Lawmakers Urge Biden Administration To Extend Telehealth Prescribing Flexibilities For Opioid Use Disorder

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Dive Brief:

• A bipartisan group of two dozen lawmakers is urging the Biden administration to extend telehealth prescribing flexibilities for opioid use disorder treatment. 
• The representatives, led by Reps. Annie Kuster, D-N.H., and Carol Miller, R-W.Va., argued flexibilities allowing telehealth prescriptions of buprenorphine without an in-person visit has increased access to treatment and reduced overdoses.
• But those flexibilities are set to expire at the end of the year. Lawmakers also raised concerns that the Drug Enforcement Administration could propose more stringent requirements for telehealth prescriptions of buprenorphine, a medication that be used to treat opioid use disorder, limiting its use just as overdose deaths have begun to decline. 

Dive Insight:

Telehealth advocates have been sounding the alarm about a looming deadline to extend telehealth prescribing flexibilities for controlled substances. 

The flexibilities, enacted during the COVID-19 pandemic to preserve access to care, paused enforcement of a law that required most practitioners to have at least one in-person evaluation before prescribing controlled substances like buprenorphine or stimulants for ADHD treatment. 

Those changes were originally set to expire with the rest of the public health emergency in May 2023, but they’ve since been extended twice. About a year ago, the DEA said it would work to write new regulations by the fall 2024.

Now, lawmakers are worried the DEA could propose prescribing rules that include “onerous” and “burdensome” in-person visit and special provider registration requirements, according to the letter sent to officials in the Biden administration Wednesday. 

The concerns come after an August report from Politico, warning the regulator planned to propose significant restrictions to telehealth prescribing.

The lawmakers argued buprenorphine merits a more permissive approach. The drug is a partial agonist medication, meaning it can’t maximally activate opioid receptors and is less likely to be misused, according to the letter.

Plus, the illicit opioid market poses a serious threat to people who struggle with opioid use disorder. More than 81,000 Americans died from an overdose involving opioids in 2023, according to provisional data from the Centers for Disease Control and Prevention.

“These facts should lead you to maximize access to buprenorphine as a tool to prevent overdoses and put people on the road to recovery, not limit access over a misplaced fear of diversion,” the legislators wrote.

Other research has found expanded telehealth services could reduce the likelihood of medically treated and fatal opioid overdoses and have helped Medicaid beneficiaries stay in treatment. 

The letter isn’t the first time lawmakers have raised concerns about telehealth prescribing for controlled substances. Late last month, several representatives, including Kuster, said the changes were critical during a bill markup session in the House Committee on Energy and Commerce.