Can treatment happen by phone or video?

What telehealth treatment can include

NIAAA's page on telehealth options for alcohol treatment says you can get professional care by phone or video chat, and that many health care professionals and programs have offered it for years. It describes putting together a care team remotely, for example a therapist for counseling and an addiction doctor for medication support.

NIAAA's treatment booklet lists telehealth visits as one way outpatient care can happen, for counseling, medication support or both.

For opioid use disorder, NIDA's page on medications notes that health care providers can prescribe buprenorphine through telehealth. Methadone is different: it comes from opioid treatment programs, which usually involves attending in person.

NIAAA also describes online self-guided programs that can be added to a plan led by a health care professional. Some are prescribed by a doctor or therapist and some charge a fee. NIAAA does not endorse particular commercial products.

When remote care may not be enough

Telehealth is a form of outpatient care. It may not be suitable if you are at risk of serious withdrawal, have a medical condition that needs examining in person, or need more support than appointments can provide. An assessment should help decide that.

NIAAA's telehealth page also notes that online groups and apps can be helpful, but that some issues need a professional. If remote care is offered to you, ask the clinician whether anything about your situation would make in-person or more intensive care safer.

Think about privacy before the first appointment

Counseling by video means talking about personal things wherever you are. Ask yourself where you could speak without being overheard. That might be a parked car, a closed room at a set time or a friend's home. If someone at home monitors your phone or messages, or you would not be safe if they overheard, tell the service and ask about other options.

Check what the service uses: a phone line, a video platform, an app or a patient portal. Ask how to join, whether you need to download anything and what happens if the connection drops. If you share a device, consider who can see notifications or appointment reminders.

Check coverage and cost

NIAAA notes that Medicare and other insurers have expanded coverage of telehealth services, and advises checking with your insurance company. Check the specific kind of visit rather than assuming it is covered the same way as an office appointment.

When you call your plan, name the kind of care, such as telehealth counseling or medication appointments, and ask whether the particular provider is covered, what you would pay per visit and whether prior approval is needed. If the provider charges separately for an app or program, ask about that too.

Questions to ask a telehealth service

Before you agree, find out who you will actually be speaking to and what their qualifications are. Ask how often appointments would be and how long they last. Ask whether medication can be prescribed remotely for your situation and, if so, how you would collect it and whether any in-person visits or tests are needed.

Ask how to reach someone between appointments, and what the service expects you to do in an emergency. A clinician on a video call may not be able to get help to you quickly. For a medical emergency you call 911, and for a mental health crisis you can call or text 988.

Making it work week to week

Put appointments in your calendar with the joining link or number, and test the connection before the first one. Have a medication list and any questions nearby.

If remote care stops working, for example because you cannot find privacy or you are struggling between sessions, tell the clinician. That is a reason to adjust the plan, perhaps with more frequent contact or a different setting, not a reason to quietly stop attending.