Members of Congress and advocates worry that a proposed rule by the Biden administration will make it harder for people to access a medication commonly used to treat opioid use disorder. The Drug Enforcement Administration is proposing to limit telehealth prescriptions for buprenorphine to an initial 30-day supply until the patient can be seen in person by a physician. The proposal follows a three-year period during the pandemic in which DEA allowed providers to prescribe buprenorphine through telehealth without requiring an in-person visit, Roll Call reports. Providers said the pandemic-era flexibility worked, allowing them to expand access to the life saving-drug and keep patients in treatment. It was particularly helpful for people who lacked transportation or lived in areas with doctor shortages. They say the flexibility should continue after the public health emergency ends next month. “This could mean the difference between continuing therapy and going back to their addiction,” said Brock Slabach of the National Rural Health Association, which represents health care providers in rural communities.
Buprenorphine treatment usually lasts from six months to one year and has been shown to reduce overdose deaths by diminishing the effects of withdrawal symptoms, which can lead people back to using opioids. There were nearly 81,000 overdose deaths involving opioids in 2021, says the Centers for Disease Control and Prevention. With the public health emergency ending in May, DEA, which has the authority to regulate buprenorphine because of the possibility it could be misused, says it needs to transition to an approach that balances the need for opioid use disorder treatment with the risk of diversion or the use of buprenorphine for illicit purposes by requiring new patients to see a provider in person if they want to continue buprenorphine for longer than 30 days. Under the proposed rule, people who were prescribed buprenorphine through telehealth during the pandemic who had not been evaluated by a provider in person will have 180 days after the rule takes effect to keep their prescription. “DEA is committed to the expansion of telemedicine with guardrails that prevent the online overprescribing of controlled medications that can cause harm,” said DEA Administrator Anne Milgram. The proposal unleashed a wave of anger and frustration from advocates and lawmakers who have long been skeptical of the DEA’s approach to medication-assisted treatment.