Gender and Utilization Patterns of Telehealth for Substance Use Disorder: An Analysis of National Survey Data

Background and Purpose

The limitations of in-person treatment during the COVID-19 pandemic led to a rapid expansion of phone and video-delivered services for substance misuse that has continued in the years post-pandemic. To strengthen service impact, it is important to understand their reach, scope, and patterns of use. Research on gender differences in substance use disorder (SUD) has highlighted distinctive treatment needs and pathways for women and men. However, much is still unknown about phone and video-delivered (telehealth) services and their differential use and impact by gender. This analysis explored: 1) gender and other demographic associations with use of telehealth SUD services, and 2) gender differences in the use of telehealth SUD services and other kinds of treatment services.

Methods

We used data from the 2022 National Survey on Drug Use and Health (NSDUH). Respondents included in the analyses received SUD treatment services within the last 12 months. Chi-square analysis was used to examine gender differences in the total number of SUD services utilized, while binary logistic regression was used to obtain odds ratios of demographic associations with receipt of telehealth services alone or as one of multiple treatments types.

Results

Respondents who used telehealth SUD services (N=890) reported an average of approximately 4 additional types of SUD treatments within a 12-month period. The mean number of SUD service types used did not significantly vary between women (mean=4.6) and men (mean=5.1). 8.2% of respondents reported using only telehealth services during that timeframe (women=10.9%, men=6.0%). Controlling for race, marital status, age, metro area, perceived health, education, employment, income, and insurance status, clients who received any SUD treatment services (N=2,787) did not have significantly different odds of using telehealth services based on gender. However, clients who used only telehealth SUD services had higher odds of being women (aOR=2.38, p=.04).

Conclusions

The majority of respondents who reported using telehealth SUD services used them in conjunction with multiple types of other treatment services. Although women were not more likely to use telehealth services or to use fewer total services, they did have higher odds of using only telehealth treatment.

Due to limitations in the data set, it was not possible to know whether services were utilized concurrently or separately, the duration of each, or their effectiveness. Future research should examine these questions as well as the extent to which singular use of telehealth SUD services is due to a preference for this mode of care versus barriers to in-person treatment.