Over the last five years, telehealth has reshaped how Americans access health care, including treatment for substance use disorders (SUD). Despite its proven ability to reduce barriers and improve retention, only 17.6% of people receiving SUD treatment use telehealth services¹. Traditional models still dominate, creating hurdles including long drives to clinics, inflexible schedules, limited provider availability, and stigma in the waiting room. Linked with a host of logistical and cost burdens such as the need to arrange childcare and take time off from work, these are more than inconveniences, they’re overlooked blockers that prevent people from getting the care they need and quietly drive up healthcare costs.
A recently published study, led by Pelago’s clinical research team, explores what happens when you remove those barriers and meet patients where they are. Through qualitative interviews with people receiving buprenorphine and behavioral health support via a digital care model for Opioid Use Disorder (OUD), researchers found a clear theme: when care becomes accessible, people engage, stay connected longer, and recover.
A patient-centered shift in OUD care
The study interviewed 15 participants from a large pilot of Pelago’s 12-week digital program that combined:
- Virtual appointments with licensed providers
- A mobile app for direct messaging and behavioral health support
- Buprenorphine prescriptions, delivered by mail or picked up from a local pharmacy
All participants had been diagnosed with moderate to severe OUD. Many had previously tried to access care through methadone clinics, local prescribers, or detox-only programs, only to run into obstacles.
What stood out in their stories wasn’t just that telehealth was easier. It was that it changed their relationship with care itself.
What traditional programs get wrong
Prior to discovering OUD care via telehealth, participants described having pursued treatment within a system that often worked against them. Many had to travel long distances—sometimes over 60 miles each way—to reach a clinic. Once there, rigid attendance rules meant that missing a single appointment due to something as simple as a snowstorm or a car breakdown could mean starting the entire process over again. For those seeking medication treatment, financial strain was a common theme, with some paying up to $300 every two weeks when providers didn’t accept their insurance.
Others ran into dead ends when local prescribers retired or programs were overwhelmed, leaving them without a clear path forward.
The reason that [my past treatments] weren’t successful is because the first doctor… ended up not practicing anymore, like out of the blue. Trying to find another doctor to prescribe [buprenorphine] around here was just not easy.
These barriers weren’t just frustration, they were often the reason people stopped treatment or relapsed.
What telehealth gets right
In contrast, participants in the digital health program described a far more supportive and sustainable experience. Without the need to commute, they could attend appointments from the comfort of home. Flexible scheduling allowed them to balance care with the demands of work, parenting, and recovery.
Communication was more direct and responsive, thanks to app-based messaging that provided access to care teams in real time. When cravings or crises emerged, support was just a message or a call away. As one participant put it, “Most people who are on opioids, they’ve hit some kind of rock bottom and they need all the time they have [to get their life together]… Telehealth was really good because it took a lot of that out of it.”
Why it matters for employers and health plans
This study adds to growing evidence that digital care models don’t just match in-person treatment, they may outperform it. And as substance use continues to impact workforces across industries, it’s increasingly clear that flexible care options are essential.
Fewer than 10% of those with an SUD receive any form of treatment¹. And the reasons are as familiar as they are fixable:
- 17.1% say they couldn’t afford it or didn’t have insurance
- 15.6% didn’t know where to go
- 14.6% were afraid it would hurt their job
- 13.4% feared their privacy wouldn’t be protected
Telehealth offers a way to change that. By reducing logistical burdens, minimizing stigma, and making it easier to stay connected to care teams, virtual models can help people start, and stick with treatment. For employers and health plans, that means more people getting support earlier, better retention in care, and fewer downstream costs of untreated SUD—like those tied to chronic conditions, avoidable hospitalizations, and even cancer risks.
When care is accessible, people engage. And when recovery is allowed to fit into daily life, rather than disrupt it, everyone benefits.
¹ SAMHSA, 2023 National Survey on Drug Use and Health, 2023.
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