Alcohol Use Disorder Treatment Declined Among Veterans at Pandemic Onset

Despite the rapid uptake of telehealth, the number of veterans treated for alcohol use disorder declined during the COVID-19 pandemic, according to findings published in Addiction.

“The COVID-19 pandemic disrupted health care provision in the United States and prompted increases in telehealth-delivery of care,” said Ponni V Perumalswami, MD, MSCR, affiliated with the Veterans Affairs Ann Arbor Healthcare System and University of Michigan, and coauthors. “This study measured alcohol use disorder treatment trends across visit modalities before and during COVID-19.”

The retrospective study involved a national cohort of patients treated at Veterans Health Administration (VHA) facilities before and after COVID-19 reached the United States. Dr Perumalswami and coinvestigators studied monthly trends in telephone, video, and in-person visits, as well as patient characteristics, from March 2019 to February 2020 and from March 2020 to February 2021. 

During the early prepandemic period, the predicted percentage of veterans receiving treatment for alcohol use disorder was 13.8% (n=49,494). However, at the pandemic's onset, this percentage declined by 4.3% (P = .001), largely due to a decrease in psychotherapy utilization. 

After the initial decline, the predicted treatment rate increased by 0.3% each month (P = .026) but remained below that of the prepandemic period throughout the rest of the study.

In February 2021, half of psychotherapy visits for alcohol use disorder were conducted through video (n=58,748), while in-person and phone appointments comprised 36.6% (n=43,251) and 13.8% (n=16,299) of visits, respectively. For veterans receiving pharmacotherapy, phone visits were utilized most often at a rate of 38.9% (n=3623); just over one-third of pharmacotherapy appointments were conducted in person (34.3%, n=3193), and video was utilized least (26.8%, n=2498).

There were no significant differences in patient characteristics between both periods, findings showed.

The percentage of veterans who received treatment for alcohol use disorder declined during the pandemic, largely due to reduced psychotherapy utilization, Dr Perumalswami and coinvestigators concluded.

Reference:
Perumalswami PV, Kilpatrick S, Frost MC, et al. The impact of COVID-19 on trends in alcohol use disorder treatment in Veterans Health Administration. Addiction. Published online February 3, 2023. doi:10.1111/add.16156