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Proposed DEA Rule: Addressing the Opioid Crisis and Telehealth Prescriptions

Written and medically reviewed by Dorcas Morak, Pharm.D

Updated on June 28th, 2023

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Written and medically reviewed by Dorcas Morak, PharmD

The Biden administration has taken action by proposing a new policy through the Drug Enforcement Administration (DEA) to combat the growing opioid crisis. The policy mandates that patients have an in-person visit with a doctor before receiving prescriptions for drugs such as attention deficit disorder medication or addictive painkillers. This change in prescription protocol will have potential implications for the millions who relied on telehealth services during the pandemic.

In response to COVID-19, the DEA temporarily waived federal requirements, allowing doctors to prescribe potent drugs like Oxycontin, Adderall, and Ritalin without an in-person consultation. However, the DEA now plans to reinstate these regulations, stating that patients seeking initial prescriptions for highly-abusable drugs must have at least one in-person visit with a doctor. Subsequent refills may be obtained through telehealth appointments.

The agency also intends to impose stricter regulations on how doctors can prescribe less addictive drugs to patients without physical consultations. Medications like codeine, Xanax, Ambien, and buprenorphine (Buprenex) used for pain relief, anxiety treatment, sleep aid, and opioid addiction, respectively, can be initially prescribed over telehealth for a 30-day supply. However, patients would be required to have an in-person visit with a doctor for refill prescriptions. It's important to note that common prescriptions like antibiotics, skin creams, birth control, and insulin can still be obtained through telehealth visits.

Impact on Patients

The proposed regulation aims to balance expanded telehealth access with safety considerations, especially for rural patients. During the pandemic, increased accessibility to certain medications has facilitated necessary treatment for many individuals. However, concerns have arisen regarding the potential exploitation of lenient rules by profit-seeking entities, leading to overprescribing medications to individuals who may not genuinely need them. Thus, it is crucial to eliminate barriers to accessing necessary prescriptions while mitigating the risk of misuse.

In 2021, the United States experienced a record number of overdose deaths, with opioids accounting for approximately three-quarters of those deaths. This crisis was initially driven by pharmaceutical companies, pharmacies, and doctors who promoted these drugs to patients decades ago.

Impact on the Telehealth Industry

The relaxation of regulations significantly impacted the thriving telehealth industry, which witnessed the emergence of tech startups providing treatment and prescription medications for mental health or attention deficit disorders. This industry greatly benefited from the relaxed requirements for in-person visits during the pandemic. However, some national retailers have recently stopped fulfilling drug orders from certain telehealth apps.

Continuing Treatment with Distant Doctors

The DEA intended to implement the new rule before the expiration of the COVID-19 public health emergency on May 11, effectively ending the relaxed regulations. Individuals who receive treatment from doctors located far away will likely need to plan for in-person visits once the regulation takes effect. Patients will have six months to schedule an in-person visit with their doctors once the regulation is enacted.

The Biden administration's proposed DEA rule represents a significant change in the prescription process for specific medications to address the opioid crisis and prioritize patient safety. It underscores the importance of finding a balance between telehealth access and responsible prescribing practices.

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