While the rise of the sober curious movement and the growing availability of non-alcoholic options signal a shift away from drinking, alcohol use disorder (AUD) remains prevalent. At the same time, substance use disorder (SUD) affects over 46 million people aged 12 and older, according to the 2021 National Survey on Drug Use and Health. The demand for effective, scalable treatment solutions is greater than ever. Yet, traditional care models often fall short, either due to geographic limitations, resource constraints, or an inability to keep pace with the complexity of modern-day substance use challenges.
Enter technology: a key enabler of transformation in healthcare. Telemental health care, particularly for individuals with severe conditions like AUD and SUD, offers an accessible and effective path forward. More specifically, virtual intensive outpatient programs (IOPs) deliver structured, comprehensive care to those with higher acuity needs, supporting long-term recovery from the comfort of patients’ homes.
Once seen as a niche service, virtual care has become essential in addressing a broad spectrum of mental health and addiction issues. By integrating technology into AUD and SUD treatment, we can engage patients more effectively, track outcomes, and reduce the barriers that have historically prevented people from accessing care. Virtual IOPs offer a scalable, evidence-based solution, ensuring that even those with severe addiction receive the highest level of care in a supportive, accessible environment.
Redefining Engagement and Accessibility
Traditionally, AUD and SUD treatment have been hampered by several barriers: limited access to care, the stigma surrounding addiction, and logistical challenges, such as transportation or the need for time off work. Virtual IOPs break down many of these barriers by offering a more flexible, accessible alternative.
One of the most significant benefits of virtual care is privacy. For many, the fear of being seen entering a treatment facility can be a major deterrent. In small communities, the visibility of one’s car parked outside a recovery center may even prevent people from seeking help altogether. Virtual IOPs allow patients to receive the treatment they need in the privacy and comfort of their own homes. Until we can remove this stigma once and for all, this will help more people enter care.
Additionally, virtual care reduces logistical burdens. No longer do patients need to drive long distances, rearrange their schedules, or find childcare to attend appointments. Care only works if you go, and virtual IOPs make it easier for patients to simply show up. By eliminating the friction points that prevent people from accessing care, we can improve adherence and outcomes. This is particularly important for those with caregiving obligations, a group highlighted in the U.S. Surgeon General’s advisory as being under immense pressure, who often neglect their own health and well-being due to the competing demands of caring for others. Virtual IOPs provide these individuals with the flexibility to prioritize their own recovery while managing their caregiving responsibilities.
Technology enables new ways to engage with patients, transforming how we connect with and support these individuals. For example, creating a sense of community in virtual spaces is essential, especially when dealing with personal and sensitive issues like addiction. This requires new skills for facilitators—learning how to read virtual body language, ensure participation, and create an environment where patients feel safe to share their experiences. When done right, virtual IOPs can foster a strong sense of belonging, even without in-person interactions.
Navigating the Regulatory Landscape
Despite the clear benefits of virtual IOPs, the regulatory landscape hasn’t quite caught up. Current state-level regulations are often designed for physical brick-and-mortar facilities, and while accrediting bodies like the Joint Commission now offer fully virtual surveys, the default is still physical facilities in many states to participate in insurance programs.
This fragmented regulatory framework creates significant challenges, and providers must navigate varying regulations and licensing requirements. Each state may have different intake forms, documentation processes, and compliance standards, adding layers of complexity to what should be a seamless care experience.
Moreover, the debate over controlled substances introduces additional challenges. The evolving regulatory environment around telehealth and controlled substances remains a concern for the industry. While COVID-19 telemedicine flexibilities for prescribing controlled substances were extended through December 31, 2024, the DEA’s proposed rule has significant implications for how virtual programs are delivered and how they are integrated into broader healthcare ecosystems. While the regulatory landscape remains a challenge, continued advocacy and collaboration with policymakers and accrediting bodies are crucial to ensuring that virtual IOPs can reach their full potential, providing equitable, accessible, and compliant care for those in need.
Emphasizing Outcome Measurement and Quality Assurance
Not all IOPs are created equal, and as more players enter the virtual care space, it becomes increasingly important to measure outcomes rigorously. Payers, in particular, are looking for data to guide their decisions about which virtual programs to include in their networks.
Transparency and accountability, paired with data, are at the heart of driving treatment improvements and establishing trust with both patients and payers. For example, by using outcome data, the industry can continuously refine programs to ensure that they are meeting patients’ needs. This is particularly important in the virtual space, where maintaining high standards of care requires constant evaluation and iteration.
Industry Collaboration and Integration
To effectively provide AUD and SUD treatment, virtual IOPs must be part of a larger, integrated system of care. One of the biggest misconceptions about virtual treatment is that it operates in isolation. In reality, virtual programs often work closely with brick-and-mortar facilities. For example, when patients are discharged from in-patient care but still need ongoing support, telehealth providers with established partnerships can transition these individuals into virtual IOPs, allowing them to continue their recovery from home. This integrated approach ensures that patients receive the right level of care at the right time, whether transitioning between care levels or managing co-occurring disorders. It also provides crucial support during the high-risk period of re-entering their former community.
Building strong partnerships between telehealth providers and other healthcare entities is critical to advancing the field of virtual SUD treatment. By working together, we can create a more comprehensive and effective care model that reduces costs and improves patient outcomes.
Future Directions
As we look to the future, the potential for virtual-first treatment modalities is vast. While AUD is an important and popular area of focus, there is a growing demand for virtual programs that address other addictions, such as gambling and cannabis use. There is also the need to ensure programs address co-occurring mental health conditions.
I envision a future where virtual IOPs are not just an alternative but a preferred method of treatment for a wide range of addictions. By continuing to innovate and adapt to the needs of patients, it’s possible to make treatment more inclusive and accessible to everyone, regardless of location or circumstance.
In closing, virtual IOPs represent a critical evolution in SUD treatment. By breaking down barriers to care, enhancing engagement, and focusing on outcomes, we can help more people access the help they need and ultimately reduce the burden of these disorders on individuals and communities.
Julia Bernstein is the Chief Operations Officer at Brightside Health, a telemental health platform, where she maintains the operational rigor of the company as it expands its member base and enters new markets. This life-saving work serves individuals with mild-to-severe clinical depression, anxiety, and other mood disorders, as well as substance use disorders. Her LinkedIn can be found HERE and the company website can be accessed HERE.
