This month, the U.S. Department of Health and Human Services (HHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) took crucial steps to better access to opioid use disorder treatment. As part of this effort, a final rule was implemented that includes a provision for the initiation of treatment via telehealth. However, the accessibility of this regulation is limited to practitioners in Opioid Treatment Programs (OTPs) alone, bypassing other providers such as primary care physicians and addiction medicine specialists.
While telehealth advocates appreciate the HHS final rule, they believe that further action needs to be taken by the Drug Enforcement Administration (DEA) to more broadly expand access to treatment via telehealth. As things stand, while HHS and SAMHSA have jurisdiction over OTPs, the DEA oversees the prescribing of controlled substances.
OTPs began to offer their services through telehealth during the Covid-19 pandemic when in-person treatment became tricky. According to the final rule, practitioners in OTPs can initiate patients on methadone via an audio-visual telehealth appointment and could start patients on buprenorphine via an audio-only telehealth appointment.
There is a pressing need for the DEA to expand access to treatment beyond what HHS and SAMHSA have implemented. With the latter’s final rule on OTPs, hope is high amongst telehealth advocates that the former will take action to permanently permit care providers to utilize telehealth and make such accessibility permanent.
However, the final rule’s limitations leave certain telehealth advocates disappointed. Kyle Zebley, senior vice president of public policy at the American Telemedicine Association, shared his hope that the DEA would surpass what SAMHSA has done when it comes to the virtual prescribing of controlled substances.
The team at telehealth company Bicycle Health also voiced their support for the HHS final rule while outlining its limitations. According to Pew Charitable Trusts, as of March 2021, there were only 1,816 OTPs in the U.S.
In this context, Zebley has voiced the idea that the DEA should create a special registration process that would permit medical professionals to register with the agency to virtually prescribe controlled substances. However, Zebley believes that predicting the DEA’s moves could be risky.
This report was compiled from an article originally published on MedCity News.