The substance use disorder (SUD) treatment industry stands at a precipice as several regulations are set to transform the field in 2025.
Crucial telehealth policies hang in the balance after the Drug Enforcement Administration (DEA) kicked the can on COVID-era prescribing flexibilities, now set to expire at the end of 2025. Further deferrals or the revocation of these policies could destabilize what has become common practice in the SUD industry.
The changing of the guard at the White House also portends possible changes. A new head of Centers for Medicare & Medicaid Services – a post-President-elect Donald Trump has decided to fill with famed TV personality Dr. Mehmet Oz – could lead to “meaningful” changes in key Medicaid policies.
Much hangs in the balance with the new Trump administration. While providers often emphasize that SUD care is a bipartisan issue, Trump’s promised deregulations and opinions regarding the Affordable Care Act (ACA) could destabilize the SUD treatment status quo.
Addiction Treatment Business polled several industry leaders on the regulations most likely to rock the SUD treatment space in 2025 – these are their predictions.
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The most profound regulatory development facing SUD treatment providers in 2025 has to do with the DEA’s extension of the allowance for prescribing controlled medications via telehealth without requiring in-person visits through 2025. This extension enables Centerstone and other providers to continue providing medication-assisted treatment (MAT) for substance use disorders (SUD) through telehealth, which has been incredibly effective in eliminating barriers to care.
When combined with the elimination of the waiver requirement for prescribing Suboxone, this policy change is expected to improve access to MAT for a larger number of patients. However, the future of these provisions beyond 2025 remains uncertain.
– David C. Guth, Jr., CEO of Centerstone
A leaked DEA proposal this year revealed an attempt to roll back telemedicine access for buprenorphine, but was met with widespread resistance from physicians, health advocates, and bipartisan members of Congress. Telemedicine access has been temporarily extended for another year. In 2025, we need legislation to make this critical modality for addiction medicine permanent. We hope the TREATS act will gain momentum.
– Stephanie Strong, founder and CEO of Boulder Care
The burden of the substance use disorder epidemic disproportionately falls on Medicaid beneficiaries and the uninsured. With a new administration and leadership at CMS, there could be meaningful changes to Medicaid. Nearly 12% of Medicaid beneficiaries over 18 have a diagnosed SUD. Policy changes to how states administer benefits can lead providers to meaningfully change operations, ideally to improve outcomes for members.
– Cooper Zelnick, president of Groups Recover Together
The ongoing telemedicine prescribing debate will continue to have huge ramifications for this industry. In September of this year, a lot of telehealth providers were looking toward the beginning of 2025 not knowing whether they’d be able to continue providing care for their patients reliant on medications for their SUD or opioid use disorder (OUD) treatment. Another extension from the DEA means these providers will have the opportunity to continue care, but it’s not a permanent solution. In 2025, we’ll need to continue to prove these care models work and lobby for evidence-based rulemaking or Congressional actions that take into account the real experiences of Americans struggling with OUD.
– Ankit Gupta, founder and CEO of Bicycle Health
With the incoming administration, the regulatory outlook for 2025 is, at best, uncertain. While we know that the administration is committed to reducing the flow of illegal drugs such as fentanyl, we don’t yet know how their promised focus on deregulation and their approach to healthcare will impact SUD treatment. Without a doubt allowing individuals to stay on their parents’ health insurance until age 26 and rules forcing insurers to cover substance use disorder treatment and mental health has benefited both families and the treatment industry. So how the administration approaches what actions they take in regard to parity and the ACA could really impact whether and how treatment is accessed in the coming years. I’m also concerned about the potential that there will be a reduction of federal oversight, instead allowing individual states to set regulations. While some states have the infrastructure to absorb some of that responsibility, the majority do not. This would also make the patchwork of regulations that multi-state providers already navigate worse and perhaps cost-prohibitive to continue offering services in more than one state. All of this would be devastating to families and make the addiction crisis worse.
