DEA May Be Bringing Telehealth Registration for Addiction Treatment

Amid the coronavirus pandemic, seeing health professionals in person has become harder than ever. People struggling with substance misuse looking to find treatment are no exception. This is especially unfortunate as most medication-assisted treatments (MAT) such as buprenorphine and suboxone require an in-person examination to be prescribed.

But a recent development may change that. According to mHealth Intelligence, over 80 organizations—including telehealth providers, health systems, the American Telemedicine Association, and America’s Health Insurance Plans—have signed a letter addressed to Acting DEA Administrator Timothy Shea to create a special registration for individuals with substance use disorder (SUD) seeking treatment via telehealth. If allowed, doctors would be able to prescribe controlled substances used in MAT without the in-person medical examination.

Expanding Telehealth Registration for Addiction Treatment

Telehealth is defined as the “use of digital information and communication technologies such as computers and mobile devices to access health care services remotely,” according to the Mayo Clinic. It’s a tool that has been effectively used in other aspects of medicine, including for meeting with therapists and psychiatrists.

The concept of a special registration came from the Ryan Haight Act of 2008, which mandated a system that would allow providers to prescribe, deliver, and distribute controlled substances without an in-person examination. The Substance Use Disorder Prevention that Promotes Opioid Recover and Treatment (SUPPORT) for Patients and Communities Act, which passed in 2018, also has a similar provision.

The special registration, however, would come with a few conditions. For one, providers will have to demonstrate a legitimate need for the special registration. They also will only be able to prescribe medication to patients in the same state in which they practice. Additionally, providers will have to comply with all federal and state laws.

In addition to industry organizations and providers, Virginia Democratic Senator Mark Warner advocated for special registration earlier this year. He wrote in January:

“Providers across the country have been frustrated in their inability to provide adequate care as they wait for Congressionally mandated guidance from your agency to clarify the process whereby health care professionals can legally use telehealth to better treat patients suffering from substance use disorder. The DEA’s failure to promulgate the rule has meant that – despite Congress’ best efforts – many patients suffering from substance use disorders remain unable to access treatment via telehealth. These patients cannot afford to wait and we are concerned the DEA is standing in the way of treatment for individuals that cannot access a provider in person – particularly those in rural and underserved areas.”

The Two Epidemics

The signatories of the letter highlighted the increase in SUD since the onset of the COVID-19 pandemic, which includes increases in overdose-related deaths in over 40 states. But even before the pandemic, opioid addiction was a monumental problem. Since the onset of the opioid crisis, which is generally considered to have begun in 1999, over 700,000 people have died of a drug overdose in the U.S., including over 70,000 in 2019. The crisis has also cost the U.S. economy trillions of dollars, according to one estimate.