New Collaboration Brings Opioid Use Disorder Treatment to Formerly Incarcerated Patients

Opioid addiction startup founder calls for better reimbursement and legal changes to improve access

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Nearly one in five people who are incarcerated battle opioid use disorder (OUD), and opioid-related overdose is the leading cause of death for those released from the criminal justice system. A new collaboration aims to change these stats.

The collaboration, which was announced last week, is between Bicycle Health, Wellpath and the Federal Bureau of Prisons. San Francisco-based Bicycle Health is a virtual provider of opioid use disorder treatment, while Nashville, Tennessee-based Wellpath is a medical and mental health provider that serves vulnerable patients, including those who are in prisons and jails.

Through the collaboration, Wellpath has entered into a contract with the Federal Bureau of Prisons to provide virtual services for opioid use disorder to patients living in the Bureau’s residential reentry centers. Wellpath will offer care coordination services to Bicycle Health, which will be the provider of the OUD services. These virtual services include the evaluation of the patients, medication management of OUD and drug testing. The collaboration will start in 42 states, with plans to expand in the future.

This is the first collaboration of its kind, claimed Ankit Gupta, CEO and founder of Bicycle Health.

“The need is really quite high [for this population],” Gupta said in an interview. “It’s great to see the Bureau actually recognizing that need and doing something about it.”

Dr. Thomas Pangburn, chief clinical officer of Wellpath, echoed Gupta’s comments and said providing treatment via telehealth will greatly expand access.

“Telehealth is now well understood to be a widespread, highly effective treatment delivery option for patients with opioid use disorder, which is why we chose to work with Bicycle Health. In doing so, we’re able to overcome many of the obstacles that prevent formerly incarcerated people from getting the MOUD treatment they need,” Pangburn said in a news release. “This collaboration helps streamline the process for re-entry by providing evidence-based and convenient treatment options, which can make a real difference for those struggling with opioid addiction.”

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The benefits of this collaboration may be short-lived, however. The Drug Enforcement Administration released proposed rules Friday for the prescribing of controlled medications via telemedicine. This includes buprenorphine, which is used to treat OUD. Through the proposed rule, a patient can receive an initial 30-day prescription for buprenorphine through telemedicine. After that, the prescriber can meet the patient in-person, or the patient can be referred from a provider who has done an in-person examination. Additionally, the patient can be in-person with a medical provider and have a virtual call with a prescriber at the same time. This rule differs from flexibilities allowed through the Covid-19 public health emergency (set to end in May), which allowed patients to receive prescriptions via telemedicine without an in-person visit.

These proposed changes will have serious negative impacts on patients, especially those who are formerly incarcerated, Gupta argued.

“If these proposals end up becoming final, it will significantly decrease access to telemedicine-based opioid use disorder treatment models … I think there’s a lot of improvement that needs to be done in order to maintain access. Otherwise, it could lead to a significant increase in overdose death rates,” Gupta said.

Bicycle Health, Wellpath and the Federal Bureau of Prisons have not discussed how they will change the collaboration if these rules become final, Gupta said. But ultimately, Gupta hopes this collaboration will have a significant impact on the opioid epidemic. 

“Telemedicine is actually the perfect modality to [provide care in a criminal justice setting],” he said. “Through telemedicine, you could be at a prison or jail, inside the facility. [The provider could] continue seeing the patient when they’re entering a residential reentry center and then continue seeing the patient aftwards when they’re fully released in the community.”

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Photo: sorbetto, Getty Images

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