April 4, 2023 – During the COVID-19 pandemic, the DEA authorized physicians to prescribe controlled substances, including medications to treat opioid use disorder (OUD), based on telehealth patient visits. The AMA agrees with the DEA proposal to continue to allow these practices based on virtual patient visits after the end of the public health emergency as it has helped patients access care. The AMA is grateful the DEA recognizes that patients being treated with these medications often have challenges securing and traveling to in-person appointments.
The AMA has several suggestions to improve the DEA proposals:
- The proposal requires patients being treated for OUD to have an in-person visit within 30 days of their initial buprenorphine prescription to obtain refills. The AMA recommends that this timeframe be extended to at least six months. The 30-day requirement could cause many patients who were started on buprenorphine to have their prescriptions lapse, leading to more overdose deaths.
- New patients prescribed controlled substances in Schedules III-V should be able to fill and renew prescriptions for at least six months before an in-person visit is required. A 30-day rule would result in the lapse of their prescriptions, leading to complications from conditions, emergency department visits, and hospitalizations.
- The AMA recommends the DEA extend prescribing based on telemedicine to all Schedule III-V medications. It should also provide a special registration or exceptions process that would extend telemedicine to Schedule II medications.
- The AMA is concerned that the recordkeeping requirements of the proposed rules will diminish its effectiveness in increasing access to needed medications. The AMA encourages the DEA to adopt a more flexible approach.
- The DEA should target more rigorous enforcement to outlier practices that allow controlled substances to be prescribed based on a form with no meaningful patient-physician relationship.
Letters:
Expansion of Induction of Buprenorphine via Telemedicine Encounter
