June 8th, 2026
By Sylvia Trujillo, MPP, JD and Emilia Ochoa-Ruiz, MS, PMP
Substance use disorders (SUDs), including opioid use disorder (OUD), remain one of the most significant public health challenges facing healthcare organizations and communities today. Recovery is rarely a straight path. Patients often navigate transportation challenges, stigma, workforce shortages, unstable housing, co-occurring behavioral health conditions, and varying levels of readiness for treatment. These realities make continuity of care difficult, particularly in rural and underserved communities.
Digital health tools are not a replacement for recovery-oriented clinical care. They are increasingly becoming an important extension of that care. When thoughtfully implemented, telehealth, mobile engagement platforms, remote monitoring tools, and digital support programs can help individuals access treatment sooner, remain connected to care, and receive support between visits.
Recent research continues to demonstrate the value of reducing barriers to treatment initiation. A large cohort study of Medicaid beneficiaries in Kentucky and Ohio found that individuals who initiated buprenorphine treatment through telemedicine had higher odds of remaining in treatment for at least 90 days compared with those who initiated care in person. Importantly, the study found no increase in opioid-related nonfatal overdose events among telemedicine participants. These findings reinforce a simple but important lesson: when treatment is easier to access, patients are more likely to stay engaged.
Beyond the Visit: Expanding Recovery Support
Digital health is extending support beyond traditional appointments. Recovery does not happen during a single visit. It occurs through ongoing engagement, accountability, encouragement, and connection.
A recent study published in JAMA Network Open evaluated the use of smartphone-based contingency management among individuals receiving medication for opioid use disorder (MOUD). Participants who chose to use the digital contingency management program demonstrated fewer days of opioid use and remained in treatment longer than individuals receiving MOUD alone. While the study design does not establish causation, the findings suggest that structured digital supports may strengthen recovery efforts when combined with evidence-based treatment.
For healthcare providers, this highlights an important opportunity. Digital tools can help reinforce recovery goals between appointments, support patient engagement, and provide additional touchpoints without placing unsustainable demands on clinical staff.
Addressing Common Gaps in Substance Use Care
Many healthcare organizations encounter similar challenges when caring for individuals with substance use disorders:
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- Long travel distances that contribute to missed appointments
- Delays in follow-up after emergency department or hospital encounters
- Shortages of behavioral health and addiction medicine providers
- Privacy concerns and stigma within small communities
- Fragmented referral processes and lengthy wait times for specialty services
Telehealth and digital engagement strategies can help address these challenges by creating more flexible pathways into care.
A successful tele-SUD program often includes:
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- Rapid telehealth intake appointments
- Timely access to medications when clinically appropriate
- Frequent follow-up visits during stabilization
- Care coordination and case management support
- Connections to counseling, peer recovery services, and community resources
- Flexible options for video and audio-only visits when broadband access or privacy limitations exist
Organizations that focus on reducing friction at every step of the patient journey are often better positioned to support long-term engagement and recovery.
Building Trust Through Responsible Technology Use
Substance use treatment is built on trust. Patients must feel confident that their information is protected and that technology is being used responsibly.
As healthcare organizations explore artificial intelligence and other emerging technologies, caution is warranted. The World Health Organization has highlighted concerns related to transparency, bias, misinformation, and accountability in the use of large language and multimodal AI systems. These concerns become especially important when working with individuals who may be vulnerable or experiencing behavioral health crises.
For most organizations, the safest applications of AI in SUD programs currently involve administrative and operational tasks such as:
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- Documentation support
- Workflow optimization
- Appointment scheduling assistance
- Referral management
- Care coordination support
Any AI-assisted process should include human oversight, clear governance policies, and transparent communication with patients regarding how technology is being used.
Policy and Compliance Considerations
Technology alone does not create a successful telehealth program. Sustainable programs require clear workflows, compliance oversight, and operational consistency.
California’s Medi-Cal program broadly supports telehealth delivery, including care management and patient self-management services. Organizations should ensure patient consent requirements are met and appropriately documented in accordance with current Medi-Cal and state telehealth policies.
Building compliance processes early helps organizations avoid operational challenges later and creates a stronger foundation for long-term sustainability.
Field Notes from the Front Lines
Several lessons continue to emerge across telehealth and digital health programs supporting substance use treatment:
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- Access is only the first step. Long-term success depends on what happens after the initial appointment.
- Low-barrier intake processes are most effective when paired with structured follow-up and stabilization pathways.
- Frequent, brief touchpoints early in treatment can help improve engagement.
- Digital tools should complement clinical care, not replace it.
- Organizations should prioritize solutions supported by evidence and measurable outcomes rather than adopting technology solely because it is new.
Provider Lens
Rural Hospitals and Critical Access Hospitals (CAHs)
Hospitals often serve as the first point of contact during a substance use crisis. Telehealth follow-up programs can help bridge the gap between emergency or inpatient care and ongoing outpatient treatment. Partnerships with telehealth providers may help address local workforce shortages while improving continuity of care after discharge.
Mobile engagement tools and structured follow-up programs may also support retention during the critical early stages of recovery.
Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs/CHCs)
Primary care settings are frequently the most consistent point of contact for patients with substance use disorders. Integrating telehealth services into primary care workflows can reduce missed appointments, strengthen care coordination, and support whole-person care approaches.
Organizations should establish clear consent, privacy, and documentation workflows that align with Medi-Cal telehealth requirements.
Community-Based Providers
Community-based behavioral health organizations can expand their reach through telehealth and digital engagement tools. When evaluating mobile applications or digital recovery supports, organizations should assess clinical appropriateness, data privacy protections, transparency regarding data use, and alignment with patient preferences.
Successful implementation depends on pairing technology with a clear clinical workflow and ongoing patient outreach.
Patient Corner
If you or someone you care about is struggling with opioid use or another substance use disorder, treatment may be available through phone or video visits. Telehealth can help reduce travel burdens and may allow you to connect with care more quickly.
When speaking with a healthcare provider, consider asking:
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- Can treatment begin through telehealth?
- How often will follow-up visits occur?
- What support is available between appointments?
- Are counseling or peer support services available?
- What should I do if I experience a crisis or need urgent help?
If you believe someone is experiencing an overdose or another medical emergency, call 911 or seek emergency medical care immediately.
CTRC Call to Action
The California Telehealth Resource Center (CTRC) can help organizations develop practical, sustainable digital health strategies that support substance use treatment and recovery.
Healthcare organizations can:
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- Utilize CTRC Contact Us for Technical Assistance to design telehealth workflows that improve engagement and continuity of care.
- Leverage CTRC AI Governance and AI Vendor Checklist resources when selecting AI-enabled solutions
Digital health is not a cure for the substance use crisis. However, when integrated into a thoughtful clinical care model, it can help remove barriers, strengthen engagement, and create more opportunities for recovery.
References
Hammerslag, L. R., Mack, A., Chandler, R. K., Fanucchi, L. C., Feaster, D. J., LaRochelle, M. R., Lofwall, M. R., Nau, M., Villani, J., Walsh, S. L., Westgate, P. M., Slavova, S., & Talbert, J. C. (2023). Telemedicine buprenorphine initiation and retention in opioid use disorder treatment for Medicaid enrollees. JAMA Network Open, 6(10), e2336914. https://doi.org/10.1001/jamanetworkopen.2023.36914
Marino, E. N., Karns-Wright, T., Perez, M. C., & Potter, J. S. (2024). Smartphone app-based contingency management and opioid use disorder treatment outcomes. JAMA Network Open, 7(12), e2448405. https://doi.org/10.1001/jamanetworkopen.2024.48405
Substance Abuse and Mental Health Services Administration. (2024). Federal guidelines for opioid treatment programs. Federal Guidelines for Opioid Treatment Programs (2024) | SAMHSA Library
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