Washington – Patients may soon be able to receive addiction treatment and medication through telehealth visits – without having to see a doctor in person.
The Biden administration unveiled new rules aimed at increasing patient access to certain medications and addiction treatments, and proposed Drug Enforcement Administration (DEA) rules announced Friday make permanent certain Trump-era reimbursements for doctors to prescribe medicines through telehealth, which was established at the start of the COVID-19 pandemic. At the same time, the administration is reintroducing restrictions on other drugs that are more addictive.
The move would allow doctors on a permanent basis to prescribe non-narcotic drugs in one 30-day supply after a single telehealth visit. This is likely to take effect days before Mr Biden plans to end the public health emergency on May 11. The rules also carve out an exception for buprenorphine, a drug used to treat opioid addiction.
In both of these cases, after first receiving a 30-day supply of the drug externally, patients must then visit their doctor to receive these medications — Ambien, Valium, Xanax and Lyrica, among others — classified by the DEA as Schedule III, IV , and V controlled substances.
DEA officials told CBS News that the new rules prioritized continuity of care for patients and ongoing treatments for substance use disorders, ensuring that those adjusting to the pandemic rules could continue their care with their established doctors.
The government’s proposed changes would not affect telemedicine consultations by a doctor or general practitioner who previously examined a patient in person or virtual prescribing of drugs outside the DEA’s list of controlled substances. These non-controlled substances include acne creams, blood pressure and cholesterol medications, antibiotics, birth control, and insulin.
However, the DEA’s new plan restricts providers from prescribing narcotics, known as Schedule II drugs, because they can be highly addictive and lead to long-term health complications.
Since March 2020, after the Secretary of Health and Human Services declared a public health emergency, DEA-registered physicians were allowed to issue prescriptions for all Schedule II through V drugs to telehealth patients or “patients for whom they have not performed an in – person medical assessment.”
These licenses included several classifications of drugs, from more addictive drugs like oxycodone to less addictive mental health drugs like Fluoxetine and buprenorphine.
Under the new proposed rules, a patient’s ability to obtain a narcotic without first physically visiting their doctor — which went unlimited during the COVID-19 emergency — would be eliminated, returning to pre-pandemic policies. DEA officials said such safeguards were put in place to protect the public.
When the COVID-era expansions were first enacted, doctors were required to ensure that the drugs prescribed served a “legitimate medical purpose” and the consultation with the patient was conducted using a video communication system.
When COVID-19 hit the United States, health professionals became was already struggling with another epidemic – The drug crisis. The emergency provisions proved to be revolutionary for those fighting drug addiction.
These temporary and new rules — aimed at allowing patients to get the medicine they need without risking exposure to the coronavirus in the doctor’s office — were celebrated by patient care advocates, who have since come to worry about how the end of the nationwide health emergency could disrupt patients’ medical treatment.
The pandemic increase in remote prescribing and home use of drugs has sparked a debate among the public health community as government officials balance the availability of drugs with patient safety.
Still, Friday’s legislative changes will be a boon to those dealing with substance use disorders, making treatment both accessible and affordable, especially for Americans in remote or rural areas of the United States with limited access to in-person medical appointments.
In recent months have pressure from Congress mounted to develop a plan for continuity of care that would ensure that patients who had the ability to obtain and refill prescription medications via telehealth would go uninterrupted. Ministry of Justice officials said at the end of last year they worked in the administration to finalize a strategy.
“The DEA is committed to ensuring that all Americans can access the medicines they need,” DEA Administrator Anne Milgram said in a statement. “The permanent expansion of telemedicine flexibility will continue to provide greater access to care for patients across the country while ensuring patient safety.”
Friday night’s announcement provides a middle ground for first-time patients and their providers, giving them the freedom to start a month of treatment via telehealth.
It happens only a few days after the Food and Drug Administration’s head, Dr. Robert Califf, criticized what he characterized as the “absolutely insane” overprescription of certain drugs like Adderall – a Schedule II drug.
“So as long as that’s happening, it’s very hard to say we’re not doing it — we’re just going to open the floodgates for this,” Califf said during a meeting of the National Institutes of Health’s HEAL Initiative. “So you all need to research … what are the appropriate ways to do this? I personally had to advocate for telehealth in our program in Dayton before I came to the FDA when the state medical boards tried to shut down the opportunity to give So I’m all for it, but we need to define the parameters better.”
The public now has 30 days to comment on the new flexibility options before the rules are final. According to DEA officials, the proposed rules would go into effect after a six-month grace period after the end of the public health emergency — which is scheduled for May 11 — for patients to ensure their care is maintained.
Officials said they are soliciting comments from the public on various safeguards and flexibility.
– Alexander Tin contributed reporting.
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