The American Psychiatric Association, American Telemedicine Association and 70 other organizations signed a letter this past Friday urging the U.S. Drug Enforcement Administration to collaborate with the U.S. Department of Health and Human Services and permanently revise requirements regarding controlled-substance prescriptions.  

"Our experience during the pandemic was that telehealth meant our member psychiatrists were able to treat more patients, which was critical as we faced a mental health crisis," APA CEO and Medical Director Dr. Saul Levin said in a statement.  

WHY IT MATTERS  

As the letter outlines, during the COVID-19 public health emergency, the DEA waived the prior in-person evaluation requirement for patients being prescribed controlled substances via telehealth.  

This, in turn, meant providers could increase access to clinically appropriate medications, including for mental health and substance-use disorder treatment, said the signers.  

Citing a 2021 study, they noted that the use of telehealth in harm-reduction primary-care programs providing buprenorphine helped increase access to care and overcome health inequities.   

"Extending this waiver permanently will ensure patients can continue to access life-saving mental health and substance-use treatment, especially those who are geographically distant from their clinicians or face other disparities," said Levin.  

The letter asked the DEA and HHS to work with Congress and remove the prior in-person requirement permanently after the pandemic.   

In the meantime, said the groups, the DEA should also remove any location-specific restrictions on patients in the Special Registration process the agency is currently developing under the Ryan Haight Act for the prescription of controlled substances via telemedicine.  

The letter noted that these policy changes would leave in place all appropriate restrictions on the prescribing clinician, with the provider and dispenser still needing to have controlled-substances authority.   

"The only difference is that the patient does not need to be physically located in a facility with controlled-substances authority when the medication is prescribed," read the letter.  

The letter signers also asserted that the limitation does not give DEA additional tools to go after bad actors.   

"We welcome the opportunity to work with the DEA on mechanisms that can be used to prevent illegal online drug sales," said the letter.   

In addition to ATA, APA and ATA Action, other signing groups included the American Medical Association, the American Association of Nurse Practitioners, Mass General Brigham, One Medical and the South Carolina chapter of HIMSS.  

"We urge policymakers to consider that, during the pandemic, telemedicine effectively increased access to necessary care for patients in their home or other location, without increased diversion related to the waiver," Kyle Zebley, vice president of public policy at the ATA and executive director of ATA Action, said in a statement.  

THE LARGER TREND  

Back in 2018, the Senate acknowledged the importance of telemedicine use in the fight against the opioid epidemic with the passage through committee of the Opioid Crisis Act of 2018.  

Two years later, dozens of organizations  – including the ATA – urged the DEA to enable remote prescriptions for controlled substances in the long term, noting the success of telemedicine in treating opioid-use disorder.  

ON THE RECORD  

"We welcome the opportunity to discuss a proposed framework to ensure Americans maintain access to clinically appropriate care," ATA's Zebley said in a statement.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.