Report Sheds Light on How Pandemic Experiences Could Shape Industry’s Future

A report published this month by multiple executives in the fields of addiction treatment and behavioral health has brought into sharper focus the toll that the COVID-19 pandemic has taken both on the mental health of the nation, as well as the treatment industry. The findings also offer a preview of how the field could be reshaped in the coming years, based on the experiences of the past 15 months.

The State of Addiction Treatment 2021 report shows how extended periods of isolation and stress created by job losses, financial worries and the looming threat of COVID cause alcohol and illicit substance use—along with drug overdose death rates—to spike. Among the stats shared in the report:

• From May to June 2020, women reported consuming alcohol on 17% more days and having 44% more heavy drinking days (defined as 4 or more drinks within a couple hours) compared to a year prior, according to a RAND Corp. study of 1,540 U.S. adults. The increase in alcohol consumption led to more individuals seeking treatment for alcohol use disorder, with a rise specifically among AUD patients entering treatment for the first time.
• Of 11,553 patients in treatment participating in an average of 4.3 monthly surveys conducted by Vista Research Group in March, more than 15% said they or an individual they depend on had lost their job. Meanwhile, 8.5% said they were unable to pay their rent, mortgage or utility bills and 3.2% reported food insecurity.
• During the pandemic, rates of adults reporting symptoms of depression and/or anxiety nearly quadrupled compared to 2019, according to National Center for Health Statistics data, with such symptoms being more commonly reported particularly among women and younger adults, as well as Black, Hispanic and mixed-race Americans, as well as individuals without bachelor’s degrees. Joanna Conti, Vista’s founder and CEO and author of 3 chapters in the report, tells BHE that individuals facing serious financial impacts during the pandemic were the most likely to relapse immediately after treatment.

Treatment impact

With quarantine directives implemented by local and state governments across the country early in the pandemic, the implementation of telehealth platforms was hailed as a boon for treatment centers’ ability to continue facilitating care. As COVID-related restrictions have begun to loosen, patient feedback data suggests there is a role for telehealth in the future of addiction treatment, but there isn’t much appetite among patients for it to entirely replace in-person care.

Satisfaction with treatment dipped across all modalities in the pandemic’s early months, per Vista Research Group statistics, but the largest drop was reported by patients receiving all treatment virtually. Telehealth-only patients have since continued to report lower satisfaction scores. Among the reasons for dissatisfaction cited by patients: Sessions felt more impersonal, quality of communication declined, and patients felt more isolated.

Notably, however, patients receiving a mix of in-person treatment and telehealth-based sessions reported higher rates of satisfaction than those who have been in-person only.

“I believe what patients were telling us is that they like the hybrid model and having the ease of meeting occasionally via telehealth and also meeting face to face,” Conti says.

Tracking outcomes

The report’s final section shifts away from pandemic-related analysis and focuses on outcomes tracking as a means to improving quality of care by addiction treatment providers. Vista Research Group found that among 3,698 adult patients discharged between July 2016 and October 2019, 36% remained abstinent for the prior 30 days a year after treatment. Among the centers Vista works with, Conti says that rate ranges between 19% and 50%.

“I don’t think you could do this difficult work if you didn’t believe what you were doing was unusually effective,” Conti says. “But now that we’ve measured treatment effectiveness for a broad variety of treatment centers, we’ve found it varies tremendously. … What makes that interesting to me is that every single one of the centers that is investing in proving how effective they are believe we’re going to show that they truly are more effective than average. Of course, that’s not possible.”

Still, Conti says, a commitment to standardized measurement has proven to be an effective tool for improving outcomes. Of 17 treatment centers tracked by Vista, 14 reported improved outcomes in their second year of tracking vs. the first, and across all 17 centers, “20% more patients reported being in recovery at 6 months post- treatment in the second year the centers were tracking their outcomes versus the first year,” according to the report.