September 27, 2016

GILES COUNTY, Va. — Robert Devereaux is a family physician in this southwest corner of Virginia, where problems surrounding prescription opioid use far outstrip the capacity of psychiatrists and addiction specialists to treat them. When he found crushed fragments of painkiller pills inside the nose of an older patient with chronic back pain, the most Devereaux could do was refuse to prescribe more.

“There are a lot of patients in denial. … It’s a lot of families that have suffered horribly from this,” he said, sitting in his one-story clinic in the small town of Pearisburg. “The mental health issues aren’t going to go away.”

But some health professionals, as well as the federal government, think technology could offer a solution — by using video chat to connect patients in need with faraway physicians who know how to treat addiction.

Their telemedicine effort is part of a larger initiative to fight the opioid epidemic in hard-hit rural areas such as Appalachia. This summer, the U.S. Department of Agriculture directed $1.4 million to five pilot projects in southwest Virginia, Tennessee and Kentucky. One will be run by Carilion Clinic, the health system that operates Devereaux’s practice, along with other hospitals and medical practices in the region.

“This is an obvious potential direction to move in,” said Colleen Barry, a professor of health policy at Johns Hopkins University and co-director of its Center for Mental Health and Addiction Policy Research. “There are some real opportunities and some pretty significant challenges.”

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