# Health Systems Node of the NIDA Clinical Trials Network

> **NIH NIH UG1** · KAISER FOUNDATION RESEARCH INSTITUTE · 2021 · $161,122

## Abstract

Project Summary/Abstract
The COVID-19 pandemic has led to a dramatic shift to virtual treatment for patients with drug
use disorder (DUD), at the same time as drug use has increased during the pandemic, and
people of color are at disproportionate risk of distress and drug use. This shift raises questions
about potential disparities in access to virtual treatment, given the existing ‘digital divide,’ where
older patients, patients of color, and patients of lower socio-economic status may have less
access to broadband, computers, and other digital devices. Patients may also face barriers such
as confidentiality concerns, lack of private space for participating in virtual sessions, and
dissatisfaction with the virtual therapeutic experience. At the same time, features of virtual
treatment, such as convenience and elimination of transportation and its costs, may increase
access and use, particularly for underrepresented patient populations. The proposed study
examines disparities in virtual treatment among adult and adolescent patients with DUD in a
large, diverse, health care delivery system that was able to quickly pivot to virtual DUD
treatment delivery during the pandemic. Using rich electronic health record and claims data, we
examine changes in DUD identification, and in several treatment measures (initiation,
engagement, and retention in specialty addiction treatment; medication for opioid use disorder)
comparing visit types (virtual/non-virtual, telephone, video) from a pre-COVID-19 (3/2019-
12/2019) to post-COVID-19 onset (3/2020-12/2020) time period. With large samples of 61,199
adult and 3,494 adolescent patients with DUD, we will specifically explore disparities by
race/ethnicity, gender, age, and socioeconomic status. We explore differential insurance loss
during this turbulent time, as well as health services utilization (e.g. emergency department,
primary care, psychiatry, email secure messages) by the study population. Our rigorous analytic
plan incorporates interrupted time series (ITS), and generalized estimating equation (GEE)
models to address study aims. Early evidence suggests drug use, and adverse events such as
opioid overdose, have increased during the COVID-19 pandemic, and virtual treatment will likely
continue post-pandemic as an important treatment modality. Findings have important
implications for patient care, particularly for improving access to and quality of care for
vulnerable populations. Further, the study cohort will be a valuable resource for future research
on virtual DUD treatment, and its long-term impact on patient outcomes.

## Key facts

- **NIH application ID:** 10285695
- **Project number:** 3UG1DA040314-06S3
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Katharine Anthony Bradley
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $161,122
- **Award type:** 3
- **Project period:** 2015-09-01 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10285695

## Citation

> US National Institutes of Health, RePORTER application 10285695, Health Systems Node of the NIDA Clinical Trials Network (3UG1DA040314-06S3). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10285695. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*