Use of Diverted Buprenorphine by Individuals Initiating Telehealth Opioid Use Disorder Treatment

Background: Telehealth-only provision of buprenorphine for opioid use disorder was made possible during the COVID-19 pandemic, but policymakers are considering ending this practice. A primary concern is potential diversion of buprenorphine, although it is unknown how many patients enter telehealth-only treatment already using diverted buprenorphine. Methods: We performed a retrospective chart review of 500 consecutive newly enrolled patients in our large telehealth-only program in January 2023. We recorded if the patient was already taking buprenorphine at the time of the intake visit and if the buprenorphine was from a diverted source. Results: Five hundred patients enrolled from January 3-20, 2023. Patients were 61.0% male; mean age was 40.3 (standard deviation 10.3) years. Buprenorphine use at the time of enrollment was reported by 46.4% (n = 232) of patients, and 18.4% (n = 92) reported using diverted buprenorphine. Conclusions/Importance: Over one in six patients initiating care with our telehealth-only practice reported taking diverted buprenorphine. These findings indicate that the telehealth care setting possibly decreases diversion of buprenorphine when patients use this modality to obtain legitimate treatment.