Several
telehealth
advocates
are
coming
out
in
support
of
the
Drug
Enforcement
Administration’s
(DEA)
third
extension
of
Covid-19
telehealth
flexibilities
for
the
prescribing
of
controlled
substances.
However,
they
argue
that
more
work
needs
to
be
done
to
make
these
flexibilities
permanent.
The
flexibilities,
introduced
in
2020,
permit
providers
to
prescribe
some
controlled
substances
virtually
without
first
requiring
an
in-person
visit.
These
flexibilities
were
set
to
expire
at
the
end
of
the
year,
but
will
now
expire
at
the
end
of
2025
with
the
third
extension
announced
last
week.
The
issue
has
been
closely
followed
by
many
experts,
as
seen
by
the
38,000
comments
the
DEA
received
in
2023
in
response
to
a
set
of
proposed
telemedicine
rules
that
would
have
rolled
back
some
of
the
flexibilities
allowed
during
the
pandemic.
For
one
telehealth
advocate,
the
extension
was
a
“tremendous
relief,”
noting
that
the
flexibilities
have
greatly
improved
access
for
underserved
communities.
“It
is
with
a
real
sense
of
gratitude
that
the
Drug
Enforcement
Administration
and
the
Biden
administration
decided
to
continue
this
flexibility
that’s
now
been
in
place
for
almost
half
a
decade
so
that
we
can
continue
to
take
the
time
to
get
the
permanent
framework
right.
…
It
was
going
to
be
calamitous
if
we
were
going
to
allow
for
this
flexibility
to
expire
December
31
this
year,”
said
Kyle
Zebley,
senior
vice
president
of
public
policy
at
the
American
Telemedicine
Association,
in
an
interview.
“Continuity
of
care
would
be
severed
for
hundreds
of
thousands,
if
not
more,
patients.”
Zebley
noted
that
it
is
important
to
prevent
abuse
of
the
flexibilities
and
called
for
a
special
registration
process
that
allows
medical
professionals
to
register
with
the
agency
in
order
to
virtually
prescribe
controlled
substances.
Congress
mandated
the
DEA
to
create
this
process
back
in
2008,
but
the
agency
has
yet
to
do
so.
However,
he
added
that
instances
of
inappropriate
prescribing
“is
minuscule
compared
to
the
level
of
access
that’s
been
achieved.”
Another
telehealth
expert
—
Stephanie
Strong,
founder
and
CEO
of
Boulder
Care
—
echoed
Zebley’s
comments.
Boulder
Care
offers
virtual
addiction
care,
including
the
prescribing
of
buprenorphine,
which
treats
opioid
use
disorder
and
is
included
in
the
telehealth
flexibilities.
“We
anticipated
this
extension,
and
celebrate
the
win
as
an
important
step
forward.
Still,
this
measure
is
only
temporary:
the
DEA
and
HHS
continue
to
make
rules
that
kick
the
can
down
the
road,”
Strong
said.
“Our
country
needs
strong
leadership
and
a
vision
for
modernizing
the
healthcare
system,
which
necessarily
includes
making
telehealth
a
permanent
option
for
millions
of
Americans
who
rely
on
it.”
Strong
added
that
she
wants
to
see
the
TREATS
Act
gain
momentum
in
2025,
which
would
make
telehealth
flexibilities
permanent
for
those
with
opioid
use
disorder.
There
is
also
hope
that
the
Trump
administration
will
introduce
a
permanent
solution
to
the
virtual
prescribing
of
controlled
substances,
according
to
Eric
Triana,
chief
compliance
officer
at
Talkiatry.
The
company
offers
virtual
psychiatry
services.
“After
nearly
five
years,
the
benefits
of
telemedicine
services
including
prescribing
without
ever
having
an
in-person
medical
visit
has
proven
to
be
vital
for
patients
in
every
state,
both
rural
and
urban,
due
to
shortages
of
mental
health
providers,”
Triana
stated.
“I
anticipate
that
the
new
administration
will
prioritize
finalizing
a
permanent
rule
with
reasonable
common-sense
safeguards
to
assist
DEA
investigators
in
detecting
diversion
without
interfering
with
patient
access
to
telemedicine
behavioral
health
services
when
provided
through
synchronous
audio
and
video.”
Zebley
is
also
hopeful
that
the
Trump
administration
will
create
a
more
permanent
telehealth
framework
before
the
new
extension
expires,
particularly
considering
the
previous
Trump
administration
first
introduced
the
flexibilities.
That
said,
rulemaking
takes
time
and
it’s
possible
another
extension
may
be
needed,
he
said.
Photo
credit:
Sorbetto,
Getty
Images