The Drug Enforcement Administration (DEA) recently unveiled a new regulation that could revolutionize the way controlled substances are prescribed through telehealth platforms. This long-awaited rule, released just days before President Joe Biden’s term ends, aims to streamline the process of prescribing Schedule II to V drugs, such as Adderall or Xanax, without the need for an in-person evaluation.
One of the key components of this proposed rule is the creation of special registrations that would authorize healthcare providers and telehealth companies to prescribe controlled substances remotely. Additionally, the DEA finalized a regulation that permits registered practitioners to virtually dispense buprenorphine, a medication used to treat opioid use disorder.
Prior to the COVID-19 pandemic, prescribing controlled substances via telehealth was limited by stringent regulations requiring an in-person visit. However, temporary flexibilities were introduced to ensure continued access to care during the public health emergency. These flexibilities have been extended multiple times and were recently preserved through a November rulemaking, extending the changes until the end of 2025.
The proposed rule by the DEA creates a permanent framework for telehealth prescriptions of controlled substances, offering multiple special registrations for providers and telehealth platforms. This includes authorizing clinicians to prescribe Schedule III to V drugs and specialized providers to dispense Schedule II to V medications. Providers would also need to maintain state telemedicine registrations for each state they practice in.
While the proposed rule aims to protect access to care and prevent improper dispensing of drugs, some industry groups have raised concerns about the feasibility and potential limitations it could impose. The American Telemedicine Association (ATA) expressed worry that the restrictions outlined in the rule could hinder access to virtual care, calling it a “major setback” for telehealth.
The Alliance for Connected Care, another industry group, welcomed the DEA’s special registration process but raised concerns about geographic restrictions and limitations on virtual prescriptions. They emphasized the importance of telehealth for various medical issues, including mental health, substance use disorder, and terminal illness.
In addition to the proposed rule, the DEA also finalized a regulation allowing registered providers to dispense an initial six-month supply of buprenorphine via telehealth. This move is expected to prevent lapses in care for patients seeking treatment for opioid use disorder.
Overall, the DEA’s proposed rule on telehealth prescribing and the finalized regulation on buprenorphine dispensing signify a significant step towards expanding access to care through telehealth platforms. As the regulations go into effect, it will be crucial for stakeholders to monitor the impact on patient care and access to controlled substances via telehealth.
