The Drug Enforcement Administration (DEA) is more than a year behind on creating a special registration process that would allow behavioral health providers to tele-prescribe certain medications for substance use disorder (SUD) treatment.
Now, dozens of organizations are putting pressure on federal officials to change that, asking them to move forward and make medication-assisted treatment (MAT) accessible to all Americans regardless of where they live or whether they can travel.
More than 80 organizations — including the National Council for Behavioral Health, the American Psychiatric Association and other advocacy groups — have signed a letter asking DEA Acting Administrator Timothy Shea to get a move on.
“The undersigned organizations write to encourage the DEA to expedite and complete its efforts to implement a telemedicine special registration process enabling providers to safely prescribe controlled substances remotely,” the signatories wrote. “Our experience during COVID-19 has demonstrated the value of increased access to telemedicine to enable all qualified providers … to prescribe MAT to patients with opioid use disorder (OUD).”
The issue at hand dates back to October 2018, when President Donald Trump signed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. It mandates the creation of the special registration process, which would allow qualified providers to tele-prescribe control substances to patients they haven’t seen in person.
Usually, such tele-subscription is not allowed under the Ryan Haight Act of 2008. It prohibits doctors from remotely prescribing controlled substances to patients until after they’ve conducted an in-person visit.
The idea behind the change is to make it easier for folks in rural areas and treatment desserts to access MAT, which is widely considered the gold standard of SUD care. But the DEA is dragging its feet. While it was supposed to come out with a special registration process a full year ago in October 2019, the DEA has still yet to do so.
That’s a point of contention for the dozens of advocacy organizations who signed the letter to Shea earlier this month.
“It has now been two full years since the SUPPORT Act was signed into law with no appreciable progress in moving forward a rulemaking process to implement this key telemedicine provision,” the letter said.
The lack of special registration is especially troubling given the COVID-19 emergency, the letter argues. Amid the coronavirus, drug overdose rates have spiked nationwide, making improved access to care especially important.
In response, both HHS and the DEA have temporarily waived a variety of telemedicine restrictions during the coronavirus public health emergency, making it possible for behavioral health providers to temporarily tele-prescribe controlled substances for MAT. However, those flexibilities alone are not enough, the organizations wrote to Shea.
“While we appreciate these public health emergency-related changes, statute requires the implementation of a permanent regulation,” they said in the letter. “The time for that regulation is long overdue.”