation to combat both crises

Both COVID-19 and the opioid epidemic have disrupted healthcare. Leaders can draw on lessons learnt from both crises and continue the exploration of virtual care, data analytics, technologies and policy to create solutions to improve the future of health.


Before the COVID-19 pandemic, healthcare in the United States was already grappling with another crisis: the opioid epidemic. As leaders continue to seek ways to address the many challenges the COVID-19 pandemic and the opioid epidemic bring, they must navigate a complicated web of social, economic and financial implications and questions related to the crises.

Healthcare has already started to respond to the seismic shifts patients and communities are experiencing as a result of the confluence of the COVID-19 pandemic and the opioid epidemic, implementing new technology solutions and innovative strategies to deliver care to patients, maintain continuity of operations and mitigate the spread of COVID-19.

This report explores the challenges and opportunities COVID-19–related disruptions present for individuals, communities and systems impacted by opioid use disorder (OUD) with a focus on innovations that have the potential to influence the future of health. These include the proliferation of new virtual treatment options for OUD, development of data-informed healthcare, adoption of new technologies and advancement of policies that enable access to these innovations. Figure 1 illustrates the numerous impacts COVID-19 disruptions have had on public health and healthcare delivery—creating new obstacles as well as opportunities for innovation—and subsequent impacts for people with OUD.

As leaders continue to seek ways to address the many challenges the COVID-19 pandemic and the opioid epidemic bring, they must navigate a complicated web of social, economic and financial implications and questions related to the crises.

Challenges caused by the healthcare disruption

COVID-19 has created challenges that in many cases have disproportionately or uniquely impacted individuals with OUD, including worsening mental and behavioural health needs, exacerbating pre-existing issues related to social determinants of health, and increasing or causing new challenges to accessing. As healthcare and policies continue to evolve, it will be important to consider these challenges for all Americans, including continuing to provide the services needed for those with behavioural health needs and OUD in particular.

Behavioural health

Behavioural health is a term used to encompass a number of facets that impact a person’s well-being, including but not limited to mental health, substance use disorder (SUD), adverse life events or stressors and individual behaviours that impact mental and physical health.

Source: Agency for Healthcare Research and Quality, “What is integrated behavioral health?,” accessed January 2021.

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Impact on vulnerable populations

COVID-19 and OUD both threaten the health and well-being of the people they affect and draw new attention to health disparities among communities. The Centers for Disease Control and Prevention (CDC) examined the impact of COVID-19 on people from racial and ethnic minority groups and identified several factors that may contribute to increased risk for COVID-19 severity and death, including discrimination within the healthcare system, disproportionate representation of racial and ethnic minorities in higher-risk essential work settings, wealth disparities and housing.1 These factors contribute to stark racial disparities in the number of cases, hospitalisations and deaths due to COVID-19. For example, as of August 2020, Black Americans were 4.7 times more likely to need hospitalisation than white, non-Hispanic Americans, and 2.1 times more likely to die.2 These factors—such as limited access to healthcare and economic resources—also exacerbate negative outcomes for people with SUDs, as OUD and overdose share similar structural and social risk factors.3 This dangerous overlap comes at a time when the demographics of the opioid epidemic were already changing to disproportionately impact people of colour, particularly non-Hispanic Black Americans and Hispanic Americans. This is possibly related to an influx of synthetic opioids such as illicitly manufactured fentanyl, which have proliferated in the drug supply.4

Increased incidences of mental health and substance use disorder issues

Mental health and SUDs already have high rates of co-occurrence. The Substance Abuse and Mental Health Services Administration (SAMHSA)’s 2012 National Survey on Drug Use and Health identified that approximately 8.4 million American adults have comorbid mental health and SUDs.5 The inherent threats of a pandemic to physical health and economic security, as well as the overall uncertainty for the future, cause general stress at a population level, potentially exacerbating mental health and substance use outcomes.6 While the COVID-19 pandemic is a source of tremendous stress itself, the strategies implemented to address it may also adversely affect both mental health and SUDs. Studies have started to examine how social distancing–related impacts on mental health could cause particular problems for people with SUDs. These consequences may already be occurring across the United States, especially in certain areas where early data shows increased incidences of opioid overdose in 2020. The economic impact of COVID-19 may also exacerbate SUD prevalence and severity.7 Negative life events such as job loss—which some 20.6 million Americans experienced from February to May 20208, with about half remaining unemployed as of September 20209—are linked with increased risk of SUDs as well as mental health issues such as “increased depression, anxiety, distress and low self-esteem” that may trigger or exacerbate substance use.10 At the same time, many front-line or essential workers who continue to be employed under hazardous conditions report feelings of burnout and increased anxiety.11

“Social distance, isolation, or quarantine are essential measures to help prevent coronavirus transmission—however; these strategies, and the pandemic outbreak itself, have been associated with negative emotions, such as irritability, anxiety, fear, sadness, anger or boredom. These conditions are known to trigger relapse, even in those long-term abstainers, or intensify drug consumption.” 

—Felipe Ornell et al., “The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment,” Psychiatry Research 289 (2020).

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New access to healthcare obstacles

Even as stressors related to the pandemic have exacerbated mental health and SUD challenges, the pandemic has disrupted healthcare operations, which are necessary to address those challenges. These disruptions have introduced new issues with treatment of people with SUD with devastating consequences. In certain areas, in-person recovery programmes have been halted or limited to maintain social distancing.12 For some patients, required medical appointments to refill treatment prescriptions (e.g., monthly injections of medication to support OUD recovery) were delayed. In at least one documented case, this led to withdrawal, relapse and death as a result of overdose.13 Some of these social distancing mandates have since been relaxed, enabling prescribers to provide additional weeks’ worth of medication to avoid interruptions in care.14 Access to other services, such as syringe services programmes and other harm-reduction resources, have undergone operational disruptions as well.15 Finally, across healthcare, many patients are delaying treatment—including avoiding emergency room visits for critical care needs (which could include opioid overdose)—due to fear of contracting COVID-19.16 In addition to new obstacles generated by the pandemic, there are existing challenges for people with SUD who try to access care. For example, gaps in broadband infrastructure to support virtual medical visits, absence of transportation and lack of health insurance are all increasingly difficult to overcome in combination with new obstacles created by the pandemic.

Opportunities for innovation

While the COVID-19 pandemic will continue to exacerbate many existing issues related to the opioid epidemic, it could also fuel progress toward improving prevention and treatment of OUD. The pandemic continues to provide opportunities to scale up existing strategies and develop completely new strategies to address OUD, which may leave a lasting impact even after COVID-19 subsides.

Exponential growth in virtual healthcare for OUD patients

Creative policymaking for virtual health during COVID-19 should be applied to other public health challenges, such as the opioid crisis.

Virtual health—defined as a variety of “at-a-distance” interactions that further the care, health and well-being of healthcare customers in a connected, coordinated manner17—provides new treatment approaches and expands access to care for OUD. Healthcare delivery at a distance will likely continue to grow as the United States navigates COVID-19 outbreaks and works to minimise in-person interactions.

As a result of COVID-19, the federal government implemented sweeping regulatory waivers and flexibilities to enhance access to virtual health services such as telemedicine. For example, while 76% of hospitals had fully implemented telemedicine by 2017,18 its use has increased manifold during the COVID-19 pandemic. Prior to the pandemic, about 13,000 fee-for-service (FFS) Medicare beneficiaries used telemedicine in a week; in April 2020, this number grew to almost 1.7 million users a week.19 This shift, facilitated by an influx of regulatory flexibilities, might have accelerated virtual health by a decade.

The pandemic’s impact on virtual health has already altered the way many people being treated for OUD receive care and improved access to treatment for SUD. Medication-assisted treatment (MAT), sometimes also known as medication for opioid use disorder (MOUD), involves the combination of behavioural therapy with the use of methadone, buprenorphine, or naltrexone to address neurological components of SUD (e.g., blocking withdrawal symptoms). Prior to COVID-19, issues such as provider shortages, strict federal and state care delivery policies, transportation challenges and stigma created challenges to MOUD/MAT access, especially in rural areas.20

The pandemic’s impact on virtual health has already altered the way many people being treated for OUD receive care and improved access to treatment for SUD.

The pandemic compounded these challenges for Americans in rural and urban areas alike, leaving many physicians unable to dispense medications to patients or monitor their treatment in person. However, changes in virtual health and MOUD/MAT policies have helped overcome these obstacles. For example, the Drug Enforcement Administration (DEA), in partnership with SAMHSA, provided new flexibility to enable providers to admit and treat new patients with OUD, and to prescribe controlled substances to patients using telemedicine without first conducting an in-person evaluation.21

SAMHSA has also experimented with ways to ensure access to MOUD/MAT during COVID-19, including passing guidance around contactless “doorstep” delivery and pick up of medications for OUD and increasing the number of doses permitted to patients.22 Many states have taken advantages of these new flexibilities—for example, in Massachusetts, the Department of Public Health waived provisions for opioid treatment programmes, enabling patients to take home up to 28 days of medication, as well as the administration of “curbside dosing.”23 Additionally, SAMHSA has provided resources in the form of virtual meetings and other recovery tools that can complement the medical component of MOUD/MAT.24 Similarly, many state departments of health or mental health are also providing or facilitating access to online recovery groups. The Alabama Department of Mental Health, for example, was offering 14 different online support groups as of November 2020.25

Considerations for federal health agencies and policymakers:

  • Continue to collaborate with state, tribal, territorial and local (STTL) partners to develop or adjust policy flexibilities at the federal level that STTL entities can leverage to improve access to healthcare and services for people with OUD
  • As the COVID-19 federal response evolves and the federal government moves from response to recovery and planning for future resilience, explore lessons learnt from COVID-19 that can be used to protect the continuity of behavioural health services in the future, or even during localised public health emergencies (e.g., natural disasters)
  • Utilise an ecosystem approach—engage STTL and private sector partners and the behavioural health community—when making decisions on how to preserve or modify policy flexibilities that were created during COVID-19this can lead to improved behavioural health service delivery during steady-state/nonemergency periods

Considerations for state and local health department policymakers:

  • Explore options to facilitate take-home and curbside MOUD/MAT for established opioid treatment programmes (OTPs) leveraging recent regulatory flexibilities that agencies such as SAMHSA have provided during the COVID-19 pandemic
  • Promote, fund, or work with community partners to conduct outreach to patients to make telehealth services more accessible (technical assistance, communication, language translation, etc.), and engage CMS and other payers to explore long-term feasibility of expanded virtual health reimbursement for OUD and telemental health services

Considerations for health systems and care providers:

Establish collaborative partnerships with nonprofit organisations and local health departments to find innovative ways to fund efforts—such as pilot programmes—targeted at expanding access to virtual support groups and other recovery tools that complement MOUD/MAT

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As the healthcare system continues to enhance telemedicine capabilities and as federal and state governments extend waivers through the duration of the pandemic, it may be possible to retain some of the achievements of an expanded virtual healthcare system to address underlying access to care challenges and enhance the quality of remote care for SUD. The Centers for Medicare and Medicaid Services (CMS) has indicated that it will explore opportunities to permanently maintain expanded virtual health and reimbursement for telemedicine through Medicare.26 If current virtual health policies are shown to be effective, permanent policies could have a monumental impact on the accessibility of MOUD/MAT—and healthcare more broadly—long after the pandemic is over.

The rise of data-informed healthcare

An explosion of data-sharing technologies, new analytical tools, and unconventional partnerships can unlock better population and personal health management.

Advancements in technology and new data continue to radically change the future of health. 5G networks are redefining sharing of healthcare data by enabling large sets of data to be shared through virtual health platforms in real time and transforming the ways we use health records, diagnostics, telemedicine and more.27 Data-sharing partnerships between public and private sector organisations have also transformed the landscape for COVID-19 situational awareness and research. For instance, Amazon Web Services recently made its data lake available to the public, allowing users to quickly access data from multiple sources to build local dashboards or projections.28 To further facilitate information-sharing between different entities during the COVID-19 pandemic, the federal government revised certain provisions of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule to allow healthcare workers and first responders to more easily share critical health information.29

5G networks are redefining sharing of healthcare data by enabling large sets of data to be shared through virtual health platforms in real time and transforming the ways we use health records, diagnostics, telemedicine and more.

These advancements and partnerships will undoubtedly change health and healthcare beyond COVID-19 and could have implications for substance use in the longer term. Also playing a critical role, alongside the proliferation of new data sets and data-sharing mechanisms, is artificial intelligence (AI). Analysis of vast, population-level data sets by AI could enable providers, policymakers and the public to better understand patterns for any kind of epidemic. AI can help pinpoint the impact of new MOUD/MAT policies on public health or identify which specific types of social determinants of health or external barriers may be impacting a community’s access to care. In addition to using AI to analyse complex data sets, investments in AI for COVID-19 activities such as contact tracing30 could also be leveraged to improve population health data tracking for other healthcare needs—such as OUD—affecting large swathes of the population.

Today, many people feel empowered to collect and analyse their own health data: Deloitte’s 2020 global healthcare consumer survey found that 42% of US consumers used technologies including websites, smartphones, fitness trackers, or other personal medical devices to measure data about their health and fitness. In 2020, about half of those consumers shared their health data with their doctor. New population-level data and better personal health data can better equip providers and improve patient experiences during behavioural health and SUDs visits, whether virtual or in person. These new insights, combined with blended data and machine learning/AI, can be used to enhance care for individuals—streamlining intake processes and reducing provider time spent on paperwork, assisting with the identification and selection of the best strategies for intervention, and supporting case management and care coordination between multiple providers, for example. Data-driven personalisation of care has particularly salient implications for SUD treatment, which can be complicated by co-occurring mental and physical health issues as well as by social stigma. Data-informed treatment that uses new data-sharing flexibilities or large data sets from novel sources could help create customised treatment plans and intervention strategies for individuals with any health need, including OUD. As public sector health and human services and private healthcare continue to move toward advanced data interoperability between different systems, automated data exchange between clinicians, consumers, and other data sets can help fill in the gaps for better public health decision-making at the population or community level.

As personal health data tools and applications become more accessible and interoperable, including when new data is available, and as COVID-19 continues to change the health data landscape, providers likely will be better equipped to provide holistic care for OUD and other complex healthcare needs that take into account the “whole person.”

Considerations for federal health agencies and policymakers:

  • Explore partnerships—including public-private partnerships—that maximise access to data, and identify opportunities to adapt and apply current COVID-19 data-sharing solutions for OUD and other population health issues
  • Develop or support policies that empower consumers to control and securely share data that can shape “whole person” healthcare

Considerations for state health agencies and policymakers:

  • Explore partnerships—including public-private partnerships—that maximise access to data, and work with other states to scale these partnerships across multistate regions
  • Investigate opportunities to leverage AI to solve complicated public health problems

Considerations for health systems and care providers:

  • Identify opportunities to securely exchange shareable data with public sector platforms to better inform public health decision-making
  • Leverage patient-driven healthcare platforms that empower consumers to control and securely share data, and leverage that data towards improved “whole person” healthcare
  • Explore using feedback-informed treatment methods and analysis, where data points are used to complement or supplement provider insights and observations.
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Accelerated adoption of new technologies

COVID-19 accelerated development of tools that allow for healthcare delivery to occur through a smartphone, a wearable device, or a virtual reality (VR) headset. Sustaining this momentum and adopting such practices for OUD could be critical in combatting the opioid epidemic.

COVID-19 has accelerated the use of virtual health services and personal health devices for individuals and providers alike. In addition to an increase in use of telemedicine for SUD and MOUD/MAT, novel technologies such as personal devices or wearable device-enabled applications, VR, the Internet of Things (IoT) and AI can improve outcomes and will likely continue to be used for those with OUD during the pandemic.

Devices such as smartphones and smartwatches are being used to support medication adherence. For example, a Vermont programme provided buprenorphine or methadone to patients in a locked pill wheel that would open once a day, and patients used a smartphone application to record themselves taking the medication.31 It’s not difficult to imagine combining that capability with other smartphone or personal device-assisted virtual health tools—building on proliferating applications for talk therapy,32 for example—to expand the reach of MOUD/MAT.

Virtual health via smartphones and wearable devices may help individuals stay in treatment even when they do not have in-person access. For example, Pear Therapeutics, a company that creates prescription digital therapeutics, has developed a smartphone application called “reSET” that uses gamification and health coaching to promote retention in OUD treatment programmes, which the FDA authorised for patient use.33 Additionally, new wearables such as Bridge, which transmits electric pulses to inconspicuous electrodes around the ear and has been shown to decrease withdrawal symptoms by 97% after five days of use,34 are entering the market as well. The FDA has recently granted De Novo classification35 to the Bridge device as the first evidence-based, drug-free device designed to alleviate opioid withdrawal. In addition to providing authorisation and regulatory oversight for these novel applications and devices, the FDA has held “innovation challenges” that incentivise product developers to create new tools for SUD treatment, providing access to assistance from FDA and expediting premarket review of products.36

VR—which creates a digital environment that replaces the user’s real-world environment—is another area where emerging technologies may have applications for preventing or mitigating OUD. Such technologies have become increasingly relevant for healthcare during COVID-19. VR is currently being used in the fight against COVID-19 to enable physicians to view scans and images in three dimensions and serve as a realistic training environment for healthcare providers when limited personal protective equipment (PPE) is available.

While the opioid epidemic has illustrated the consequences of overprescribing medications for pain, it is important to treat pain and underlying health issues causing chronic pain.

Many Americans have to manage acute or chronic pain at some point in their lives. While the opioid epidemic has illustrated the consequences of overprescribing medications for pain, it is important to treat pain and underlying health issues causing chronic pain. A number of studies indicate the possibility that VR may “decrease pain levels, anxiety and time thinking about pain”37—even during painful medical procedures. Studies examining the use of VR for longer-term, chronic pain found encouraging evidence for the use of VR for pain management.

The use of personal technologies such as VR, wearables, and smartphones during COVID-19 may accelerate healthcare providers’ willingness to embrace and adopt similar technology to help reduce the incidence of OUD well into the future.

Considerations for federal health agencies and policymakers:

  • Continue to incentivise development of new technologies for OUD treatment through creative efforts that engage stakeholders across industry
  • As regulators, assess the quality and effectiveness of new treatments and medical devices created by industry partners, as well as potential for future reimbursement
  • Convene stakeholders across the healthcare ecosystem to explore the viability of new alternative treatment options, such as VR

Considerations for state health agencies and policymakers:

  • Look for opportunities to pilot these technologies through state or community programmes for people with OUD

Considerations for health systems and care providers:

  • Identify opportunities to provide services and support to patients through wearable devices and smartphone applications, which can complement in-person or virtual visits
  • Communicate the value of new technologies to patients and partners to support uptake/mitigate stigma, and monitor the status and availability of new alternative treatment options, such as VR
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Conclusion: Helping leaders and communities navigate an unpredictable future of health

COVID-19 has created immense challenges for the healthcare system and has fundamentally changed the way care is often approached and delivered. For people living with OUD and other chronic conditions, the pandemic has created new and exacerbated existing challenges. At the same time, pioneers across government, healthcare, technology and public health have responded to COVID-19 with innovations designed to address those challenges and improve the health and well-being of Americans. As we stand at the intersection of the opioid epidemic and COVID-19, both likely will continue to shape our world in unexpected ways. Along with the disruption of COVID-19, many other underlying environmental, social and economic factors make the opioid epidemic an especially complex and “wicked problem38 for Americans today—and one that will not vanish anytime soon. Looking to innovative solutions that emerge in times of such disruption could be a critical step to addressing the issues patients and communities are facing during these two healthcare crises.

It will be important to draw on lessons learnt from both crises to create new solutions that can improve the future of health as a whole.

Deloitte Government & Public Services Practice

At Deloitte, we support leaders across federal, state and local government in addressing public health issues and have mobilised our resources to develop initiatives and tools that can advance innovation in this new and challenging environment. Deloitte brings together a global network of subject matter specialists with backgrounds in medicine, policy, public health, supply chain and data science to develop strategies and advise clients across government, life sciences and healthcare, and law enforcement to address the entire ecosystem impacted by the opioid crisis.

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  1. Centers for Disease Control and Prevention, “Health equity considerations and racial and ethnic minority groups ,” July 24, 2020.

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  2. Centers for Disease Control and Prevention, “COVID-19 hospitalization and death by race/ethnicity ,” November 30, 2020.

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  3. National Institute on Drug Abuse, “Effects of COVID-19 on the opioid crisis: Francis Collins with Nora Volkow ,” July 6, 2020.

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  4. Kumiko M. Lippold et al., “Racial/ethnic and age group differences in opioid and synthetic opioid—involved overdose deaths among adults aged ≥18 years in metropolitan areas—United States, 2015–2017 ,” Morbidity and Mortality Weekly Report 68, no. 43 (2019): pp. 967–73.

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  5. Jonaki Bose et al., Results from the 2012 national survey on drug use and health: Summary of national findings , U.S. Department of Health and Human Services, September 2013.

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  6. Nirmita Panchal et al., “The implications of COVID-19 for mental health and substance use ,” Kaiser Family Foundation, August 21, 2020.

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  7. Felipe Ornell et al., “The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment ,” Psychiatry Research 289 (2020).

    View in Article
  8. Rakesh Kochhar, “Hispanic women, immigrants, young adults, those with less education hit hardest by COVID-19 job losses ,” Pew Research Center, June 9, 2020.

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  9. Kim Parker, Rachel Minkin, and Jesse Bennett, “Economic fallout from COVID-19 continues to hit lower-income Americans the hardest ,” Pew Research Center, September 24, 2020.

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  10. Panchal et al., “The implications of COVID-19 for mental health and substance use .”

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  11. Ibid.; Beth Braverman, “The coronavirus is taking a huge toll on workers’ mental health across America ,” CNBC, April 6, 2020.

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  12. Chris McGreal, “‘Opioid overdoses are skyrocketing’: as Covid-19 sweeps across US an old epidemic returns ,” The Guardian , July 9, 2020.

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  13. William Brangham and Mike Fritz, “How the pandemic is complicating America’s addiction crisis ,” PBS News Hour, July 22, 2020.

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  14. Ibid.

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  15. National Institute on Drug Abuse, “Effects of COVID-19 on the opioid crisis: Francis Collins with Nora Volkow .”

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  16. Ibid.

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  17. Virtual Health KX DNet page.

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  18. American Hospital Association, “Fact sheet: Telehealth ,” accessed January 2021.

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  19. Seema Verma, “Early impact of CMS expansion of Medicare telehealth during COVID-19 ,” Health Affairs, July 15, 2020.

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  20. Christine Hancoc et al., Treating the rural opioid epidemic , National Rural Health Association Policy Brief, February 2017.

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  21. Thomas W. Prevoznik, “Guidance document ,” US Department of Justice, Drug Enforcement Administration, March 31, 2020.

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  22. Substance Abuse and Mental Health Services Administration (SAMHSA), “OTP guidance for patients quarantined at home with the coronavirus ,” March 30, 2020; SAMHSA, “Opioid Treatment Program (OTP) guidance ,” March 16, 2020.

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  23. Deirdre Calvert, “Alert regarding COVID-19 for opioid treatment programs ,” Department of Public Health, March 18, 2020.

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  24. SAMHSA, “Your recovery is important: Virtual recovery resources ,” accessed January 2021.

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  25., “Online support groups ,” accessed January 2021.

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  26. Jacqueline LaPointe, “CMS to assess telehealth reimbursement rates post-pandemic ,” Revcycle Intelligence, July 21, 2020.

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  27. Heather Landi, “Emory Healthcare, Verizon open first 5G-enabled innovation hub ,” Fierce Healthcare, February 24, 2020.

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  28. AWS Data Lake Team, “A public data lake for analysis of COVID-19 data ,” AWS Big Data Blog, April 8, 2020.

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  29., “HIPAA and COVID-19 ,” accessed January 2021.

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  30. Jeremy Hsu, “Can AI make Bluetooth contact tracing better? ,” IEEE Spectrum , September 8, 2020.

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  31. Healthcare Innovation, Final report: Telehealth opiate treatment pilot project , June 15, 2017.

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  32. Pooja Chandrashekar, “Do mental health mobile apps work: evidence and recommendations for designing high-efficacy mental health mobile apps ,” Mhealth 4, no. 6 (2018).

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  33. Pear Therapeutics, “reSET ,” accessed January 2021; US Food and Drug Administration (FDA), “FDA clears mobile medical app to help those with opioid use disorder stay in recovery programs ,” press release, December 10, 2018.

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  34. Amantha May, “New wearable for opioid withdrawal ,” HealthTech Insider, July 10, 2020.

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  35. The FDA uses the de novo process to classify new medical equipment or devices that provide “reasonable assurance of safety and effectiveness” and allow for the deice to be marketed. See: FDA, “De novo classification request ,” November 20, 2019.

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  36. FDA, “As part of efforts to combat opioid crisis, FDA launches innovation challenge to spur development of medical devices—including digital health and diagnostics—that target pain, addiction and diversion ,” news release, May 30, 2018.

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  37. Angela Li et al., “Virtual reality and pain management: Current trends and future directions ,” Pain Management 1, no. 2 (2011): pp. 147–57.

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  38. Kevin M. Bingham, Terri Cooper, and Lindsay Musser Hough, Fighting the opioid crisis: An ecosystem approach to a wicket problem , Deloitte University Press, 2016.

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The authors would like to thank the following Deloitte professionals for their contributions to this report: Lindsay Hough for her thoughtful input and review of the paper; Lydia Turner for her inputs on policy shifts at the federal and state level; Sean ConlinArielle Rose OppenheimerMaggie Little, and others from the HealthPrism team for sharing information about Deloitte’s data analytics capabilities related to the opioid epidemic. Additionally, the authors would like to thank Carolyn P. Edwards and Charlotte Sawyer for their work conducting supporting research and providing edits to early drafts of the report.

The authors would also like to thank David Noone and John McInerney for their help to finalize the report for publication.

Cover image by: Alex Nabaum

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