Drug overdoses have killed more Americans than every major U.S. war combined That is the scale of the substance use crisis in this country.

And for many of the patients most affected — people in rural areas, people with unstable housing, people without reliable transportation, and people who already struggle to access care — telepsychiatry may be one of the most important ways to help them.

But assessing substance use disorders through a screen comes with challenges. A patient may appear stable on video while hiding intoxication, withdrawal, overdose risk, suicidality, or an unsafe environment lingers just outside the frame.

In this episode of The Telepsychiatry Advantage, Dr. Edward Kaftarian explains how clinicians should assess substance use risk in a telepsychiatry visit: what to ask first, what warning signs to look for, why patient location matters, how the home environment can reveal risk, and when telehealth needs support from in-person resources.

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DISCLAIMER: The opinions expressed in the podcast are Dr. Kaftarian's personal opinions regarding best practices and are not intended to establish or represent the standard of care. It remains the responsibility of each listener to ensure compliance with all applicable standards of care, laws, regulations, and professional requirements.