Why DEA’s latest move on telehealth could be a lifesaver

AMA News Wire

Why DEA’s latest move on telehealth could be a lifesaver

Nov 1, 2023

What’s the news: Physicians can continue to prescribe controlled substances based on telehealth patient visits after the Drug Enforcement Administration (DEA) extended this regulatory flexibility through Dec. 31, 2024.

“The AMA is grateful the DEA recognizes patients being treated with these medications, including medication to treat opioid-use disorder, often have challenges securing and traveling to in-person appointments, and that the agency is committed to avoiding lapses in their care,” said AMA President Jesse M. Ehrenfeld, MD, MPH.

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At a DEA “listening session” earlier this fall, Dr. Ehrenfeld urged the DEA to adopt federal policy on prescribing controlled substances based on telehealth visits that will continue to support patients’ access to evidence-based care. In his remarks (PDF), Dr. Ehrenfeld also encouraged the DEA to refrain from imposing new barriers that could undo the improvements in patient access during the COVID-19 public health emergency, which expired earlier this year.

After the extension’s announcement, Dr. Ehrenfeld said that “the AMA will continue to encourage DEA, as it revises the rules, to provide an appropriate balance between advancing patients’ access to care via the mix of in-person and virtual services that best meets their needs while also ensuring patient safety.”

Supporting telehealth is an essential component of the AMA Recovery Plan for America’s Physicians.

Telehealth is critical to the future of health care, which is why the AMA continues to lead the charge to aggressively expand telehealth policy, research and resources to ensure physician practice sustainability and fair payment.

Why it’s important: The experience during the COVID-19 public health emergency showed that using telemedicine to prescribe controlled substances helped patients—those with and those without an in-person evaluation—to start and maintain necessary, evidence-based care for many medical conditions, including opioid use disorder.

For example, between September 2019 and February 2021, patients who were treated for opioid-use disorder through telehealth had 33% lower adjusted odds of a fatal overdose than those who got no medication treatment, according to a 2023 study in JAMA Psychiatry.

Telemedicine also has allowed patients seeking buprenorphine to start opioid-use disorder treatment without the delay of an in-person evaluation, a 2021 study in the Journal of Substance Use and Addiction Treatment revealed. In Upstate New York before the public health emergency, the average wait for an in-person visit was 12 weeks. Patients seeking opioid-use disorder treatment, the study’s authors observed, often must overcome barriers such as lack of transportation or child care.

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In his remarks to the DEA, Dr. Ehrenfeld emphasized that “whether audio-only, audiovisual, or in-person care, physicians provide high-quality, evidence-based care that relies on thorough assessments and sound decision-making.” He also said that safeguards such as state laws and the Controlled Substances Act are already in place to help ensure patient safety and prevent diversion.

The remarks come in addition to AMA advocacy with the DEA regarding prescribing buprenorphine via telemedicine (PDF) and prescribing controlled substances via telehealth (PDF) when a physician and patient haven’t had a previous in-person visit. A September letter to the DEA from Sens. Mark Warner, D-Va., John Thune, R-S.D., and others cited the AMA’s support for protecting the benefits of prescribing controlled substances based on telehealth visits.

Learn more: The AMA believes that science, evidence, and compassion must continue to guide patient care and policy change as the nation’s opioid epidemic has become a more dangerous and complicated illicit drug overdose epidemic.

Find state- and specialty-specific resources at the AMA's End the Epidemic website, explore overdose-related data metrics on the AMA’s overdose data dashboard and read about the inspiring physicians who are helping patients with substance-use disorders or chronic pain.