Study Shows Telehealth Removes Key Obstacles in OUD Care, but Pharmacy Barriers Persist
Written by Skyla Kohanski, URI PharmD ‘28; edited by Jef Bratberg, PharmD, FAPhA
November 21, 2025: Telehealth is reshaping how patients access OUD treatment, eliminating many of the challenges inherent in traditional care. Still, persistent pharmacy barriers risk limiting the impact of this progress.
A new qualitative study examining patient experiences in a digital telehealth program delivering buprenorphine for opioid use disorder successfully removed many of the most persistent barriers patients face in traditional treatment settings. Patients described telehealth care as more accessible, flexible, and supportive than traditional methadone, buprenorphine, and residential treatment settings. However, despite these gains, pharmacy refusal to fill telehealth-issued buprenorphine prescriptions emerged as a significant challenge.
Across interviews, participants recounted longstanding obstacles associated with in-person OUD treatment. Those with prior methadone and buprenorphine treatment described daily dosing requirements, rigid attendance policies, high out-of-pocket costs, and difficulty finding consistent prescribers. For rural participants, traveling 60 miles or more each way to a methadone clinic was common, making long-term engagement difficult to sustain.
Experiences in non-MOUD treatment settings also posed challenges. One participant explained that a residential detox program included strict lockdown restrictions and no opportunity for ongoing maintenance treatment, leading to dropout and relapse after discharge.
In contrast, participants overwhelmingly described the telehealth program as easier to engage with and maintain. It allowed them to attend appointments from home, avoid transportation burdens, and schedule care around work and family obligations. The program offered a mobile application that enabled direct communication with providers and counselors, providing participants with timely support and reducing the need for frequent in-person visits.
Despite these advantages, participants often encountered significant challenges at local pharmacies that refused to fill prescriptions for buprenorphine issued through telehealth. The study attributes these findings to confusion around Public Health Emergency (PHE) flexibilities and supply-threshold limits imposed after opioid litigation settlements. In this scenario, rural participants were disproportionately affected, sometimes requiring emergency 3-day bridge prescriptions or waiting for mailed medication.
Findings support making PHE-era telehealth flexibilities permanent so that patients who benefit from virtual care are not blocked at the pharmacy counter.
The study contributes to the growing evidence supporting the continued use of telehealth flexibilities for buprenorphine treatment, noting that patients experienced fewer barriers and showed improved engagement. Pharmacy access is a significant obstacle that requires regulatory and industry solutions to ensure the timely initiation of care.
