After the Drug Enforcement Administration (DEA) announced Wednesday that it is temporarily extending Covid-19 flexibilities for the prescribing of controlled substances via telemedicine, several telehealth advocates came out in support of the decision.

These flexibilities allow physicians to virtually prescribe controlled substances — such as buprenorphine to treat opioid addiction or Adderall to treat ADHD — without an in-person examination. But in February, the DEA released a proposed rule that would roll back some of these flexibilities by requiring an in-person exam for drugs like narcotics and stimulants. For less addictive psychiatric medications and drugs that treat substance use disorder, patients would be able to receive an initial 30-day supply through telemedicine, but would require an in-person visit after.

While the DEA previously described the proposed rule as a way to ensure patient safety, many telehealth companies and advocates argued that it would greatly cut access for those who need the medications. The DEA said Wednesday that it received a record 38,000 comments on the proposal, leading the agency to submit an extension of the Covid-19 flexibilities to the Office of Management and Budget (though it didn’t say how long the extension would last).

“We take those comments seriously and are considering them carefully,” DEA Administrator Ann Milgram said in a statement. “We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities while we work to find a way forward to give Americans that access with appropriate safeguards.”

Ankit Gupta, CEO and founder of virtual substance use disorder provider Bicycle Health, applauded the DEA’s decision to extend the flexibilities. 

“The DEA is doing the right thing by delaying the implementation of this rule,” Gupta said in a statement. “Our hope is that they use the time to collaborate with experts in healthcare to create an effective special registration process for telehealth-based buprenorphine treatment programs, per their original mandate from Congress.” 

The special registration process Gupta is referring to would allow providers to register with the DEA to prescribe controlled substances through telemedicine. The DEA has said it would do this since 2009, but has not followed through. 

Gupta added that Covid-19 showed how telehealth can address the lack of access to buprenorphine. About 40% of counties in the U.S. are without a single provider who can prescribe the treatment.

“[Opioid use disorder] is one of those rare illnesses that has a well defined cure – which is medication for opioid use disorder (MOUD) with buprenorphine – that people simply could not access before telehealth,” he said. “For nearly two decades, the country was losing this battle against opioid use disorder because treatment wasn’t accessible. The problem was getting appreciably worse every year and there was no plan to address it. The pandemic created this opportunity to use telehealth, and it actually worked – far better than anyone expected. Now is not the time to reverse course.”

Michael Petegorsky, general counsel of Mindbloom, echoed Gupta’s comments. Mindbloom is a telemedicine provider of ketamine-assisted therapy, which is also affected by the proposed rule.

“As the mental health crisis in America continues to worsen – with nearly 1 in 4 adults suffering from mental illness in the past year and less than 50% receiving treatment – the federal government must expand access to clinically-appropriate treatments and commit to supporting telehealth so that individuals suffering from depression, anxiety, and other conditions can access evidence-based treatment options, like ketamine therapy, that work well for them,” Petegorsky said in a statement. “We are grateful that the DEA is taking the time to consider the comments from patients and providers across the healthcare spectrum.”

The DEA said additional information about the rule will come out once it is fully published in the Federal Register.

Photo: sorbetto, Getty Images